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mumps

Etiology: - mumps virus Epidemiology: - transmitted by respiratory droplets or direct contact with an infected person [10] - disease is specific to humans [10] - prevalence of detectable antibody 90% [3] - 92% immunity needed for herd immunity [3] - Mumps outbreak among vaccinated children in Washington state in 2016-2017 [6] - 221 cases reported in Texas Jan-April 2017 [8] - mumps outbreaks have occurred among young adults despite prior full mumps vaccination [9] - during a mumps outbreak on a college campus, asymptomatic vaccinated students did not appear to shed virus [9] - possible exposure at National Cheerleading competition in Dallas, Texas, 2018 - no known cases reported other than index case [12] Clinical manifestations: - prodome of low-grade fever, myalgia & headache - sialadenitis - parotitis (83%) - bilateral facial swelling, may be asymmetric - submaxillary gland, sublingual gland swelling (40%) - edema & erythema of parotid duct opening with no purulent drainage [14] - orchitis (30% of postpubertal men) - bilateral testicular pain & swelling - fever (36%) - sore throat (32%) Laboratory: - mumps virus antigen - mumps virus serology - generally returned in 10-14 days - mumps virus RNA - mumps virus culture - see ARUP consult [4] Complications: - orchitis (5%), oophoritis - encephalitis - hearing loss [14] Management: 1) vaccines (prophylaxis) a) measles-mumps-rubella vaccine (MMR) - 2 doses, a 3rd dose may help prevent mumps outbreak [8,11] b) mumps & rubella vaccine c) vaccinate empirically, do not wait for serology if at risk d) vaccines are live virus, avoid in pregnant women & immunocompromised 2) non-vaccine strategies to control mumps: a) dentify & isolate suspect cases b) communicate with & report to local & state public health, as appropriate c) make local decisions about removing susceptible healthcare providers from areas of potential transmission d) practice handwashing and respiratory hygiene.

Related

measles, mumps & rubella combined vaccine (MMR) mumps antigen skin testing mumps virus rubella & mumps combined vaccine (Biavax II)

General

viral infection

References

  1. Prescriber's Letter 13(5): 2006 Recent Mumps Outbrake Highlights the Importance of Vaccines Detail-Document#: 220604 (subscription needed) http://www.prescribersletter.com
  2. Centers for Disease Control and Prevention (CDC). Mumps epidemic--Iowa, 2006. MMWR Morb Mortal Wkly Rep. 2006 Apr 7;55(13):366-8. PMID: 16601665 - Exposure to mumps during air travel--United States, April 2006. MMWR Morb Mortal Wkly Rep. 2006 Apr 14;55(14):401-2. PMID: 16617290 - Update: Multistate Outbreak of Mumps --- United States, January 1--May 2, 2006 MMWR May 18, 2006 / 55(Dispatch);1-5 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm55d518a1.htm - Notice to Readers: Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP) for the Control and Elimination of Mumps MMWR, June 1, 2006 / 55(Early Release);1-2 Corresponding NGC guideline withdrawn Dec 2011 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm55e601a1.htm
  3. Kutty PK et al. Seroprevalence of antibody to mumps virus in the US population, 1999-2004. J Infect Dis 2010 Sep 1; 202:667 PMID: 20662720 - Quinlisk MP. Mumps control today. J Infect Dis 2010 Sep 1; 202:655. PMID: 20662719
  4. ARUP Consult: Mumps Virus The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/mumps-virus
  5. Young K, Sadoughi S, Sofair A U.S. Seeing More Mumps Physician's First Watch, Nov 21, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
  6. Orciari Herman A, Sadoughi S, Saitz R Washington State Mumps Outbreak Affecting Vaccinated Kids Physician's First Watch, Feb 9, 2017 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
  7. Orciari Herman A, Sofair A, Chavey WE Texas Reports Most Mumps Cases in Over 20 Years. Physician's First Watch, April 14, 2017 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org - Texas Alerts Providers, Public about Mumps as Cases Reach 20-year High. Texas Health & Human Services. News Release. April 12, 2017 http://www.dshs.texas.gov/news/releases/2017/20170412.aspx
  8. Ogbuanu IU et al Impact of a Third Dose of Measles-Mumps-Rubella Vaccine on a Mumps Outbreak Pediatrics. Nov 5, 2012 PMID: 23129075 http://pediatrics.aappublications.org/content/early/2012/10/30/peds.2012-0177.abstract - Cardemil CV, Dahl RM, James L et al Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control. N Engl J Med 2017; 377:947-956. September 7, 2017. PMID: 28877026 http://www.nejm.org/doi/full/10.1056/NEJMoa1703309
  9. Bonwitt J et al. Absence of asymptomatic mumps virus shedding among vaccinated college students during a mumps outbreak - Washington, February - June 2017. MMWR Morb Mortal Wkly Rep 2017 Dec 1; 66:1307 https://www.cdc.gov/mmwr/volumes/66/wr/mm6647a5.htm
  10. Wikipedia: Mumps https://en.wikipedia.org/wiki/Mumps
  11. Marin M, Marlow M, Moore KL, Patel M. Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus-Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak. MMWR Morb Mortal Wkly Rep 2018;67:33 PMID: 29324728 Free PMC Article https://www.cdc.gov/mmwr/volumes/67/wr/mm6701a7.htm
  12. Bever L Thousands of cheerleaders may have been exposed to mumps at a national competition. Washington Post. March 8, 2018 https://www.washingtonpost.com/news/early-lead/wp/2018/03/07/thousands-of-cheerleaders-may-have-been-exposed-to-mumps-at-national-competition/
  13. Bockelman C, Frawley TC, Long B, Koyfman A. Mumps: An Emergency Medicine-Focused Update. J Emerg Med. 2018 Feb;54(2):207-214 PMID: 29110978 Review.
  14. NEJM Knowledge+ Otolaryngology
  15. CDC MUMPS wesite http://www.cdc.gov/nip/diseases/mumps/default.htm - University of Missouri Mumps Website http://studenthealth.missouri.edu/needtoknow/mumps.html - Washington state Mumps Outbreak Page http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Mumps/MumpsOutbreak