Those of us in the Baby Boom generation know mumps as one of several childhood illnesses that we all got. Mumps, German measles, measles and chicken pox were illnesses that nearly all of us had contracted by the time we were ten or eleven. All of these diseases now have vaccines, and in New York State, you must have been vaccinated for them before being allowed into school.
Vaccines are funny things. They are intended to provoke an immune response so that when the real germ arrives, your body responds and prevents the illness. Maybe it’s people who are funny, because every vaccine does not work in all of the people. The mumps vaccine seems to be effective in only 79% to 95% of patients.
Segue to late June 2009, at a summer camp for Orthodox Jewish boys in Sullivan County N.Y. An eleven year old boy, just back from a visit to Great Britain, develops mumps. Before the camp closes for the year, other campers and counselors become ill with the viral disease.
But, wait… public health authorities begin to be notified of cases of mumps in Brooklyn and in Orange and Rockland counties in New York, and in counties in New Jersey. By the end of January, 2010, about 2,000 cases of mumps have been confirmed in this disease outbreak.
It is a unique outbreak. Orthodox boys spend very little time around girls. They sit apart in religious services and attend separate schools or single sex classes. In this outbreak, 76% of those who have caught the mumps are male, and 97% practice the Orthodox or Hasidic forms of Judaism.
75% of the patients where their vaccination status is known had received the recommended doses of mumps vaccine. Currently, one dose is given about age 12 months and another about age five, before the child enters school.
Baby Boomers remember the symptoms of the mumps,
fever, headache, fatigue and loss of appetite. Its defining symptom is the swelling of the cheeks and jaw that appears. The salivary glands on one or both sides of the face near the ears become very tender and swollen. Symptoms appear between 12 and 25 days after infection.
It’s the “chipmunk cheeks” that most remember. The swollen glands do not appear every time, and they can appear only on one side of the face.
Mumps is not a benign illness. It has several potential aftereffects, and can be fatal in rare cases.
The most common complication is inflammation of the testicles (orchitis) in males who have reached puberty; rarely does this lead to fertility problems.
Other rare complications from the mumps include:
- Inflammation of the brain and/or tissue covering the brain and spinal cord (encephalitis/meningitis)
- Inflammation of the ovaries (oophoritis) and/or breasts (mastitis) in females who have reached puberty
- Deafness
The Patient Zero of this mumps outbreak is assumed to have caught the infection in England. The British Isles have had an on-going mumps outbreak for several years. It is a much larger outbreak, with England and Wales have recorded 7,410 cases of the mumps in the period January to November 2009.
It was a British medical magazine, the Lancet, that originally published a study by Wakefield, et al, that linked the MMR vaccine to autism. Just a few weeks ago, after much criticism and many studies refuting the original premise, the Lancet retracted the Wakefield study.
The damage was done, however, as tens of thousands of parents refused to vaccinate their children for fear of autism. The mumps outbreak in Great Britain is one result of this flight from vaccination. There is no current scientific evidence of a link between vaccination and autism.
Mumps is spread
by mucus or droplets from the nose or throat of an infected person, usually when a person coughs or sneezes. Surfaces of items (such as toys) can also spread the virus if someone who is sick touches them without washing their hands, and someone else then touches the same surface and then rubs their eyes, mouth, nose etc.
The period of time that an infected person can most easily transmit mumps to a non-infected person ranges from 1-2 days before symptoms appear to about 5 days after the symptoms appear. The incubation time, which how long it takes for symptoms to appear after a person is exposed to the virus, can range from 12-25 days.
Most mumps transmission likely occurs before the salivary glands begin to swell and within the 5 days after the swelling begins. Therefore, CDC recommends isolation of mumps patients for 5 days after their glands begin to swell.
Mumps is a viral illness. There is no cure for any viral illness including mumps. Treatment consists of pain relief and fever reduction, and observation for complications. Children under age 18 should not be given aspirin for a fever.
Ask a doctor before you give aspirin to your child or teenager. Aspirin may cause Reye’s syndrome (a serious condition in which fat builds up on the brain, liver, and other body organs) in children and teenagers, especially if they have a virus such as chicken pox or the flu.
