Mumps Outbreak United States, 2006

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• Mumps Outbreak United States, 2006

Epidemiology and Prevention of Vaccine-Preventable
Diseases National Immunization Program Centers
for Disease Control and Prevention
Revised January 2007
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Mumps Outbreak, 2006

• Source of the initial cases unknown
• Outbreak peaked in mid-April
• Median age of persons reported with mumps was 22
  years
• Highest incidence was among young adults 18-24
  years of age, many of whom were college students
• Transmission of mumps virus occurred in many
  settings, including college dormitories and
  healthcare facilities

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Factors Contributing To Mumps Outbreak, 2006

• College campus environment
• Lack of a 2-dose MMR college entry requirement or
  lack of enforcement of a requirement
• Delayed recognition and diagnosis of mumps
• Mumps vaccine failure
• Vaccine might be less effective in preventing
  asymptomatic infection or atypical mumps than in
  preventing parotitis
• Waning immunity

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Mumps Diagnostic Testing

• Serum to test for mumps IgM antibody within 5
  days of illness onset
• A swab from the parotid duct or other affected
  salivary gland duct
• Parotid duct swab is the preferred viral sample

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Mumps Diagnostic Testing

• If the IgM antibody titer is negative, a second
  (convalescent) serum specimen for IgM antibodies
  should be obtained 2 to 3 weeks after onset of
  the illness
• Paired serum specimens also can be used to detect
  a significant rise in the level of mumps IgG

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Mumps Diagnostic Testing

• Negative laboratory tests, especially in
  vaccinated persons, should not be used to rule
  out a mumps diagnosis
• In the absence of another diagnosis, persons
  meeting the clinical case definition should be
  reported as a probable mumps case

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Presumptive Evidence of Mumps Immunity

• Documentation of adequate vaccination
• Laboratory evidence of immunity
• Birth before 1957
• Documentation of physician-diagnosed mumps

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Presumptive Evidence of Mumps Immunity

• Adequate vaccination
• 1 dose for preschool-aged children and adults not
  at high risk of exposure to mumps
• 2 doses school-aged children grades (K-12th
  grade) and for adults at high risk of exposure to
  mumps

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Mumps Vaccination ofHealthcare Personnel

• Born in 1957 or later
• documentation of 2 doses of live mumps virus
  vaccine (minimum interval between doses is 28
  days)
• Born before 1957 (without a history of
  physician-diagnosed mumps or laboratory evidence
  of mumps immunity)
• consider recommending 1 dose of a live mumps
  virus vaccine

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Mumps Vaccination ofHealthcare Personnel

• During a mumps outbreak healthcare facilities
  should strongly consider recommending 2 doses of
  mumps vaccine to unvaccinated personnel born
  before 1957 who do not have evidence of mumps
  immunity

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National Immunization ProgramContact Information

• Telephone 800.CDC.INFO
• Email nipinfo_at_cdc.gov
• Website www.cdc.gov/nip