Monitoring mumps

State and local health officials are urging doctors to keep a watch for possible cases of mumps after three University of Texas at Austin students were diagnosed, and their classmates scattered far and wide as the semester ended this week.

Mumps, a viral infection spread by droplets from coughing and sneezing, was common before a vaccine was introduced in 1967. Symptoms can include fever, headache, muscle aches, fatigue and swelling of salivary glands that produce the trademark puffy cheeks, known as parotitis.

But small outbreaks still occur, particularly in large group settings and involving a strain of the virus that doesn’t respond as well to the vaccine, said Dr. Jason Bowling, staff epidemiologist at University Hospital and assistant professor of medicine at UT Health Science Center San Antonio.

“Overall, the mumps vaccine is thought to be pretty effective,” Dr. Bowling said. “However, it clearly does not confer complete immunity, and some of that might be due to the strain of the virus causing infections. There was a large U.S. outbreak that involved a college campus in 2006.  That outbreak was caused by a serogroup G wild-strain virus.  The mumps vaccine is derived from genotype A virus.  The vaccine may not be as effective in providing immunity against the serogroup G strain.”

Mumps vaccine is included in the measles, mumps, rubella combination.

Symptoms can take as long as 25 days to surface after infection, but typically appear within 14 to 18 days. Patients can infect others three to four days after parotitis occurs, but even those who carry the infection without displaying any symptoms can sometimes infect others.

Anyone diagnosed with mumps or suspected of having mumps should stay home for four days after the onset of parotitis. As for healthcare providers, state law says even suspected cases must be reported to local or state health departments.

“Mumps overall is generally well tolerated, but it can potentially cause severe consequences for a rare few, including encephalitis, orchitis/oophoritis (inflammation of the testicles or ovaries), sterility and deafness,” said Dr. Bowling, who added that Bexar County had a small outbreak in 2010,with a couple of patients treated at University Hospital.

Image from National Library of Medicine, Harper’s Weekly 1860