Mumps epidemic in Iowa
Mumps outbreak concerns U.S. health officials
Some 515 cases (of mumps) have been reported in Iowa, plus 43 in Nebraska, 33 in Kansas, and single digits in Illinois, Missouri, Wisconsin, and Minnesota.
"Why Iowa, and why now? We really don't know," said William Bellini of the federal Centers for Disease Control and Prevention in Atlanta. "There are a lot of unknowns." Officials speculate that the epidemic might have been set off by someone from Britain, which has been experiencing a large mumps outbreak for several years.
Experts hope the relatively high U.S. vaccination rates will contain the outbreak. The tens of thousands of cases in Britain have been blamed on problems with that country's vaccination program, and concerns among some parents that childhood vaccines may increase the risk of autism, which left a significant proportion of the population unvaccinated. (from San Francisco Chronicle)
Of the 245 patients this year, at least 66 percent had had the recommended two-shot vaccination, while 14 percent had received one dose, the Public Health Department said.
"The vaccine is working," Quinlisk said. "The vaccine certainly was made to cover this particular strain, because it's a fairly common strain of mumps." Quinlisk said the vaccine overall is considered about 95 percent effective. (from Yahoo News)
Information about mumps by Mayo Clinic Staff
The mumps virus spreads easily from person to person through infected saliva. A person is considered contagious from three days before symptoms appear to about four days after. In general, you're considered immune to mumps if you've previously had the infection or if you've been immunized against mumps.
To stop the spread of the disease, those with mumps should not return to child care, school or work until five days after symptoms began or until they are well, whichever is longer. Individuals with known exposure to someone with mumps should have their immunization status checked. Those who have not received two doses of the MMR vaccine should be vaccinated.
Complications of mumps are rare but include:
- Meningitis
- Encephalitis
- Hearing loss
- Inflammation of the testicles (orchitis)
- Inflammation of the ovaries
In addition, mumps infection in the first trimester of pregnancy may increase the risk of miscarriage.
If you have unexplained swelling in your jaw and neck, or you have these symptoms after a known exposure to someone who has the mumps, call your doctor promptly. by Mayo Clinic Staff
Want updates or have questions
Since the first report of mumps to IDPH, the state health department has monitored, communicated and educated health care providers and the public about the increase in numbers of cases. Mumps resources, including twice-weekly case updates, can be viewed on IDPH's Web site.
The Iowa Department of Public Health answers freqently asked questions about mumps here.
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The article mentions that in the UK the outbreak is partially blamed on the lack of childhood immunizations...Has that been found to be the case in Iowa as well?
The Iowa Department of Public Health is reporting that about 65% of the Iowa mumps cases have occurred in people who received the recommended two doses of the MMR vaccine. Another 15% or so received a single dose. The CDC estimates that 5 - 10% of people who get both doses of the vaccine fail to become completely immune, for one reason or another. But 10% can't account for the total number of cases. Still, scientists are hopeful that the relatively high rate of MMR vaccination in the US will provide "herd immunity" that will check the spread of the disease. Epidemiologists are also considering the possibility that MMR immunization may "wear off" in time, suggesting that perhaps adults should get booster shots.
Dr. Julie L. Gerberding, director of the Centers for Disease Control, quoted in a New York Times article, said:
Additionally, according to this Associated Press article, a few people who know they've had contact with someone with mumps, and experienced symptoms themselves, declined to seek medical treatment or to quarantine themselves. That's a recipe for the spread of disease!
Another attempt to answer why so many mumps cases are happening in vaccinated people. This is from the FAQ link at the bottom of the above article.
Why are so many cases occurring in vaccinated people?
There have been many questions about why people, who have been vaccinated, are getting mumps. As you read through the examples that follow, keep these key points in mind.
* The mumps vaccine (part of the MMR vaccine) is about 95% effective.
* This means out of every 100 people vaccinated, 95 will be protected. However, the vaccine will not "take" in 5 people, and these people will remain susceptible to the disease.
* By comparison, the measles vaccine (also part of the MMR vaccine) is about 98% effective and the annual influenza vaccine is about 70-85% effective.
Example 1:
In a community of 100 people, 100% have been vaccinated. Everyone is exposed to mumps. What happens?
* 95 people (95%) in the community are protected by the vaccine and do not get mumps.
* 5 people (5%) in the community become ill with mumps because the vaccine did not "take".
* Of the 5 people who get mumps, all (100%) have been vaccinated.
Example 2:
In a community of 100, 98% have been vaccinated (a similar rate to what is being seen today in Iowa's K-12 schools and some colleges.) Thus 98 people are vaccinated and 2 people are not. Everyone is exposed to mumps. What happens?
* 93 people (95% of the 98 who are vaccinated) in the community are protected by the vaccine and do not get mumps.
* 5 people (5% of the 98 who are vaccinated) become ill with mumps because the vaccine did not "take".
* 2 people who have never been vaccinated get ill because they have no immunity to the disease.
* Of the 7 (5 vaccinated +2 unvaccinated) people who get mumps, 71% (5/7) were vaccinated. (This is similar to what is happening now in Iowa.)
Thus a large percent of the people with mumps have been vaccinated. This is expected in a highly vaccinated population when dealing with a vaccine that is 95% effective and a contagious disease like mumps. This does not mean that the vaccine is not working; in fact the mumps vaccine is working as expected.
I think that Iowa's health is very imporant and the Iowan's should be more careful of it. So Isay stay away from people who have mumps.
Thank you for being responsible and for mentioning the fact that mumps can attack the testicles of males who are past puberty. I wish the major media were more responsible and less puritanical in reporting this. I had the disease when I was thirteen and had no idea what was happening to me when my testicles were attacked, or even that this symptom was related to mumps. (I ignorantly thought that this symptom was somehow related to masturbation, which to my uptight parents was a no-no.) As a consequence, I kept quiet until the pain was so unbearable, I could hardly walk. One of my testicles was half eaten away by this serious illness. Males who experience this symptom need to 1) notify their doctors immediately and 2) keep to their beds and try not to move. Trust me, this aspect of mumps needs to be widely, openly, and honestly circulated.
New mumps cases are being reported at a rate of 50 a day. And scattered cases are starting to appear in settings like daycare centers.
Here's today's update.
Why blame other countries to hide ours? So many cases of disease have been reported regularly. It indicates, our vaccination or preventive measures for that matter are inadequate. We should act swiftly and seriously to educate the public and contain the disease. Priorities the case and act immediately without wasting time on mud slinging on others. Thanks for the information.
I do agree with you that to stop the spread of the disease, those with mumps should not return to child care, school or work until five days after symptoms began or until they are well, whichever is longer. The public should be taught the sense of health and hygiene to maintain in such situation.
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