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Mumps in Lake County - Plotkin
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The Lake County Health Department/Community Health Center (LCHD/CHC) is continuing to investigate a mumps outbreak at Barrington High School. As of March 24, six confirmed cases and 16 probable cases have been reported at Barrington High School. Normally, only 2 to 3 reports of mumps on average have been received in Lake County annually. Cases are now reported primarily among Lake County high school students and Cook County middle school students with many of those people having one or more MMR vaccinations. Some cases also reside in DuPage, Kane and McHenry counties.
In the United States and in Illinois, the number of mumps cases can vary each year. The disease typically peaks in late winter or spring, frequently coinciding with peak influenza season. Because of this mumps increase, and the fact that schools will be dismissing for spring break, we would like to remind health care providers to be vigilant in looking for signs and symptoms of mumps, especially in those attending schools. Please consult with your local health department regarding testing of persons with parotitis for mumps and influenza.
Mumps is an acute vaccine-preventable viral illness transmitted by respiratory droplets and saliva with an incubation period of 12-25 days. Up to half of people who get mumps have very mild or no symptoms, and therefore do not know they were infected with mumps. The most common symptoms include: low grade fever, headache, muscle aches, tiredness, loss of appetite, swollen and tender salivary glands under the ears on one or both sides. Orchitis, oophoritis, meningitis, encephalitis, hearing loss, mastitis, and pancreatitis can also occur but are rare.
Parotitis can also be caused by other pathogens such as influenza, parainfluenza, and Epstein Barr virus among a few others, therefore, testing for other pathogens can help differentiate between mumps and another viral illness. CDC recommends that, during the 2016-2017 influenza season, clinicians evaluating patients with acute parotitis not associated with laboratory-confirmed mumps outbreaks should include influenza in the differential diagnoses and consider testing patients for influenza viruses even in the absence of respiratory symptoms. If testing for mumps is requested at the Illinois Department of Public Health (IDPH) laboratory, IDPH recommends influenza testing also be conducted. If mumps or influenza testing is needed at IDPH, providers should contact their local health department for authorization and instructions.
Laboratory confirmation of suspect or probable cases is important. Buccal swabs should be collected from symptomatic cases and sent to a commercial laboratory that conducts Mumps PCR testing. The optimal time for buccal swab specimen collection is preferably within three days of onset (parotitis) in those previously vaccinated or within eight days after symptom onset in unvaccinated individuals. Mumps serology testing (IgM, IgG) should be paired with the Mumps PCR buccal swab.
Prevention is the key to mumps control and vaccine is an essential tool. Children should receive the first dose of mumps-containing vaccine, MMR, at 12-15 months and the second dose at 4-6 years. All adults born during or after 1957 should have documentation of one dose of MMR. Adults at higher risk, students, health care personnel, international travelers, and persons with potential mumps exposure should have documentation of two doses of mumps vaccine or other proof of immunity to mumps. Mumps vaccine coupled with proper handwashing and disposal of facial tissues, covering coughs, not sharing items that would go in the mouth and staying home while ill are effective actions in controlling and preventing further disease spread.
Under the Illinois Administrative Code, IDPH Code 690.550(a)(2) and (b) all cases of mumps shall be excluded for 5 days after the onset of symptoms (parotitis). In addition, all susceptible close contacts shall be excluded from school, child care facilities or the workplace from days 12 through 25 after exposure. When multiple cases occur, susceptible contacts to cases need to be excluded through the 25th day after the onset of parotitis in the last case at the school or workplace. Mumps is a reportable disease and must be reported to the public health authority within 24 hours.
If you have questions or concerns, please contact the LCHD/CHC Communicable Disease program at 847-377-8130.
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