What You Need to Know:
A mumps outbreak involving five students has been confirmed at Moravian College in Bethlehem, Pennsylvania. Nearly 20 more students are undergoing testing for mumps because of exposure to those students with a confirmed diagnosis.
Mumps is caused by paramyxovirus and has an average incubation period between 16 and 18 days. Symptoms include parotid salivary gland pain, edema, and tenderness, low-grade fever, myalgias, anorexia, headache, and malaise. Inflammation of the parotid glands (parotitis) that causes edema is the hallmark feature of mumps, with peak swelling occurring between days one and three of the illness. Approximately 75% of patients will experience bilateral parotid swelling, although some patients demonstrate an atypical presentation with only respiratory symptoms, or no symptoms at all. Persons who have been vaccinated against mumps typically have a milder form of the illness with fewer complications.
The mumps virus is transmitted by droplet or direct person-to-person contact. Infection transmission begins two days before parotitis onset through five days after the parotitis resolves. However, some research has shown that the mumps virus may live up to 14 days in semen and urine.
Prior to the introduction of the mumps vaccine in 1967, approximately 186,000 cases were reported annually. Many persons diagnosed with mumps suffered severe complications, including permanent deafness, orchitis, mastitis, oophoritis, pancreatitis, and life-threatening encephalitis.
The measles-mumps-rubella (MMR) vaccine is the most effective prevention for mumps. It is typically given in two separate doses and is 88% effective in preventing mumps. Single dose administration is 78% effective. In 2017, new vaccine recommendations were issued for persons considered high-risk for acquiring mumps during an outbreak. These persons are now advised to receive three doses of the MMR vaccine.
Mumps diagnosis is confirmed via the RT-PCR test through buccal swab, urine, or cerebrospinal fluid, and viral culture. IgM serology may also be used to help with diagnosis. Every confirmed case of mumps must be reported to the health department in the United States for surveillance purposes.
Read more about mumps:
Harrison’s Principles of Internal Medicine, 20e: Chapter 202. Mumps
Current Medical Diagnosis and Treatment 2020: Chapter 32-02. Major Vaccine-Preventable Viral Infections
Current Diagnosis and Treatment Pediatrics, 24e: Chapter 40. Infections: Viral and Rickettsial
Centers for Disease Control and Prevention: Mumps