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Thousands may have been exposed to mumps at cheerleading event in Texas
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The Texas Department of State Health Services has contacted parents and participants of a national cheerleading event that included thousands of athletes to report they may have been exposed to a person with mumps.
“Mumps is a highly contagious infection. Prior to the mumps vaccine in 1967, there were about 200,000 cases of mumps occurring every year in the United States, and mumps was the most common cause of deafness and sterility,” Paul Offit, MD, director of the Vaccine Education Center at The Children’s Hospital of Philadelphia, told Infectious Diseases in Children. “Since the vaccine has been developed, there have been as few as 200 cases per year, but the mumps virus has never been eliminated from the United States.”
There were 23,655 athletes and 2,600 coaches from 39 states and nine countries participating in the National Cheerleaders Association All-Star National Championship Feb. 23 to Feb. 25 in Dallas, according to information posted on the National Cheerleaders Association’s website.
The letter from the Texas Department of State Health Services, dated March 2, informed parents that the time between being infected and developing symptoms typically lasts 14 to 18 days. People who have mumps are infectious from 3 days before to 5 days after swollen glands appear; however infected people without symptoms may still be able to transmit mumps, according to the letter.
The Texas Department of State Health Services advised parents that vaccinated individuals could still become infected and that anyone diagnosed or suspected of having mumps should stay home for 5 days after the appearance of swollen glands.
There were 23,655 athletes and 2,600 coaches from 39 states and nine countries participating in the National Cheerleaders Association All-Star National Championship Feb. 23 to Feb. 25 in Dallas, according to information posted on the National Cheerleaders Association’s website.
“Those who have received one or two doses of mumps vaccine are typically protected for up to 10 years after the last dose,” Offit, a member of the Infectious Diseases in Children Editorial Board, said. “But outbreaks on college campuses, which have occurred recently, most frequently affect those who were vaccinated more than 10 years previously. Regarding the Dallas outbreak, it would be reasonable for anyone who received the vaccine more than 10 years to receive a mumps-containing vaccine.”
The CDC reports that in recent years, there has been an increase in reported cases of mumps, from 229 in 2012 to 6,366 cases in 2016. The increases have been mainly due to outbreaks in settings where people are in close contact, including college campuses, the agency reported. – by Bruce Thiel
References:
https://nca.varsity.com/Competitions/All-Star-Nationals
www.cdc.gov/mumps/outbreaks.html
Perspective
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C. Buddy Creech, MD, MPH
From Hippocrates’ description of the disease in the 5th century BC, to the discovery of the virus by Johnson and Goodpasture in 1934, to a number of recent outbreaks and exposures across the U.S., mumps remains a formidable pathogen. Since 1971, the use of measles-mumps-rubella vaccine has led to a 99% reduction in reported cases; however, as the current exposure in Texas reminds us, the potential transmissibility of mumps is quite high, particularly in populations with waning immunity.
For infectious disease exposures and outbreaks such as this, recognizing the clinical features of disease is the first step. Fortunately, mumps is often not a vague illness; many patients will experience the characteristic swelling of the parotid glands, fever and myalgia. The second step is to confirm the clinical diagnosis through buccal/oral and serum specimens. Since many other respiratory viruses and oral bacteria may lead to inflammation of the parotid gland, confirmation of mumps virus in the saliva by RT-PCR and evaluation of the serologic response to mumps virus are needed. Third, we must be diligent to counsel patients on the occasional complications of mumps, which include meningoencephalitis, orchitis, and deafness. Finally, we must work with state and local health departments to determine whether enough cases have occurred to warrant additional doses (i.e., 3rd dose) of MMR to those at highest risk for mumps, a strategy recently approved by the CDC Advisory Committee on Immunization Practices.
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