Mumps - U.S. - Outbreak Tops 1,000 in Eight States

[DB]

http://www.medpagetoday.com/Infectio...Health/tb/3122

Mumps Outbreak Tops 1,000 in Eight States

ATLANTA, April 19 - The CDC said today that more than 1,000 cases of mumps have been reported in eight states, but Iowa continues to be the epicenter of the outbreak, with 815 confirmed, probable and suspect cases there.

CDC director Julie Gerberding, M.D., M.P.H., said at a press conference here that this year's mumps outbreak is the largest to hit the U.S. in more than 20 years.

Other states with confirmed cases are Kansas, Illinois, Minnesota, Missouri, Nebraska, Oklahoma, and Wisconsin, she said. Seven additional states, which Dr. Gerberding would not identify, are investigating possible mumps cases, she said.

Dr. Gerberding said the CDC has shipped 25,000 doses of mumps vaccine to the Iowa Department of Public Health, and vaccine maker Merck is donating an additional 25,000 doses to the CDC, a gesture that she characterized as both generous and necessary because the CDC is nearing the end of its fiscal year.

The Iowa agency is scheduled to update its mumps reporting tomorrow, but the 815 cases reported yesterday reflect a jump of 210 cases from the data reported April 13. That increase suggests that the outbreak has not yet peaked.

Dr. Gerberding confirmed this observation, noting that it is impossible to predict an end to the outbreak or if the outbreak will be limited to the states currently affected. She said the best defense against mumps is vaccination with two doses of the mumps-measles-rubella (MMR) vaccine. "And for people who have active infection, isolation is very important," she said.

Sixty-four percent of the Iowa mumps cases have occurred in people who received the recommended two doses of MMR vaccine. Meghan Harris, M.P.H., an epidemiologist at the Iowa Department of Public Health, said last week that about 10% of people who receive both doses of the vaccine fail to achieve complete immunization. Dr. Gerberding agreed that "no vaccine is completely foolproof."

Fortunately, mumps has a lower morbidity and mortality than other infectious diseases, and Dr. Gerberding said the current outbreak has resulted in only 20 hospitalizations and no deaths.
The Iowa data included confirmed, suspect and probable cases of mumps. Probable cases are those that meet the clinical case definition but have no confirmed serologic or virologic testing. Suspect cases are those with positive IgM serology and confirmed cases are cases that meet clinical definition that are also laboratory-confirmed or epidemiologically linked.

[KC]

Re: Mumps Outbreak Tops 1,000 in Eight States

Colorado says strict vaccination rules could protect against mumps

By CATHERINE TSAI | Associated Press
April 26, 2006

DENVER (AP) - One day after Colorado reported its first mumps case since an outbreak in the Midwest, health officials said Wednesday that strict vaccination requirements could help insulate the state from some of the problems elsewhere.

"This isn't West Nile virus, it's not pandemic flu, it's not even avian flu," Colorado chief medical officer Dr. Ned Calonge said. But "it underscores the importance of getting our children vaccinated. We're talking all the way up to college kids," he said.

Colorado's immunization rate for mumps is about 90 percent, Calonge said.

The case reported Tuesday in a 45-year-old Douglas County woman was the state's third this year but the first since monitoring was intensified because of the Midwestern outbreak.

Iowa has reported at least 1,120 cases, and Nebraska and Kansas have each reported at least 100. Calonge said Colorado is not part of that outbreak.

Colorado students must show documentation of two mumps shots before entering school and before entering college unless they claim personal, medical or religious exemptions.

Mumps is rarely fatal, but those who catch the virus can suffer fever, headache, muscle aches, tiredness, loss of appetite and swelling of salivary glands. Severe cases can cause deafness, meningitis, encephalitis or other ailments.

Because mumps can spread through the air, an outbreak can grab hold when people in close quarters who haven't been fully immunized are exposed to someone who is sick, Calonge said. That makes schools prime ground for disease to spread, although hand washing and basic hygiene can curb it.

The University of Colorado last week alerted students and faculty to the outbreak in Iowa. Records for the Boulder campus show 2,242 of the 28,000 students are not fully vaccinated against mumps.

Of the 26,100 students at Colorado State University, 432 claimed exemptions to getting both mumps shots, health service spokeswoman Jane Higgins said.

She advised students to get vaccinated, to seek medical attention for symptoms and to be careful about sharing food and drinks.

"Mostly, students are asking if a third (shot) would be useful, and the answer is, there's no evidence a third would be helpful," Higgins said.

Health departments, emergency-room workers and schools know to watch for clusters of mumps cases to detect possible outbreaks. So far three cases in Colorado have been confirmed this year, and 24 potential cases are being tested.

Colorado had six cases last year but typically gets about two or three.

Anyone born before 1957, when the vaccine became widely available, probably has been exposed to the disease and is likely immune, but if Colorado suffers an outbreak, immunization would be recommended to those who never had mumps, Calonge said.

[Roman]

Re: Mumps Outbreak Tops 1,000 in Eight States

Interesting, they forgot to mention most of the cases involved students that have had two shots. They should have been fully vaccinated. They still got the mumps. I guess this is not important. Perhaps we are seeing the 10% failure rate. Right. I can't wait until we hear about the mandatory vaccinations for BF or chik or .....fill in the blank.

"unless they claim personal, medical or religious exemptions." How long until this right is gone?

[KC]

Re: Mumps Outbreak Tops 1,000 in Eight States

Interesting, they forgot to mention most of the cases involved students that have had two shots. They should have been fully vaccinated.

I haven't seen where anyone has said "most of the cases involved students that have had two shots."

One part of the process that hasn't been discussed is a titre test. After a vaccination, it is the best way to see if someone has developed an adequate immune response.

CDC recognizes there is only a 90% effectiveness with the two shot regimen. That is why a titre followup by parents is important.

[Roman]

Re: Mumps Outbreak Tops 1,000 in Eight States

Lobo,
"Sixty-four percent of the Iowa mumps cases have occurred in people who received the recommended two doses of MMR vaccine."

This is located in DB's post, above yours. That is clearly the majority. I would guess the number is higher. Of course that's not the message they are trying to sell. I obviously take this personally because they ultimately want to vaccinate my child. Period. No matter what. Based on what? The success of the mumps vaccine? I don't find this amusing.
Lobo, nothing personal toward you. I enjoy most of your posts. Take Care.

[Roman]

Re: Mumps Outbreak Tops 1,000 in Eight States

"That is why a titre followup by parents is important."
Just saw this. Perhaps this will be in the next wave of excuses. I can see it now. It's the parents fault. Wow, this keeps getting better.

[KC]

Re: Mumps Outbreak Tops 1,000 in Eight States

Roman,

I take no offense to anyone's personal thoughts, experience, or observations.
Just as in preparedness, each family needs to do what it thinks is right.

Learning is half about getting accurate information and half about putting it to work.

Titre test results are how we found out that the first H5N1 vaccine was less than adequate. It provided an immune response in some people but not the expected 80-90 percent range. The vaccine worked, just not at the level people expected. Some would call it a failure, some would call it a stepping stone.

We can learn a lot about H5N1 by looking at the successes and failures of research on other viruses, especially emerging viruses that have the eyes of the public.

[Roman]

Re: Mumps Outbreak Tops 1,000 in Eight States

"Just as in preparedness, each family needs to do what it thinks is right."

Bingo, It seems this "right" is on it's way out the door. Did you read the part about them not letting students attend class if they didn't have the vaccine? I guess they have that "right". What's next to go? Our right to be in public places unvaccinated? This is a very slippery slope. IMHO vaccines do not have the credibility to threaten anyone's rights. They are simply a flawed tool that may or may not work and they can have disastrous side effects. As you know, I am not alone in my beliefs. There are experts and research backing both arguments. Of course one group has a lot more money then the other. Guess who. That will not justify anyone experimenting on my child and that is exactly what they are doing.