B.C.: Mumps outbreak in Fraser East region

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Source: http://www.canada.com/chilliwacktimes/news/story.html?id=1f36c010-2788-41b3-b96c-54a1ccb4e449
Mumps outbreak in Fraser East region
News
Aidan Chafe, The Times
Published: Friday, June 13, 2008

Fraser Health Authority (FHA) released a statement last week indicating there are sporadic cases of the mumps outside of Chilliwack in surrounding communities such as Abbotsford, Agassiz and Mission.

To help contain the spread of the virus the office of the Medical Health Officer has issued a request to physicians in the Fraser East area asking them to test patients for mumps who show signs of swollen salivary glands or inflammation of the testicles.

Helena Swinkels, medical health officer for the FHA, indicated that sporadic cases have been identified, but that doesn't mean the outbreak is spreading outside of the region.

"We've seen a few isolated incidences," Swinkels said. "And we have identified those cases and are working to contain them."

So far all of the cases the FHA has seen are in unvaccinated individuals who have no vaccination at all, which stresses the importance of having vaccine schedules.

Because the virus is prevalent in children aged 12 and under, the FHA conducted a vaccination campaign in Chilliwack elementary schools. However, many young adults have not been vaccinated, and in most instances they've only received one of the two shots required for immunization. Swinkels notes most individuals over 38 were exposed to mumps as children, and are therefore immune.

Most people who have the mumps virus do not exhibit the signs or symptoms initially because the infectious period ranges from seven days before symptoms start to nine days after swollen salivary glands occur, with maximal infectivity between two days before symptoms start to five days afterwards.

With usually fewer than five cases of mumps reported in B.C. each year, the recent outbreak in Chilliwack has raised those numbers substantially. As of publication there were 40 reported cases in the Fraser Valley. If you think you might have the mumps call the local health unit at 604-702-4900.


? Chilliwack Times 2008

 

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Re: B.C.: Mumps outbreak in Fraser East region

Source: http://www.bclocalnews.com/surrey_area/surreyleader/news/27231084.html
Surrey North Delta Leader
Mumps spreading through region

By Jeff Nagel - Surrey North Delta Leader

Published: August 21, 2008 11:00 AM
Updated: August 21, 2008 11:12 AM

A mumps outbreak that started in Chilliwack is now spreading across the Lower Mainland, prompting a health warning.

Fraser Health has so far recorded 113 confirmed cases, with at least 70 more suspected.

And that's likely only the tip of the iceberg, says medical health officer Dr. Gillian Arsenault, who likens the virus to a stealth bomber that flies under the radar.

?By the time people recognize the symptoms and we confirm a case, the virus has been in the community for anywhere from a few weeks to a couple of months and is moving on to infect others,? she said.

The virus came to Canada from the U.S. and has rolled west all the way from the Maritimes.

"It's coming soon to a community near you if it isn't there already," Arsenault said.

The virus attacks the glands but it can be considerably worse than the classic sore throat and swollen cheeks experienced by children.

Adults after puberty ? particularly university students ? can be hardest hit.

Men can suffer severely swollen testicles that may shrink permanently when the infection ends, causing fertility problems.

"Alberta has a poster of flaming basketballs and guys say that's exactly what it feels like," Arsenault said.

Salivary glands, ovaries, breasts and the pancreas can also be infected.

In rare cases, brain inflammation can kill.

Arsenault's advice: make sure your immunizations are up to date and don't share spit.

Sports team members should each have their own water bottle.

Items from lipstick to cigarettes shouldn't be shared either.

"If it's got fresh spit on it, don't share it," she said. "Kiss somebody only if it's somebody really close to you."

Cough or sneeze into your sleeve, she added.

A third of people infected with mumps have no symptoms, another third experience cold-like symptoms, while the remaining third get tell-tale glandular inflammations.

Those most at risk are people who have never been vaccinated or who were vaccinated long ago.

 

[Shiloh]

Re: B.C.: Mumps outbreak in Fraser East region

Source: http://www.canada.com/vancouversun/news/story.html?id=1a22fcf4-ef8c-4a93-a482-476869abfd04

Mumps outbreak nears 200 cases
Pamela Fayerman, Vancouver Sun
Published: Tuesday, August 26, 2008

With the number of confirmed and suspected mumps cases in the Fraser Health region closing in on 200, public health officials worry it will spread into the Vancouver Coastal region and are looking for ways to avoid such a daunting scenario.

Since the outbreak began in Chilliwack in February, cases have been spreading like wildfire through the Fraser Valley.

Medical officials say its spread has been aided by conservative Christian groups that are against vaccination of all kinds.

About half the 190 confirmed and suspected cases are individuals who have never been immunized, either on religious or philosophical grounds, said Dr. Elizabeth Brodkin.

She said another 25 per cent of cases involve people who are only partly immunized.

Public health officials have declined to disclose the church affiliations, saying that would violate confidentiality, but noted that some denominations' interpretation of the Bible dictates their aversion to vaccines.

"This outbreak is really taxing us, and we think a provincial consensus is needed to determine whether we should just resign ourselves to large numbers of cases, or [determine] what to do to mitigate the spread through some sort of immunization campaign," Brodkin said in an interview.

"After all, this is not a trivial disease. We've had many cases resulting in hospitalizations and complications like deafness, meningitis and testicular involvement, which can cause sterility," she added.

Because of the mobility of individuals, she said "there's no guarantee it won't spread to the Vancouver region."

"At the moment, there is some evidence that it is moving out of the faith-based communities and into the broader communities," she said, noting that there are now cases as far west as Burnaby.

The B.C. Centre for Disease Control has convened a working group to decide if it is time to roll out a broad prevention strategy that could involve vaccinating people in the 13-to-40 age range. Members of that group either have no natural immunity through exposure to the wild mumps virus, or have not had two doses of the measles/ mumps/rubella vaccine, which is about 95 per cent effective.

Even with the two-dose vaccine, immunity to mumps starts to wane after 15 to 20 years, cautioned provincial health officer Dr. Perry Kendall.

Brodkin said the mumps outbreak in the Fraser region involves intensive investigations because every case requires notifying dozens or even hundreds of contacts that they may contract mumps as a result of their contact with the infected individual.

Dr. John Carsley, a medical health officer in Vancouver, said it's difficult to predict if the outbreak will hit Vancouver in a big way. Since the beginning of the year, there have been only four cases, which is in the normal range.

"We're not planning any extraordinary vaccination efforts at this point, but we are keeping up with our surveillance efforts and when we have a meeting with other regions [in the next week or two] we will listen to the experience of other regions and go from there," Carsley said.

The mumps outbreak eclipses the previous one 12 years ago, when there were 83 confirmed cases.

The vaccine protects against measles, mumps and rubella and contains "tamed" or weakened strains of the three viruses. It has been used in B.C. since 1981.

Mumps is spread by saliva droplets. Kissing, coughing, sneezing, shouting, sharing drinks, toothbrushes and cigarettes and even singing are all activities that can transmit the virus.

pfayerman@vancouversun.com

 

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Re: B.C.: Mumps outbreak in Fraser East region

Source: http://www.canada.com/abbotsfordtim....html?id=eb8a75b0-01cd-4e27-85e2-be9c70877b19
Mumps still spreading
Virus still very active in the Fraser Valley
The Times
Published: Tuesday, August 26, 2008

Trying to stop the spread of mumps is like dealing with a stealth bomber - it flies "under the radar" and by the time you know it's there the damage has been done and it has moved on to other targets, warn Fraser Health officials.

"By the time people recognize the symptoms and we confirm a case, the virus has been in the community for anywhere from a few weeks to a couple of months, and is moving on to infect others," said Dr. Gillian Arsenault, a Fraser Health medical health officer.

The FHA wants all B.C. residents to know that mumps is still around and is active. Summer holiday travel and increased social gatherings present perfect opportunities for the stealth virus to continue to spread.

"Our current activity started in the Chilliwack area," said Arsenault. "It continues to spread throughout parts of the Fraser Valley, including Abbotsford, Hope, Langley and now Maple Ridge. We're concerned that summer holiday travel will help to spread the virus to other parts of the province."[/B]

Mumps is spread by contact with respiratory secretions like saliva. It can be spread through kissing, coughing, sneezing and yelling. Sharing water bottles, drinks, food or cigarettes - anything with saliva - can spread the disease as well. People who have had one dose of mumps vaccine are partially immune and may not experience recognizable symptoms, but if they get infected, they can still spread the disease.

The most recognizable symptoms are swelling of the salivary glands in the cheeks and under the jaw.

Other symptoms may include fever, aches and pains and headaches.

Why do you want to avoid getting the mumps?

- You will feel absolutely miserable

- Pain, pain, pain - it will hurt just thinking about food

- One in four men and boys past puberty will develop painful swelling of the testicles

- One in 20 people with mumps develop serious illness such as mumps meningitis - an infection of the lining of the brain

Fraser Health offers the following tips to help combat the spread of this stealth virus:

- Shots - make sure your immunizations are up to date

- Spit safe - don't share spit, direct or indirect salivary contact can spread the disease

- Sleeve - cough or sneeze into your sleeve and wash or sanitize your hands regularly

- Solo - if you have the mumps, avoid contact with others for at least nine days

Information on mumps is available in six languages on the BC Healthguide website at www.bchealthguide.org/healthfiles

 

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Re: B.C.: Mumps outbreak in Fraser East region

Source: http://www.theglobeandmail.com/serv...tional/?page=rss&id=RTGAM.20080829.wbcmumps29

Two-thirds of mumps cases likely going undetected
People who have mild or no symptoms are out spreading virus, health officer says, 'and there's ... nothing we can do about that'

ANNA MEHLER PAPERNY
From Friday's Globe and Mail
August 29, 2008 at 5:42 AM EDT

VANCOUVER ? The mumps outbreak spreading through parts of the Fraser Valley could be three times as large as the 191 cases health officials have identified so far.

"We know that two-thirds of the cases we're probably not even seeing. These are people who either have no symptoms or have mild symptoms and they're out there spreading the virus, and there's absolutely nothing we can do about that," Elizabeth Brodkin, medical health officer for the Fraser Health Authority, said yesterday.

Officials are therefore not quarantining the people they do know are infected, she said. "It probably doesn't make sense to employ legal measures against people who have mumps who are finding it difficult to stay home as we've asked."

Of the 191 cases reported so far since the outbreak began in Chilliwack in February, 10 to 20 are still active. Half of the people who have been infected have not been immunized, a quarter have had at least one shot and a quarter do not have vaccination records, Dr. Brodkin said. One person developed meningitis, nine suffered hearing loss and 26 had swollen testicles or ovaries. It is not clear how many of those cases will result in permanent deafness or sterility.

It is often hard to tell whether people have been immunized, because B.C.'s electronic database is less than 10 years old. Adults, who are at risk of more serious effects from mumps, are less likely to have their vaccination records available.

In 2007, almost 800 people in Nova Scotia were infected with mumps in an outbreak that saw the province's public-health body criticized in an Auditor-General's report this year.

The report said the province did not have adequate planning or immunization record-keeping.

B.C. Provincial Health Officer Perry Kendall said he is reviewing the report's recommendations. The province's last big mumps outbreak was in 1996, when there were 161 cases.

Dr. Kendall said he is considering sending nurses to schools in search of students who have not been immunized, or ordering unvaccinated students to stay home. That would likely happen only if the outbreak gets significantly worse, he said, either when three generations of the virus have been spread or when sporadic infections are taking place at a faster rate.

"You can exclude people from school. I would be prepared to consider that, for sure ...[in] an outbreak situation in which large numbers of people weren't being immunized. [But] if they all hang out in a mall, it's not much help."

Dr. Kendall said there are no plans to test people who do not show symptoms.

A U.S. Centers for Disease Control study of a 2006 mumps outbreak found more than half of those infected had been given both recommended doses of the vaccine. Dr. Brodkin said the Fraser health agency is aware of the study and may re-examine B.C.'s immunization schedule.

Officials are asking that people born after 1970 be immunized if they have not been. Dr. Kendall said health officials are talking with Health Canada about getting extra vaccine.

"We're not running low for normal supplies; what we're trying to figure out is, if we need 200,000 extra doses, could we get them and how long would it take?"

For now, officials are waiting to see what happens next, he said. "You monitor the incidence of the disease, you look at populations that appear to be at risk and you look at how best to reduce that risk."

 

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Re: B.C.: Mumps outbreak in Fraser East region

Source: http://www.canada.com/vancouversun/....html?id=82d3af31-73ac-4df0-92cf-901bfa2a1d5d

Schools to be closely monitored for mumps
But 'we have not had a concerning increase' in cases of disease, Vancouver health officer says
Nicole Tomlinson, Vancouver Sun
Published: Friday, August 29, 2008

Students heading to high school and university next week will have a "slightly increased risk" of contracting the mumps virus compared to the rest of the population because of vaccination trends and "spit-sharing activities," a medical health officer said Thursday.

The now-standard two-dose mumps vaccine was administered to B.C. infants starting in 1996, one dose at a year old and one at 18 months.

Anyone born in B.C. before 1995 likely got only one dose, which offers less protection, said Dr. Elizabeth Brodkin of the Fraser Health Authority.

[/B]These people are now in around Grade 8 plus," Brodkin said, adding that one dose still offers "good protection" from the disease, which can cause fever, headache and swelling of the salivary glands.

"One dose is about 70- to 80-per-cent effective; two doses is about 80- to 90-per-cent effective," Brodkin said.[/B]

Students are at slightly higher risk because "they're in tight spaces in buildings, especially if they live on campus, and they tend to engage in spit-sharing activities," she said.

The Fraser Health authority, which covers about 1.5 million people in communities stretching from Burnaby to Hope, will be monitoring schools "very closely" over the next while and will decide on a "case-by-case basis" if it's worth setting up immunization clinics in more schools, she said.

Doses of the vaccine were brought into middle schools and high schools in Chilliwack in the spring, she said.

That was in response to an outbreak in the area that involved individuals who weren't immunized for religious or philosophical reasons.

Although students in high school and university are at a "slightly increased risk" for contracting mumps, people who were born in 1970 or later and who have never been immunized are the health authority's "highest priorities," Brodkin said.

Of just under 200 confirmed or suspected cases of mumps in the Fraser Health region since the outbreak in Chilliwack in February, about half were seen in individuals who had never been immunized.

Twenty-five involved people who were only partially immunized, Brodkin said earlier.

Further west, the Vancouver Coastal Health Authority has still recorded only four cases since January, said medical health officer Dr. Reka Gustafson.

"We have not had a concerning increase in mumps at all," Gustafson said, adding that the last big outbreak in the Vancouver Coastal region happened more than 10 years ago and involved about 50 cases associated with rave parties.

But the authority, which serves Vancouver, North Vancouver, West Vancouver and Richmond, is monitoring the region and is "prepared to respond" if an outbreak does occur, Gustafson said.

The B.C. Centre for Disease Control is also getting ready for an increased demand for immunization; the organization has "an extra cushion" of vaccine doses -- which guard against mumps, measles and rubella -- in transit that should arrive in a day or two, said David Patrick, director of the centre's epidemiology program.

"There's lots available, thousands of doses; we want to make sure people are up to date with their immunization," Patrick said, adding that outbreaks are often driven by people who haven't been vaccinated.

Details about how to get immunized can be obtained from the BC NurseLine, a 24-hour, confidential health information and advice line, at 1-866-215-4700.

ntomlinson@vancouversun.com

 

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Re: B.C.: Mumps outbreak in Fraser East region

Source: http://www.canada.com/victoriatimescolonist/news/story.html?id=bef252c4-d026-44af-9cce-251031e167a9

Mumps outbreak may be near end
Canwest News Service
Published: Friday, October 03, 2008

VANCOUVER -- Doctors are hopeful the mumps outbreak in the Fraser Valley is coming to an end.

Fraser Health medical health officer Dr. Elizabeth Brodkin said yesterday that while two full incubation periods -- about 50 days -- must pass before an outbreak can be declared over, "we are certainly moving in the right direction."

Since the outbreak began in February in a small Chilliwack religious community, more than 120 mumps cases have been lab-test confirmed across the Fraser Health region, with the virus spreading as far as the Coquitlam/Burnaby border.

There have been about 207 reported cases including suspect and clinical cases, which cannot be confirmed by lab testing.

The last lab-confirmed case was recorded Aug. 30.