The Arkansas department of health is currently investigating more than 2,500 cases of mumps. This outbreak is still active and affecting several counties in central and northeast Arkansas.
The majority of cases are among school aged children. The health department posted a list online of all schools with confirmed cases here.
In light of the news, we turned to Dr. Sandra Arnold, Le Bonheur’s division chief of pediatric infectious diseases. Here’s what she had to say.
Q: Can you talk about the MMR vaccine and the relationship between the vaccine and known cases in this outbreak?
A: This outbreak is actually occurring in a highly immunized population (90-95 percent of pediatric cases have been fully immunized). Health experts believe they would be seeing even more cases if the population immunization rates were not so high.
As with many vaccines, even in cases of breakthrough disease, signs and symptoms of the disease are usually milder. This is the case in this outbreak as the Arkansas department of health is reporting that they are seeing very few cases with the important complications you can see with mumps such as orchitis (inflammation of the testicles – which can, rarely, lead to sterility in males if bilateral) and encephalitis (brain inflammation – the most feared complication of mumps).
Other uncommon, but serious, complications of mumps include: inflammation in other organs leading to organs dysfunction such as the kidneys, heart, pancreas, ovaries, the ear (leading to hearing loss) and other central nervous system inflammatory problems such as meningitis, cerebellar ataxia and transverse myelitis) During an outbreak such as this, it is important to limit exposure to people with the infection. For this reason, children with vaccine exemptions (who have not received the MMR vaccine) in the same school as a case of mumps are being excluded from school for 26 days after the exposure unless they immediately receive the vaccine.
Q: How contagious is mumps?
A: Mumps is very contagious. It spreads through respiratory droplets like influenza (the flu). These large droplets can travel up to three feet from coughing and sneezing. Mumps is not airborne so it is not spread simply by being in the same room as someone with mumps. However, being near (within 3 feet) of someone exposes you while they are shedding the mumps virus in their saliva and other respiratory secretions. This means that healthcare workers will wear masks when seeing a patient with suspected mumps.
Q: What major signs and symptoms should parents look for if they suspect their child has mumps?
A: Approximately one-third of mumps cases are asymptomatic or present with a non-specific upper respiratory tract infections. Classically, symptomatic mumps causes fever and painful swelling of one or more of the salivary glands. These glands are located in the cheek, below the ear, near the angle of the jaw and underneath the jaw. Other symptoms depend on the organ involved.
Mumps was once among the most common causes of viral meningitis. Encephalitis leading to changes in mental status is rarer but can be severe. Orchitis (or testicular inflammation and swelling) is more common after puberty and can, rarely, cause sterility. Inflammation in other organs such as the thyroid, kidney, pancreas and ovaries can occur.
Q: What should parents do if they think their child has mumps?
A: Mumps is not as contagious as measles, which spreads through air over longer distances, so there is less concern about widespread exposures when someone with mumps goes to the doctor or emergency room. It is important to tell the clinic or the ER that your child has fever and swelling under the ear or jaw and that you are concerned about mumps so that the child can be placed in a room and healthcare workers can use masks.