Multiple mumps outbreaks are occurring in universities in Pennsylvania and nationwide. Many students will be leaving their campuses for the holidays and returning to their home counties. Health care providers should consider mumps for patients presenting with parotitis particularly in college students.
Recognition, Testing, and Management:
Mumps is a viral illness spread by respiratory secretions. Symptoms develop 12 to 25 days after exposure and the clinical presentation is characterized by acute onset of unilateral or bilateral tender, swelling of the parotid or other salivary glands lasting two or more days without other apparent cause. Other less common, but more serious manifestations of mumps include viral meningitis, orchitis, oophoritis, pancreatitis, and sensorineural hearing loss.
Providers who are evaluating suspected mumps cases should:
- Place patients with suspected mumps on droplet precautions, which includes the use of surgical masks for healthcare workers with close patient contact.
- Collect specimens from the patient (see the below “Job Aid” for guidance on appropriate specimen collection):
- Specimens for mumps polymerase chain reaction (PCR) testing. Please contact DOH at 1-877-PA-HEALTH (877-724- 3258) to arrange for testing coordination with the state public health laboratory.
- Serum for mumps IgM and IgG testing. Mumps serological tests are widely available at commercial laboratories.
- Nasopharyngeal swab for influenza or respiratory PCR panel testing to evaluate for other potential causes of parotitis. Influenza and other respiratory virus activity is high at this time of year and these viruses can also cause parotitis.
- Advise patients who have suspected or confirmed mumps infections to self-isolate, avoid travel, and limit close contact with others for 5 days following onset of parotitis.
- Please report possible cases by calling DOH by calling 1-877-PA-HEALTH (877-724- 3258) or your local health department.
Vaccination:
Measles, Mumps and Rubella (MMR) vaccine is the best way to prevent mumps infection. A routine 2-dose MMR series is a part of the childhood immunization schedule (Dose 1: 12 months, Dose 2: 4–6 years). During outbreaks, all persons who are unvaccinated or only have received one dose should receive MMR vaccine. A third MMR dose should be given to persons at risk of exposure who have previously received the 2-dose series.
Resources:
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- CDC Mumps Information for Healthcare Providers: https://www.cdc.gov/mumps/hcp.html
- CDC Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus–Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak: https://www.cdc.gov/mmwr/volumes/67/wr/mm6701a7.htm
- DOH Mumps Fact Sheet: https://www.health.pa.gov/topics/Documents/Diseases%20and%20Conditions/Mumps.pdf
- CDC Mumps Testing Job Aid for Clinicians: CDC Mumps Testing Provider JobAid_fi
- Contact the Pennsylvania Department of Health (DOH) at 1-877-PA-HEALTH (1-877-724-3258) or your local health department to report the suspected case.
Released by the Pennsylvania Department of Health on November 25, 2019.
