Mumps and Mumps VaccineEpidemiology and Prevention of Vaccine-Preventable Diseases

National Immunization ProgramCenters for Disease Control and PreventionRevised March 2002

MumpsAcute viral illness Parotitis and orchitis described by Hippocrates in 5th century B.C. Viral etiology described by Johnson and Goodpasture in 1934 Frequent cause of outbreaks among military personnel in prevaccine era

Mumps VirusParamyxovirus RNA virus One antigenic type Rapidly inactivated by chemical agents, heat and ultraviolet light

Mumps PathogenesisRespiratory transmission of virus

Replication in nasopharynx and regional lymph nodes

Viremia 12-25 days after exposure with spread to tissues

Multiple tissues infected during viremia

Mumps Clinical FeaturesIncubation period 14-18 days Nonspecific prodrome of low-grade fever, headache, malaise, myalgias Parotitis in 30%-40% Up to 20% of infections asymptomatic

May present as lower respiratory illness, particularly in preschool-aged children

Mumps Complications

Mumps Laboratory DiagnosisIsolation of mumps virus

Serologic testingpositive IgM antibodysignificant increase in IgG antibody between acute and convalescent specimens

Mumps EpidemiologyReservoir Human Transmission Respiratory drop nuclei Subclinical infections may transmit

Temporal pattern Peak in late winter and spring Communicability Three days before to four days onset of active disease

Mumps United States, 1968- 2001**2001 provisional data

Mumps United States, 1980-2001**2001 provisional data

Mumps - United States, 1980-2000Age Distribution of Reported Cases

Mumps Clinical Case DefinitionAcute onset of unilateral or bilateral swelling of parotid or salivary gland lasting >2 days without other apparent cause.

Mumps VaccineCompositionLive virus (Jeryl Lynn strain) Efficacy95% (Range, 90%-97%) Duration of ImmunityLifelong Schedule1 Dose

Should be administered with measles and rubella (MMR)

Mumps (MMR) Vaccine IndicationsAll infants >12 months of age Susceptible adolescents and adults without documented evidence of immunity

Mumps ImmunityBorn before 1957Documentation of physician- diagnosed mumpsSerologic evidence of mumps immunityDocumentation of adequate vaccination

MMR Adverse ReactionsFever 5%-15%Rash 5%Joint symptoms 25%Thrombocytopenia

MMR VaccineContraindications and PrecautionsSevere allergic reaction to prior dose or vaccine componentPregnancyImmunosuppressionModerate or severe acute illnessRecent blood product

Measles and Mumps Vaccines and Egg AllergyMeasles and mumps viruses grown in chick embryo fibroblast culture Studies have demonstrated safety of MMR in egg allergic children Vaccinate without testing

National Immunization ProgramHotline800.232.2522 Emailnipinfo@cdc.gov Websitewww.cdc.gov/nip

Only influenza and gonorrhea were more frequent among military personnel.Resurgence in 1986-1987 involved primarily states that did not have school entry requirements for mumps. 231 cases provisional in 2001.