Download Mumps in Yakima County 12-13-16

Yakima Health District
1210 Ahtanum Ridge Drive
Union Gap, WA 98903
Phone (509) 249-6541
Fax (509) 249-6628
http://www.yakimapublichealth.org
Health Care Provider Alert
Mumps in Yakima County
December 13, 2016
Requested actions
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Review the attached mumps advisory sent out last week.
Be aware that a mumps case has been diagnosed in Yakima County.
Be familiar with the clinical presentation of mumps.
Contact the Yakima Health District (YHD) at (509) 249 6541 to report suspected cases and to
coordinate appropriate laboratory testing and disease control follow-up.
Summary of Yakima County suspected mumps cases
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The Yakima Health District is investigating two cases of mumps at the present time.
o One is in a pre-school age child who apparently had contact with a mumps case from the ongoing
south King County outbreak; this Yakima County child does not attend child care or other congregate
settings and concern for transmission to others outside the home is low at this time. Serum was
mumps IgM negative and IgG positive and the buccal swab was PCR negative. However, negative
predictive value is low for IgM and PCR in a previously vaccinated patient with known contact to a
mumps cases. Consequently, this case has been classified as a probable (clinically-andepidemiologically confirmed) case.
o The other suspected case under investigation had no contact with any known mumps cases but did
have an acute illness with submandibular gland swelling; further evaluation is underway.
Background
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Through December 9, 2016, 54 King County and four Pierce County mumps cases had been reported in
an ongoing outbreak largely connected to the Auburn School District occurring over the past month. Most
of the cases are children and most of the cases are up-to-date on their immunization status. Nationwide,
nearly 3,000 cases have been reported to-date in 2016. Six states have reported more than 100 cases this
year: AR, IA, IN, IL, MA and OK (https://www.cdc.gov/mumps/outbreaks.html).
Mumps is a viral illness that causes swelling of the salivary glands (most commonly but not exclusively the
parotid glands—unilateral or bilateral). It usually is preceded by a several day illness with a constellation of
fever, body aches, malaise, anorexia and headache. Up to one half of mumps virus infections, though, do
not have salivary gland swelling. See last week’s advisory for coverage of additional organ involvement.
Laboratory testing:
o Days 0-3 from onset: serum for mumps IgM and mumps IgG (commercial laboratory) and buccal swab
for mumps PCR (Washington State Public Health Laboratory).
o Days 4-10 from onset: serum for mumps IgM and mumps IgG, buccal swab for mumps PCR, and urine
for mumps PCR.
Treatment: treatment is supportive.
Mode of transmission: mumps transmission occurs through respiratory droplets or through direct contact
with nasopharyngeal secretions.
Incubation period: 12-25 days (typically 16-18 days).
Infectious period: mumps virus has been found in respiratory secretions as early as 7 days before the start
of symptoms and up to 9 days after onset. However, the patient is most infectious within the first 5 days.
Therefore, CDC now recommends isolating mumps patients for 5 days following onset of parotitis
Isolation: case must remain isolated at home until five days after onset of salivary gland swelling.
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Immunity:
o MMR--one dose for preschoolers and low-risk adults
o MMR--two doses for school-age children and health care workers.
o Prior physician-documented mumps infection.
o Serologic evidence of immunity (IgG positive)
o Birth before 1957 (not applicable for use among healthcare workers in an outbreak setting)
Exclusion
o Students, childcare and non-healthcare work settings: In the event of a school- or child care-based
outbreak, students and staff who are not up-to-date on their immunizations will be excluded from 12
days after the first onset until 25 days after last case’s onset.
o Health care workers: days 9-25 following exposure (assuming they bring their immunization status
up-to-date in the meantime).
For more information
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http://www.doh.wa.gov/Newsroom/2016NewsReleases/16142MumpsInWANewsRelease
http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Mumps
https://www.cdc.gov/mumps/