Health Advisory
MUMPS

Delaware Division of Public Health (DPH) is providing the following information to the medical community concerning the importance of immediately reporting any suspect mumps cases. A large mumps outbreak began in December 2005 in Iowa and has now spread to six neighboring states. Additionally, two persons traveled on 9 different airline flights while potentially contagious. A multistate investigation is in progress.

No outbreak associated mumps has been identified in Delaware at this time.

Background

As of April 10, 2006 a total of 515 possible mumps cases were reported in Iowa. The outbreak has spread across Iowa, and mumps activity, possibly linked to the Iowa outbreak, is under investigation in Illinois, Kansas, Minnesota, Missouri, Nebraska and Wisconsin.

Due to upcoming spring breaks and periods of increased travel, it is especially important for healthcare providers to be vigilant for suspect mumps cases among persons with parotitis or other salivary gland inflammation, and to immediately report suspect cases to DPH.

Clinical Information

Mumps is an acute viral infection characterized by a nonspecific prodrome, including myalgia, anorexia, malaise, headache and fever, followed by acute onset of unilateral or bilateral swelling of parotid or other salivary glands. An estimated 60-70% mumps infections produce typical acute parotitis. Approximately 20% of infections are asymptomatic, and nearly 50% are associated with respiratory symptoms. Transmission occurs by direct contact with respiratory droplets or saliva. The incubation period is typically 14-18 days (range of 14-25 days) from exposure to symptom onset. The infectious period is from 3 days before symptoms appear to about 4 days after, although the virus has been isolated from saliva as early as 7 days before to as late as 9 days after onset of symptoms. Suspect cases should be isolated during the infectious period.

DPH Services

• DPH can assist with identifying high risk susceptibles who may be been in contact with the case during the infectious period.
• DPH can coordinate testing for patients in which there is a high clinical suspicion of mumps. Laboratory confirmation of cases is a valuable epidemiologic tool. The Division of Public Health Laboratory performs serum IgG titer testing (acute and convalescent), as well as isolation of mumps through a viral culture (throat or urine culture). Viral isolation kits are available from the DPH Lab.

How to Report

Mumps is required to be reported to DPH by rapid means. Suspect cases should be immediately reported to the Epidemiology office at 1-888-295-5156 or 302-744-4541.

For Further Information

• Contact DPH, Epidemiology at 1-888-295-5156 to report cases, to arrange for testing of highly suspect patients, and for questions. This number is available during normal business hours and for emergencies during non-business hours).
• Additional information regarding mumps can be found at:  http://www.cdc.gov/nip/diseases/mumps/default.htm