Health Advisory
MULTI-STATE MUMPS OUTBREAK

A mumps outbreak primarily linked to Jewish populations from New York and New Jersey continues to affect numerous states in the Northeast. As of the end of January 2010, greater than 1,500 cases had been reported. To date, Delaware Division of Public Health (DPH) has not investigated or confirmed any associated cases.

Background

The outbreak began in New York in June 2009. The index case returned to NY June 17, 2009 from a trip to the United Kingdom, where approximately 7,400 cases of mumps have been laboratory-confirmed. The case then attended a New York summer camp for tradition-observant Jewish boys, where he became symptomatic on June 28, 2009. Subsequent camp attendees and staff members became infected with mumps and transmission continued in multiple locations when the camp attendees returned home. The outbreak has primarily affected the tradition-observant Jewish community, with less than 3% of cases occurring among persons outside the community. This outbreak is also occurring among members of the same population in Israel.

Current Concern

Mumps transmission is a current concern due to the onset of Passover (March 30^th through April 5^th), which may offer further opportunities for transmission as people from the Jewish faith travel for this religious observance.

Recommendations for Providers

• Healthcare providers with patients in any Jewish community should ensure that these patients, including both children and adults, are up to date with measles-mumps-rubella (MMR) vaccine.The second dose of MMR vaccine for children may be administered as early as 28 days following the first dose.
• Healthcare providers may consider offering a second dose of MMR vaccine to adults who have received one dose.
• Healthcare providers who have contact within the Jewish community should ensure that they themselves and ALL staff are immune to mumps in accordance with ACIP recommendations http://www.cdc.gov/vaccines/recs/provisional/downloads/mmr-evidence-immunity-Aug2009-508.pdf or receive two doses of MMR vaccine.
• Persons with suspected mumps should be isolated for 5 days after onset of parotitis and, if they visit a healthcare setting, droplet precautions should be initiated immediately.

Reporting

Any suspect mumps cases should be immediately reported to DPH, Bureau of Epidemiology at: 1-888-295-5156.

Resources for Providers

• Vaccine Information Statement
  • Yiddish: http://www.nyc.gov/html/doh/downloads/pdf/imm/mumps_vis-yi.pdf
  • English: http://www.cdc.gov/vaccines/pubs/vis/default.htm#mmr

Additional Information

• Mumps Fact Sheet: http://www.cdc.gov/mumps/about/downloads/mumps-factsheet.pdf
• Outbreak Q&A for Patients: http://www.cdc.gov/mumps/outbreaks/outbreak-patient-qa.html

For more information on MMR vaccines, visit: http://www.cdc.gov/vaccines/vpd-vac/mumps or contact the DPH Immunization Program at 1-800-282-8672.

More information about mumps can be found at http://www.cdc.gov/mumps

For the latest information about this outbreak, go to http://www.cdc.gov/mumps/outbreaks.html

For further background information, please refer to the following articles:

• Update: Mumps Outbreak — New York and New Jersey, June 2009–January 2010
  MMWR Vol 59, No 5; February 12, 2010
• Mumps Outbreak -- New York, New Jersey, Quebec, 2009
  MMWR Vol 57, No 58 (Dispatch);1-4 November 12, 2009

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