Mumbs
	Know before you go!
	Disease profile
	Transmission
	Geographic distribution
	Symptoms
	Treatment
	Vaccine
	Prevention & precautions
	Some things to think about

Mumps

July 2005

Know before you go!

Infectious diseases not necessarily common in Canada can occur and may even be widespread in other countries. Standards of hygiene and medical care may differ from those at home. Before departure, you should learn about the health conditions in the country or countries you plan to visit, your own risk of disease and the steps you can take to prevent illness.

The risk is yours
Your risk of acquiring a disease depends on several factors. They include: your age, gender, immunization status and current state of health; your itinerary, duration and style of travel (e.g., first class, adventure) and anticipated travel activities (e.g., animal contact, exposure to fresh water, sexual contact); as well as the local disease situation.

Risk assessment consultation
The Public Health Agency of Canada strongly recommends that your travel plans include contacting a travel medicine clinic or physician 6 to 8 weeks before departure. Based on your individual risk assessment, a health care professional can determine your need for immunizations and/or preventive medication (prophylaxis) and advise you on precautions to avoid disease. We can help you locate a travel medicine clinic closest to your home.

Some facts from the experts
The information below has been developed and is updated in consultation with Public Health Agency of Canada's Committee to Advise on Tropical Medicine and Travel (CATMAT). The recommendations are intended as general advice about the prevention of measles for Canadians travelling internationally.

Mumps, also known as parotis epidemica, is caused by the mumps virus, a member of the family Paramyxoviridae, genus Paramyxovirus and is related to the parainfluenza viruses. Mumps is an acute viral disease usually characterized by fever, swelling, and tenderness of one or more salivary glands under the jaw and in the cheeks. Although usually a mild childhood disease, complications including deafness, meningitis (an inflammation of the lining of the brain and spinal cord) and in adolescent and adult males, orchitis (painful inflammation of one or both testes), may occur.

Transmission

The mumps virus is spread by direct contact with or inhalation of the secretions from an infected person's nose or mouth. Recognized less regularly than other childhood communicable diseases, such as measles or chickenpox, mumps has a period of communicability similar to that of influenza and rubella. With an incubation period of 14-18 days (range, 14-25 days), maximum transmission of mumps is felt to occur between the period extending from 1 to 2 day before the onset of symptoms to 5 days after.

Mumps occurs worldwide with cases being reported throughout the year and epidemics occurring every two to five years. People living in colder climates are especially susceptible between November and March.

In Canada

In Canada , the average number of reported cases has dropped from 354 cases per year during 1990-1997 to 99 cases per year during 1998-2001. Outbreaks were reported in 1997 and 1998. The outbreak in 1997 occurred among university students in British Columbia and the outbreak in 1998 occurred in Quebec among school children from families who had recently emigrated from countries where mumps vaccine was not included in the routine childhood immunization program. In 2002, 205 cases were reported. This increase was due to a localized outbreak of 193 cases of mumps in Alberta in a largely unimmunized population who decline vaccination for philosophical reasons.

lthough still preliminary, data for 2003 and 2004 indicate that no outbreaks were reported during this period. With fewer than 30 cases having been reported in each of those years, it is the least number of cases ever reported for mumps in Canada .

Early symptoms, lasting one to two days, are non-specific and include headache, general malaise, lack of appetite, and fever. These symptoms are then followed by the characteristic unilateral (one side) or bilateral (both sides) swelling of the parotid glands, the well-known trademark of mumps. Pain and swelling of the glands increases over 1 to 3 days, tends to decrease after one week, and usually resolves by day 10. Up to 20% of mumps infections are asymptomatic, while an additional 40%-50% may present primarily with respiratory symptoms. This is especially true in children less than 2 years of age. In addition to the complications previously mentioned, women who contract the virus during the first trimester may be at increased risk for spontaneous abortion. There is no evidence however that mumps causes congenital malformations in the unborn child.

As the illness itself is usually mild, medical intervention is rarely necessary. Management of individuals with mumps focuses primarily on providing comfort and supportive measures.

Vaccines

Canada has a high standard of childhood immunization programs, and mumps vaccination is included in our national childhood immunization schedule. A live, attenuated mumps vaccine is available either in combination with other vaccines (i.e., measles and rubella) or on its own. The National Advisory Committee on Immunization recommends vaccination of all children at 12 months of age with a combined vaccine against measles, mumps and rubella (MMR) followed by a booster dose at either 18 months of age or at 4 to 6 years of age.

Vaccination remains the best protection against mumps.

Recommendations

The Public Health Agency of Canada strongly recommends that Canadian international travellers contact a physician or travel medicine clinic prior to departure for an individual risk assessment. Based on traveller's current health status, previous immunization history and anticipated travel itinerary, their need for mumps vaccination can be assessed.

Canadian travellers should ensure that their mumps immunization status is up-to-date in accordance with the recommendations of the National Advisory Committee on Immunization.

Some things to think about...

International travel can expose Canadians to infectious diseases that are not frequently seen in North America . Our high standard of sanitation and childhood immunization programs may lead many adult Canadians to become complacent about keeping their routine immunizations up to date. Travellers should ensure that their routine childhood immunizations are up to date prior to travelling. All travellers are advised to review their immunization history with a physician well in advance of departure to confirm whether they have been properly immunized against mumps.

For more information...

• To view Immunizations recommended for travel outside of Canada.

• For more Know before you go! information.

• For health care practitioners, to view the Canadian Immunization Guide by the National Advisory Committee on Immunization.