Mumps Outbreak in the U.S. State of Iowa
The Public Health Agency of Canada is monitoring an outbreak of mumps in the U.S. state of Iowa. According to the Iowa Department of Public Health, between December 2005 and April 10, 2006 a total of 515 confirmed, probable, and suspect cases of mumps have been reported in what has become the largest mumps outbreak in the United States since 1988 .
At this time, fifty-three of ninety-nine counties have reported mumps activity and cases have been confirmed in at least one county bordering each neighboring state. With the exception of South Dakota, all states bordering Iowa have reported mumps activity ( Minnesota, Wisconsin, Illinois, Missouri, and Nebraska).
College-age students, those 18- to 22-years-old, have been infected the most; cases in other age groups are also being reported. A significant proportion of cases have been reported in individuals who had been previously vaccinated with two doses of MMR vaccine. Investigations concerning this anomaly are ongoing.
The Centers for Disease Control and Prevention (CDC) has confirmed the strain in this outbreak as genotype G. Genotype G is not uncommon and is similar to the strain responsible for the 2004-2005 mumps outbreak in the United Kingdom. The source of this outbreak has not yet been established.
Since 2001, in the U.S., an average of 265 mumps cases (range: 231--293 cases) have been reported each year. In Iowa, an average of five cases has been reported annually since 1996.
Source: Iowa Department of Public Health, CDC MMWR
Mumps is an acute viral disease with symptoms that include fever, swelling, and tenderness of one or more salivary glands under the jaw and in the cheeks. It is spread by direct contact with or inhalation of the secretions from an infected person's nose or mouth. A vaccine is available to protect against mumps.
Mumps occurs worldwide. People living in colder climates are especially susceptible between November and March. Where national vaccination programs have been implemented, the number of mumps cases has dramatically declined worldwide in all age groups and the risk of infection is greatest among older, unvaccinated groups.
For more information on Mumps, please visit the Travel Medicine Program's Disease Information Backgrounder on Mumps.
In Canada, between 1999 and 2001, 87 to 102 cases of mumps were reported annually. Outbreaks occurred in 1997, 1998, and 2002. The 1997 outbreak occurred among university students in British Columbia and the 1998 outbreak 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, 193 of which were related to a localized outbreak in Alberta, in a largely unimmunized population who declined vaccination for philosophical reasons.
Recommendations
Canadians travelling internationally should ensure that their routine childhood immunizations -- including diphtheria, whooping cough (pertussis), tetanus, polio, measles, mumps and rubella -- are up to date before travelling, regardless of their destination.
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.
As a reminder...
The Public Health Agency of Canada routinely recommends that Canadian international travellers consult their personal physician or a travel clinic four to six weeks prior to international travel, regardless of destination, for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication, and personal protective measures.
The Public Health Agency of Canada recommends, as well, that travellers who become sick or feel unwell on their return to Canada should seek a medical assessment with their personal physician. Travellers should inform their physician, without being asked, that they have been travelling or living outside of Canada, and where they have been.
Additional information from the Public Health Agency of Canada:
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