Are mumps and measles making a comeback?




The incidence of mumps is on the rise, and health officials have warned the public of a potential nationwide outbreak.

From January 1 to February 25 2017, 37 states and the District of Columbia in the U.S. reported mumps infections in 1,077 people to CDC. The highest numbers appeared in the states of Arkansas, Missouri, New York, Oklahoma, Texas and Washington, according to Morbidity and Mortality Weekly Report, Notifiable Diseases and Mortality Tables.

These statistics come on the heels of CDC results indicating that 46 states and the District of Columbia reported the virus in 5,311 people in 2016. Outbreaks in just a few states pushed last year’s numbers well above the average. From year to year, mumps cases can range from roughly a couple hundred to a couple thousand. Compared to the 5,311 cases in 2016, there were 229 cases reported in 2012.

After conducting investigations in December, the CDC said most individual state outbreaks of mumps had been occurring among vaccinated people.

Because of this finding, the Advisory Committee on Immunization Practices, has begun work to consider the option of a third dose of the measles, mumps, rubella vaccine. The committee consists of medical and public health experts who meet three times a year to offer vaccination guidance for the U.S. A work group within the committee will review studies and present its recommendations to the committee for a vote, according to the CDC.

Measles on the rise

The increased incidence of measles in the U.S. centers on a different issue. Public officials report that unvaccinated individuals and those traveling to other countries are spreading the disease in this country.

From January 1 to February 25, 2017, a total of 21 people from seven states (California, Colorado, Florida, New Jersey, New York, Pennsylvania, and Utah) were reported to have measles, according to the MMWR.

There was a recent measles outbreak in California, with most of those infected coming from Los Angeles County, according to the LA Times. This outbreak was just six months after California’s vaccine law took effect that requires almost all children who attend private or public schools in the state to be fully vaccinated regardless of their parents’ personal or religious beliefs, unless a doctor provides a medical exemption. Schools are required to verify students’ immunization records before the start of kindergarten and seventh grade.

In January, Peter Hotez, Baylor College researcher, said Texas is one of several states on the verge of a measles outbreak, mainly because parents are choosing not to vaccinate their children. Texas State Rep. Donna Howard is pushing a bill in the state that would require parents to meet with a physician before they decide not to vaccinate their children.

To stop the recent spread, public officials and the medical community continue to urge unvaccinated individuals to get vaccinated against measles, which in some communities has been met with heavy controversy and strong resistance.

As nurses it is our responsibility to identify those who have the symptoms of measles or mumps, or may have been exposed to others who are carrying either one of these contagious diseases. Our patients and their families need to be educated about the viruses and the MMR vaccine and understand the importance of taking the necessary precautions to prevent the spread, like staying at home and avoiding kissing and hugging and other close contact.

 The increased incidence of measles in the U.S. centers on a different issue. Public officials report that unvaccinated individuals and those traveling to other countries are spreading the disease in this country.

 child with teddy bear

In the know about mumps

A contagious virus, mumps is known for its puffy cheeks and swollen jaws, the results of enlarged salivary glands. According to the CDC, the most common symptoms include fever, headache, muscle aches, tiredness, loss of appetite and inflamed and tender salivary glands under the ears on one or both sides (parotitis).

Symptoms typically appear 16-18 days after infection, but this period can range from 12-25 days after infection. Some people who acquire mumps have very mild or no symptoms and may not even know they have the disease. Most people recover in a few weeks.

Mumps spreads through saliva or mucus from the mouth, nose or throat. An infected person transmits the disease by coughing, sneezing or talking; sharing objects, such as cups or utensils; and touching objects or surfaces with unwashed hands. Mumps likely spreads before the salivary glands begin to swell and up to five days after the swelling begins.

Anyone with mumps should not go back to child care, school, work or other public places until five days after symptoms began or until they are well, whichever takes longer.

 In the know about measles

 A highly contagious virus, measles usually begins with high fever, cough, runny nose (coryza) and conjunctivitis.

Its symptoms generally appear about seven to 14 days after a person has been infected. People with measles are contagious from four days before the rash appears until about four days after it appears, and are most contagious while they have a fever, runny nose and cough.

Two or three days after symptoms begin, Koplik spots (tiny white spots), may appear inside the mouth. Three to five days after symptoms begin, flat red spots appear on the face at the hairline and spread downward to the neck, trunk, arms, legs and feet. They may be accompanied by small raised bumps. When the rash appears, a person’s fever may spike to more than 104° F; after a few days, the fever subsides and the rash fades.

Measles is spread through droplet transmission (coughing and sneezing) from the nose, throat and mouth of someone who is infected with the virus. Measles can be spread to someone who is in the same room as the infected person, and up to two hours after the infected person has left the room. An individual may be infected with the virus from another person, even before the infected person develops the rash.

Vaccines for measles and mumps

Mumps and measles can be prevented with the MMR vaccine, which protects against measles, mumps and rubella. The CDC recommends that children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.

The mumps component of the MMR vaccine is about 88% effective (range: 66-95%) when a person gets two doses; one dose is about 78% effective (range: 49%−92%), according to CDC statistics. Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective, according to CDC statistics.

Children may get the MMRV vaccine, which protects against measles, mumps, rubella and varicella. This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Learn how to discuss vaccinations with parents.

 


About the author
Janice Petrella Lynch, MSN, RN

Janice Petrella Lynch, MSN, RN 

Janice Petrella Lynch, MSN, RN, is Nurse.com’s nurse editor, nurse executive and news blogger. Also a nursing educator, she has held faculty positions at Wagner College, Skidmore College, Molloy College and Adelphi University. Jan is a member of the New York Organization of Nurse Leaders and the Greater New York Nassau-Suffolk Organization of Nurse Executives. She shares her editorial and writing expertise with nurses at writing workshops; attends and covers nursing events and trade shows; and helps manage the annual Nurse.com GEM Awards program. To ask Jan a question, email jplynch@oncourselearning.com.

2 responses to “Are mumps and measles making a comeback?”

  1. Thank you for the useful information. Mumps is in our local school district so this is very relevant. Hoping to hear more about the recommendation for a third MMR dose.

  2. I hope the parents of children who have autoimmune issues have good people around them and their children who are making sure they’re vaccinated.

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