Cases of mumps have recently been identified in Virginia, particularly among college-aged students. Local health department staff have been investigating these cases to determine epidemiologic links between them.
Mumps is an acute viral illness most often characterized by parotitis, orchitis, or oophoritis unexplained by a more likely diagnosis. Other symptoms may include low-grade fever, myalgia, anorexia, malaise, and headache. However, mumps infection may present as only nonspecific or primary respiratory symptoms and up to 20% of infections are asymptomatic.
The incubation period for mumps is roughly 18 days (range 12-25 days) and individuals are infectious from 3 days before until 5 days after the onset of parotitis.
While two-dose vaccination with the MMR (measles, mumps, and rubella) vaccine is the best way to prevent mumps infection, the vaccine is not 100 percent effective.
If you are experiencing signs/symptoms of mumps, please contact your health care provider.
Local health departments also offer many routine vaccinations. Contact your local health department for more information.
In populations at increased risk for mumps due to an outbreak, the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) have recommended the use of a third dose of MMR vaccine.
The vaccine is only recommended for those populations who have been identified as being at an increased risk for mumps (e.g. members of a defined group where mumps cases are occurring).
High-risk populations are defined by the health department after extensive epidemiologic investigation.
A third dose of mumps vaccine is not routinely recommended for those outside of the defined high-risk population or outside a defined group where mumps cases are occurring.
The complete ACIP recommendation for a third dose of MMR vaccine may be viewed at .
Clinicians are asked to maintain an increased index of suspicion for mumps given the increase in cases across the Commonwealth.
The preferred testing method to confirm mumps infection is the collection of a buccal swab within 24-48 hours of parotitis onset for testing using a molecular detection assay. Testing after 48 hours of parotitis onset may be discussed with local health department staff on a case-by-case basis.
Interpretation of serologic testing results in individuals who have received MMR vaccine is difficult, thus serology is not recommended in vaccinated individuals.
Although mumps is one of the most familiar causes of parotitis, clinicians may also consider other infectious causes such as Epstein-Barr virus, cytomegalovirus, parainfluenza, influenza A, enteroviruses, lymphocytic choriomeningitis virus, HIV, nontuberculous mycobacterium, and less often, gram-positive and gram-negative bacteria.
Testing for one or more of these etiologies may help distinguish the cause of illness in a symptomatic patient.
In patients who present with signs and symptoms clinically compatible with mumps, the Virginia Department of Health recommends the following:
Immediately triage the patient. Do not allow patient to remain in your waiting area without a mask.
Use standard and droplet precautions.
Place these patients in a private room with a closed door, if possible.
Only permit health care workers with documented immunity to mumps to work with the patient.
Contact your local health department immediately to report the case and for additional guidance on testing and control measures, including exclusion from work or school.
