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An alarming outbreak of the mumps two years ago has raised questions about whether an additional vaccination is needed.
A report in The New England Journal of Medicine tracks the 2006 epidemic, the largest mumps outbreak in two decades in the United States. It occurred despite a national vaccination program aimed at eliminating the disease here by 2010.
Mumps is a viral infection characterized by fever and swollen salivary glands. Mumps had virtually disappeared in the United States in the 1990s, when doctors began using a second dose of measles-mumps-rubella vaccine among schoolchildren.
 But surprisingly, most of those who
became infected with mumps in the 2006 outbreak were college students
who had received two doses of the vaccine. The outbreak raises
questions about waning immunity and whether a third dose of vaccine may
be needed.
The outbreak appeared to start in January 2006 on college campuses in Iowa. By February, mumps was reported on other campuses, and by April the outbreak peaked, with 40 states reporting 2,786 cases. By the end of the year, a total of 6,584 cases and 85 hospitalizations had been reported, but no deaths occurred. Eight states -- Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, South Dakota and Wisconsin -- had the highest number of mumps cases.
The researchers noted that the virus likely came from students or other travelers from Britain, where there was a larger outbreak of the same strain. Since 43 percent of the world's nations do not vaccinate against mumps, additional cases from overseas are likely, the report said.
At the time of the study, lead author Dr. Gustavo H. Dayan was employed by the Centers for Disease Control and Prevention. He now works for Sanofi Pasteur, which makes a mumps vaccine. In the United States, the mumps vaccine is sold by Merck.
  Mumps is an acute, contagious disease that causes painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food and helps you chew and swallow.
Alternative Names
Epidemic parotitis
Causes
The mumps are caused by a virus, which is spread from person-to-person by respiratory droplets (for example, when you sneeze) or by direct contact with items that have been contaminated with infected saliva.
The parotid glands (the largest salivary glands, located between the ear and the jaw) are often swollen.
Mumps most commonly occurs in children between age 2 and 12 who have not been vaccinated against the disease. However, the infection can occur at any age. The time between being exposed to the virus and getting sick (incubation period) is usually 12 to 24 days.
Mumps may also infect the testes, the central nervous system, and the pancreas.
Symptoms
- Face pain
- Swelling of the parotid glands
- Fever
- Headache
- Sore throat
- Swelling of the temples or jaw (temporomandibular area)
Additional symptoms in males that may be associated with this disease:
- Testicle pain
- Testicle lump
- Scrotal swelling
Signs and Tests
A physical examination confirms the presence of the swollen glands. No testing is usually required.
Treatment
There is no specific treatment for mumps. Ice or heat packs applied to the neck area and with acetaminophen (Tylenol) may help relieve pain. Do not give aspirin to children with a viral illness because of the risk of Reye's syndrome.
Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.
Expectations (prognosis)
Patients usually do well, even if other organs are involved. After the illness, the patient has a life-long immunity to the mumps.
Calling Your Health Care Provider
Call your health care provider if you or your child has mumps and severe headache, persistent drowsiness, eye redness, or persistent vomiting or abdominal pain.
Call your health care provider if testicle pain or testicle lump occurs.
Go to the emergency room or call the local emergency number (such as 911) if convulsions occur.
Prevention
MMR immunization (vaccine) protects against measles, mumps, and rubella. It should be given to children 12-15 months old. Vaccination is repeated between 4 to 6 years of age, or between 11 and 12 years of age, if not previously given.
Recent outbreaks of the mumps have reinforced the importance of having all children vaccinated.
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