Mumps outbreak at Syracuse as CDC weighs new vaccine recommendation

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An outbreak of mumps has spurred Syracuse University to offer students a third “booster” shot of the measles, mumps and rubella vaccine.

As of Monday, there have been 27 confirmed and 48 probable cases of mumps on campus, according to Syracuse University Health Services. Mumps is a contagious disease caused by a virus spread through saliva and mucus.

Independent of this outbreak, the Advisory Committee on Immunization Practices — a panel of medical and public health experts who meet three times a year to offer vaccination guidance for the United States — will vote Wednesday on whether to recommend the use of a third dose of the MMR vaccine during outbreaks. Committee recommendations are reviewed by the US Centers for Disease Control and Prevention.

Other outbreaks in recent years, most notably one involving NHL players in 2014, have prompted the CDC to debate whether a third dose of the vaccine should be recommended in such situations. A third dose may prevent additional cases by further protecting those exposed to the virus.

Absent this official CDC recommendation, a third dose is given during outbreaks on a case-by-case basis, such as the current one at Syracuse.

The health department of Onondaga County, where Syracuse University is located, reported six additional probable cases among non-campus members as of Tuesday.

Confirmed cases have been verified by laboratory testing, while probable cases only include likely though unconfirmed symptoms.

Mumps typically begins with fever, headache, muscle aches, tiredness and loss of appetite lasting a few days. Most people will then see salivary glands swell, causing puffy cheeks and a swollen jaw.

Third dose recommendation

The MMR vaccine is 88% effective when two doses have been given. In people who receive just one shot, the vaccine is less effective.

Most recent outbreaks have occurred among vaccinated people, according to Dr. Manisha Patel, a medical officer at the CDC.

In weighing a possible recommendation on Wednesday, the CDC advisory committee will review data from recent outbreaks, including the number of vaccinated people who became infected. In its deliberations, the panel will assess the impact of a third dose in decreasing the size and duration of outbreaks.

The CDC currently recommends that children get their first dose when they are 12 to 15 months old and a second dose at 4 to 6 years.

Outbreaks of mumps tend to occur in areas where there is crowding and close contact, according to Patel. Campuses are a typical site for outbreaks because of the sharing of saliva: by coughing, sneezing, kissing and sharing utensils, lipstick or cigarettes.

Possible complications

The incubation period for mumps ranges from 12 days to 25; symptoms last at least two and usually more than 10 days. Mumps can occasionally cause complications, especially in adults. These include deafness and inflammation of the brain, ovaries, breast tissue or testicles.

Since it is caused by a virus, mumps will not respond to antibiotics. Doctors generally recommend bed rest and over-the-counter pain relievers. Most people with mumps recover completely in a few weeks, according to the CDC.

Before the US mumps vaccination program started in 1967, the CDC received reports of 186,000 cases each year. The actual number of cases was probably much higher but not always reported since most doctors considered the mumps a typical childhood disease. Since the development of the vaccine, cases have decreased by more than 99% in the United States.

Each year, the number of mumps cases fluctuates within a range of a couple hundred to a couple thousand, according to Patel.

In 2016, the United States experienced the highest number of mumps cases in a decade: more than 6,000, according to CDC preliminary reports.

The number of cases is high this year, too. As of October 7, the CDC has received reports of 4,667 total mumps infections in 47 states and the District of Columbia for the year.