Mumps outbreak: Ireland

Health authorities have warned students in the Dublin areas to get vaccinated if they have not been immunised with the MMR...

Health authorities around the country have warned people to get vaccinated if they have not been immunised with the MMR vaccine, in response to an outbreak of mumps.

Mumps is a highly contagious infection. People who are infected are most contagious for 1-2 days before the onset of symptoms, and for five days afterwards.

During this time, it is important to prevent spreading the infection to others, particularly those at high risk of developing complications. For example:

  • Teenagers and young adults who have not been vaccinated
  • Pregnant women.

Mumps usually affects children and young people with symptoms that include fever, headache and swelling of the cheek and jaw. While for most people it is a minor illness, it can have severe complications for some including swelling of the brain and deafness.

The swelling causes additional symptoms, including:

  • Pain and tenderness in the swollen glands
  • Pain on swallowing and/or difficulty swallowing.

Other symptoms of the mumps include:

  • Headache
  • Joint pain
  • Nausea
  • Dry mouth
  • Mild abdominal pain
  • Fatigue
  • Loss of appetite
  • Inflammation of ovaries or testicles
  • Deafness
  • High temperature (fever) of 38ºC or above.

If you have received two doses of the MMR vaccine or have previously had mumps, there is no need for concern. If you have not received two doses of the MMR vaccine and have not had mumps, then you should attend your student health service or GP for vaccination.

The vaccine will not protect you if you have been exposed this time, but it will protect you from future exposure.

The most common symptom of mumps is a swelling of the parotid glands (located on one or both sides of the face). Swelling and pain of the testicles is common in men and boys after puberty.

Once a person has had mumps once, they usually develop immunity against getting the virus again.

How common are mumps?

After the MMR vaccine was introduced as part of the routine childhood vaccination programme, the number of mumps cases fell massively.

However, in recent years, there has been a rise in the incidence of mumps, particularly among teenagers and young adults.

Last year there were almost 600 cases of mumps reported to the HSE, according to provisional data. A rise in the number of cases was first noted in August 2018 and has continued into this year, with approximately 275 alerts so far. The HSE says cases have been reported countrywide.

How is the mumps spread?

The mumps virus is spread in the same way as the common cold and flu viruses. It is airborne, which means that it can survive briefly in the outside environment. Therefore, mumps can be spread through:

  • Direct contact - if you sneeze or cough, tiny droplets of fluid containing the mumps virus become airborne and can be breathed in by others.
  • Indirect contact – if infected droplets are transferred to an object, such as a door handle, and someone else touches it, they may catch the mumps if they then touch their mouth or nose.
  • Sharing utensils, such as cups, cutlery or plates with an infected person

The most effective way to prevent catching mumps is to have the MMR vaccine, which is thought to be 95% effective in protecting against the mumps.

Outlook

The outlook for young children with mumps is generally good because the symptoms should pass within two weeks without causing any long-term problems.

The outlook for teenagers and adults with mumps is slightly less positive because they have a higher risk of developing complications, some of which can be serious.

Complications of mumps include:

  • Painful swelling of the testicles (in boys and men)
  • Encephalitis (swelling of the brain) or viral meningitis
  • Deafness
  • Mumps can also on a rare occasion cause infertility in men

When to seek medical advice

Contact your GP if you suspect that you or your child have mumps. While the infection is not usually serious, mumps share symptoms with other, more serious types of infection, such as glandular fever and tonsillitis. It is always best to visit your GP so that they can confirm (or rule out) a diagnosis of mumps.

Diagnosing Mumps

Mumps is usually diagnosed from the symptoms, in particular from the swelling around your parotid glands.

If you have mumps, your GP can see and feel the swelling. By looking inside your mouth, they may be able to see that your tonsils have been pushed out of their usual position.

If you have mumps you may also have a high temperature, approximately between 37.5 and 39.5ºC (100 to 103ºF).

To confirm the diagnosis, particularly in a case where symptoms are severe or there are complications, a blood, urine or cerebrospinal fluid (CSF) test can be used. The CSF test or spinal tap involves taking a sample of the fluid that runs through your spine.

If you think that you or your child has mumps, you should visit your GP so that a diagnosis can be confirmed.

Treating Mumps

As there is currently no cure for mumps, treatment is aimed at relieving the symptoms and preventing further spreading of the infection. 

The symptoms of mumps usually develop 14-25 days after being infected with the mumps virus. The average incubation period is around 17 days.

There are currently no anti-viral medications that can be used to treat mumps. Treatment is focused on relieving symptoms until your body's immune system manages to fight off the infection.

The self-care techniques listed below should help:

  • Get plenty of bed rest 
  • Over-the-counter painkillers, such as ibuprofen or paracetamol, can reduce painful symptoms. Children who are 16 years old or under should not be given aspirin.
  • Drink plenty of fluids, avoiding drinks that are known to stimulate saliva production, such as fruit juice, as excess saliva can cause pain. Water is usually the best fluid to drink.
  • Applying a cold compress to your swollen glands should help to reduce the pain.
  • Eat foods that do not require a lot of chewing, such as soup, mashed potatoes and scrambled eggs.

Preventing the spread of infection

In people with mumps, preventing the spread of infection is also important. The advice below explains the best way to do this.

  • Stay away from school, college or work until five days after the onset of your symptoms.
  • Wash your hands regularly, using soap and water.
  • Always use a tissue to cover your mouth and nose when you cough and sneeze. Throw the tissue in a bin immediately afterwards.

Preventing Mumps

  • The best way to prevent catching mumps is to be immunised with the measles, mumps and rubella (MMR) vaccine.
  • The MMR vaccine is part of the routine childhood immunisation programme. One dose is given to a child at 12 months of age. A second dose is given in junior infants of primary school at four to five years of age (except in Sligo Leitrim and Donegal where it is given by the GP). Contact your local public nurse or GP if you are uncertain about whether your child's vaccinations are up-to-date.
  • The MMR vaccine can be given at any age, so there may be circumstances where you are advised to have the MMR vaccine. For example, if you were born between 1980-1990, you may not be protected against mumps. It is unlikely that you will have been previously exposed to a mumps infection, so vaccination may be recommended.
  • If you were born before 1978, it is unlikely that you have been vaccinated against mumps. While it is likely that you will have been previously exposed to mumps, vaccination may be recommended if you have a high risk of exposure to mumps.
  • All students starting third level college, particularly those aged 17-24 years, are recommended two doses of MMR vaccine if they have not previously received the vaccine. Vaccination for older students is not usually needed.

Factors that can increase your risk of exposure to mumps include:

  • Living or working in environments that contain a high number of young people living in close contact, such as a college, university or army base
  • Being a healthcare worker

You also have a higher risk of exposure if you are travelling to a part of the world that does not offer routine vaccination against mumps, such as:

  • Most of Africa, except Egypt and Libya
  • Pakistan
  • India
  • Japan
  • South East Asia

For more information on Mumps please contact your local CarePlus Pharmacy

*Information adapted from HSE website



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