A recent outbreak of mumps concentrated among college-age students in Iowa has many young adults, doctors and administrators across the country concerned.
As of Monday, there were 245 confirmed cases of mumps in Iowa, 21 percent of which were infections among college students, according to the Iowa Department of Public Health. The virus is also beginning to spread to states nearby.
“Up until this outbreak, there are approximately 200 cases of mumps a year in the U.S. Now there have been over 200 in Iowa this year,” said Dr. Michael Rodriguez, associate professor of family medicine at the UCLA David Geffen School of Medicine. Since mumps is a virus, students without an immunization are susceptible to it.
“Outbreaks happen among people who did not have the vaccination. For college students living in close quarters like the dorms, viruses like mumps can be spread quickly between those susceptible,” Rodriguez said.
Symptoms do not normally appear until two or three weeks after a person is exposed to the virus, which can increase its spread.
“The way to tell if you may have mumps is fever, headache and swollen salivary glands,” Rodriguez said.
Mumps can be spread through airborne transmission, by droplets spreading from cough, or by saliva from shared cups or utensils, said Robert Kim-Farley, professor of epidemiology at the UCLA School of Public Health.
“College students who are close together in large classrooms, residence halls or common dinning rooms have a higher chance of transmission,” Kim-Farley said.
Doctors recommend receiving two doses of the measles, mumps and rubella vaccine, one when infants are between 12 to 15 months of age and again between the ages of 3 and 6 years old or before children start attending school, according to the Iowa Department of Public Health.
But immunization does not guarantee that a person will not get the virus.
“The Iowa Department of Public Health is looking at why so many people who were immunized still contract mumps,” Rodriguez said.
One theory is that these patients represent the portion of the population for whom vaccination is ineffective.
“It was thought that immunization was 95 percent effective if people had two doses of the MMR vaccine. ... The folks developing mumps may be the five percent (for which) the vaccine may not be effective,” Rodriguez said.
UCLA currently only requires hepatitis B immunization for entering students aged 18 and younger. Many professional schools such as the medical and nursing schools require more extensive immunizations, said nurse practitioner Evi Desser of the UCLA Arthur Ashe Student Health and Wellness Center.
“Students should take this opportunity to look into their own records, to make sure they have had all their immunizations,” she added.
Students can get their records from their pediatricians or through their high schools if they attended school in California.
“Primary and secondary schools in California are required to check their students’ immunizations. Students should therefore be able to get their California certificates of vaccination from their high schools,” Desser said.
If students want or need vaccinations, they can make appointments online with the immunization center at the Ashe Center. The cost of the combined MMR vaccine is about $51 depending on insurance coverage.
The Ashe Center also offers the TITER test, which is a blood test to check for immunization.
Rodriguez said the mumps virus is rarely fatal.
“The likelihood of death is extremely rare, although one side effect of mumps can be meningitis, which infects the brain and spinal cord. If someone were to also have a suppressed immune system, mumps could be threatening,” Rodriguez said.
There can be serious complications, including hearing loss. Also, 20 to 30 percent of males who have reached puberty can develop orchitis, a painful swelling of the testicles, Rodriguez said.
He added that it is possible that some of the infected Iowa patients “fell through the cracks,” or came from countries that do not require everyone to be immunized.
In order to control the spread of future outbreaks, universities may want to re-examine their students’ immunization records, Kim-Farley said.
“Schools might start to make sure students have had their second dose of MMR,” he said.
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