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Mumps FAQ


Current Mumps Cases*

Spokane County

286

Vaccination Status Vaccinated (175)
Unvaccinated (10)
Vaccination Status Unknown (101)
Age Ranges

0-9 years old (57)
10-19 years old (133)
20-29 years old (49)
30-39 years old (32)
40-49 years old (14)
50-59 years old (1)

Exclusions**

Spokane Public Schools District (5 schools)
Mead School District (1 school)

*Confirmed and Probable Cases in Spokane County as of Mar. 27, 2017 at 4:00 p.m.
** Exclusions as of Mar. 27, 2017 at 4:00 p.m.
Note: This information will now be updated every Monday & Thursday by 5:00 p.m.


FAQ information adapted Sept. 19, 2016 from U.S. Centers for Disease Control and WebMD. FAQs last updated Jan. 26, 2017

Current Status

Spokane County is currently experiencing an outbreak of mumps. More cases are expected.

Most people have immunity to the mumps through vaccination, so the risk to the general community of getting mumps is extremely low. But with confirmation of mumps virus in Spokane County, the health district is advising individuals to check their children’s and their own vaccination status and verify that they are up-to-date with the measles-mumps- rubella (MMR) vaccine.

If your question is not answered in the below FAQ, please call Spokane Regional Health District at (509) 324-1442.


Mumps Frequently Asked Questions

About the Virus
What is mumps?
What causes mumps?
What are the symptoms?

Mumps Transmission
How long until mumps symptoms appear?
How is mumps diagnosed?

Mumps Treatment
How is mumps treated?

Mumps Vaccination and Prevention
Who needs to be vaccinated against mumps?
Who should not be vaccinated against mumps?
Where can people get vaccinated?
Is the vaccine against mumps safe?
If a person is vaccinated, aren't they protected against mumps?
What should people do when there is a confirmed case of mumps?
What is Spokane Regional Health District’s role in responding to mumps cases?
Why, specific to the daily case count update, does the vaccination status for cases in Spokane sometimes change so dramatically?
What does "Vaccination Status Unknown" mean as part of the case count?

Mumps Immunity
Where can I get a blood titer to see if I am already immune to mumps?

Mumps Severity
Why is it important to prevent mumps?
Is mumps a serious disease?

Mumps Exclusions
Why are school exclusions necessary?
What is an exemption and how does it relate to exclusions?
Why is my child being excluded from school?
My child has an exemption but just received their first dose of MMR vaccine. Can they attend school now?
Why are school districts making everyone show proof of immunization even if a person does not work/attend affected school?
I am a staff member at a school with an exclusion order, what do I do now?
What is acceptable documentation of previous vaccination for an adult staff member of a school with an exemption order?

Related resources

Q: What is mumps?

A: Mumps is a contagious viral infection that can cause painful swelling of the salivary glands, especially the parotid glands (between the ear and the jaw). Some people with mumps won't have gland swelling. They may feel like they have a bad cold or the flu instead.

Mumps usually goes away on its own in about 10 days. But in some cases, it can cause complications that affect the brain, the testicles, the ovaries, or the pancreas.

 

Q: What causes mumps?

A: Mumps is a virus that is spread through exposure to an infected person’s respiratory droplets (created during a cough or sneeze), saliva, or mucus. Sharing cups and utensils may also spread the virus.

Individuals are most likely to spread the virus three days before and five days after swelling starts. However, an individual can potentially spread the virus seven days before, and for nine days after, symptoms start.

 

Q: What are the symptoms?

A: Symptoms may include:

  • Swelling and pain in the jaw. One or both cheeks may look swollen.
  • Fever.
  • Headache, earache, sore throat, and pain when you swallow or open your mouth.
  • Pain when you eat sour foods or drink sour liquids, such as citrus fruit or juice.
  • Tired
  • Poor appetite.
  • Testicular pain (males) or pelvic discomfort (females).

 

Q: How long until mumps symptoms appear?

A: Symptoms will typically appear 16 to 18 days after being exposed to the virus, though can be anywhere between 12 and 25 days. This is called the incubation period. Some people who are infected with the mumps virus don't have any symptoms.

If a person has more serious symptoms, such as a stiff neck or a severe headache, painful testicles, or severe belly pain, they should call a health care provider right away.

 

Q: How is mumps diagnosed?

A: Mumps is usually diagnosed based on symptoms and a history of exposure to the virus. If needed, a blood test can be done to confirm mumps and rule out other illnesses.

The mumps virus can also be identified using a sample of urine, saliva, or cerebrospinal fluid. These tests are less frequently done.

If an individual thinks he or she has mumps, they should be sure to call ahead and explain the symptoms before going to a health care provider's office. It's important to stay away from other people as much as possible to prevent spread of the disease.

 

Q: How is mumps treated?

A: In most cases, people recover from mumps with rest and care at home. In complicated cases, a hospital stay may be required.

Anyone who has mumps should stay out of school, child care, work, and public places until five days after the salivary glands first started to swell.

 

Q: Who needs to be vaccinated against mumps?

A: All children (ages 12 months and over), adolescents, and adults born in 1957 or later without a valid contraindication should have documentation of vaccination or other evidence of immunity. Additionally, some healthcare personnel who were born before 1957 may also need proof of vaccination or other evidence of immunity.

If a child or adult has had their recommended two doses of MMR vaccine, there is no recommendation at this time to revaccinate or to receive a “booster” third dose.

Pregnant women should not get MMR vaccine. Pregnant women who need the vaccine should wait until after giving birth. Women should avoid getting pregnant for 4 weeks after vaccination with MMR vaccine.

  • Healthy household members and close contacts should all be vaccinated with MMR to protect the pregnant mother. Measles, mumps, and rubella vaccine viruses are not transmitted from the vaccinated person, so MMR vaccination of a household contact does not pose a risk to a pregnant household member.

    Pregnant women who need the vaccine should wait until after giving birth. Based on CDC guidance, women should avoid getting pregnant for four weeks after vaccination with MMR vaccine. MMR can be given any time after delivery, even if the mother is breastfeeding, and is recommended before hospital discharge.
     

Q: Who should not be vaccinated against mumps? 

  • Anyone who has ever had a life-threatening allergic reaction to the antibiotic neomycin, or any other component of MMR vaccine, should not get the vaccine. Tell your doctor if you have any severe allergies.
  • Anyone who had a life-threatening allergic reaction to a previous dose of MMR or MMRV vaccine should not get another dose.
  • Some people who are sick at the time the shot is scheduled may be advised to wait until they recover before getting MMR vaccine.
  • Pregnant women should not get MMR vaccine. Pregnant women who need the vaccine should wait until after giving birth. Women should avoid getting pregnant for 4 weeks after vaccination with MMR vaccine.
    • Healthy household members and close contacts should all be vaccinated with MMR to protect the pregnant mother. Measles, mumps, and rubella vaccine viruses are not transmitted from the vaccinated person, so MMR vaccination of a household contact does not pose a risk to a pregnant household member.

      Pregnant women who need the vaccine should wait until after giving birth. Based on CDC guidance, women should avoid getting pregnant for four weeks after vaccination with MMR vaccine. MMR can be given any time after delivery, even if the mother is breastfeeding, and is recommended before hospital discharge.

  • Tell your doctor if the person getting the vaccine:
    • Has HIV/AIDS, or another disease that affects the immune system
    • Is being treated with drugs that affect the immune system, such as steroids
    • Has any kind of cancer
    • Is being treated for cancer with radiation or drugs
    • Has ever had a low platelet count (a blood disorder)
    • Has gotten another vaccine within the past 4 weeks
    • Has recently had a transfusion or received other blood products
       

Q: Where can people get vaccinated against mumps?

  • Many pharmacies* offer MMR vaccine and can bill insurance. Call first to make sure they have a supply on hand.
  • Check with your regular healthcare provider.
  • https://vaccinefinder.org

Additionally, when Spokane Regional Health District works with its partners to offer no-cost clinics, they are posted at www.srhd.org.

*There currently are no pharmacy locations providing no-cost vaccine and/or no-cost vaccine administration services. Spokane Regional Health District does not provide direct vaccination services at its facility.

How much does an MMR vaccination cost?
Varies by location and insurances, but usually between $23.44  and $114.

 

Q: Is the vaccine against mumps safe?

Hundreds of millions of doses of measles, mumps, and rubella vaccine prepared either as separate vaccines or as the combined MMR have been given in the United States, and its safety record is excellent.

Does the MMR vaccine make people sick?
No, the MMR vaccine will not make you sick, it is a very safe and well-studied vaccine. There are, however, mild side effects that recipients can experience, including soreness and tenderness around the injection site and a low-grade fever. Very rarely children develop a mild rash about seven to 12 days after getting the vaccine. Children with this rash are not contagious to others, and the rash does not mean he or she should not get their needed second dose.

Is the MMR vaccine a live virus?
Yes, the MMR vaccine is a live, attenuated virus, meaning it is a weakened form of the natural measles, mumps, and rubella viruses. This form of vaccine produces immunity to the disease in the person who got the vaccine without suffering the effects and potential complications of acquiring the disease naturally.

The MMR vaccine can be given to children who live with pregnant women or immuno-compromised people. To date, there have been no documented cases of transmission of the viruses from a recently vaccinated person to another person. 

 

Q: If a person is vaccinated, aren't they protected against mumps?

 A: Mumps can be prevented with MMR (measles-mumps-rubella) vaccine. MMR vaccine prevents most, but not all, cases of mumps and complications caused by the disease. Two doses of the vaccine are 88% (range: 66-95%) effective at preventing mumps; one dose is 78% (range: 49%−92%) effective.

With mumps circulating at higher levels than usual, this means that in addition to the unvaccinated being at risk, 12% of vaccinated individuals are also at risk as they are not afforded immunity through vaccination. People who have received two doses of the MMR vaccine are still about nine times less likely to get mumps than unvaccinated people who have the same exposure to mumps virus.

During mumps outbreaks in highly vaccinated communities, the proportion of cases that occur among people who have been vaccinated may be high (see video example above). This should not be interpreted as meaning that the vaccine is not effective. The effectiveness of the vaccine is assessed by comparing the attack rate in people who are vaccinated with the attack rate in those who have not been vaccinated. In outbreaks in highly vaccinated populations, people who have not been vaccinated against mumps usually have a much greater mumps attack rate than those who have been fully vaccinated.

If a vaccinated person does get mumps, they will likely have less severe illness than an unvaccinated person. *Source CDC. Vaccination, and proper disease prevention etiquette (washing hands, avoiding contact with those if you or someone else is sick, staying home and resting) are the strongest tools a community has against outbreaks of communicable disease.
 

Q: What should people do when there is a confirmed case of mumps?

A: Individuals should make sure they are up to date on their MMR vaccine.

Individuals also may have evidence of immunity to mumps.

This evidence includes:

  • documentation of adequate vaccination*
  • laboratory evidence of immunity
  • birth before 1957
  • documentation of physician-diagnosed mumps
  • People should let a health care provider know right away if they believe they have mumps.

* One dose of a live mumps virus vaccine for preschool-aged children and adults not at high-risk, and two doses for school-aged children and for adults at high-risk (health care workers, international travelers, and students at post-high school educational institutions).

Q: What is Spokane Regional Health District’s role in responding to mumps cases?

A: Local health departments like SRHD work closely with state public health, in this case, Washington State Department of Health, to investigate mumps cases when they occur. Together, they:

  • communicate with health care providers and offer technical assistance
  • arrange for testing clinical specimens from suspected mumps cases
  • alert clinicians and health care facilities about confirmed cases and testing recommendations
  • provide education and information to the public and health care providers through a variety of media including the SRHD website.

Q: Why, specific to the daily case count update, does the vaccination status for cases in Spokane sometimes change so dramatically?

A: Investigation of new cases is a multi-step process. When a case is reported to the health district, the initial information on vaccinaiton status is self-reported, which individuals sometimes report as "unvaccinated." Further in the investigation, dedicated staff are able to check for vaccination records and oftentimes can locate them, which changes the person's vaccination status.


Q: What does "Vaccination Status Unknown" mean as part of the case count?
A: If we cannot locate a vaccination record for an individual, regardless if they report to the health district they are vaccinated or unvaccinated, staff list the individual as "Status Unknown." Self-reported vaccination status is not a verifable means of status.
 

Q: Where can I get a blood titer to see if I am already immune to mumps?

A: If you have insurance and want the blood test covered, you must have a referral for laboratory test from a healthcare provider.

If you are interested in paying for this test out of pocket, you can schedule a test yourself at: https://www.gocinch.com/Details/Draw-Site/Measles-Mumps-Rubella-MMR.

Keep in mind that getting an MMR vaccine often costs less than doing a blood titer test and that you may still need to be vaccinated if the blood titer shows that you are not immune.


Q: Why is it important to prevent mumps?

A: Getting vaccinated is important because mumps can sometimes cause serious problems. It is also important because mumps is a contagious disease and outbreaks can easily occur.

 

Q: Is mumps a serious disease?

A: Mumps can be serious, but most people with mumps recover completely within 10 days to a few weeks. While infected with mumps, many people feel tired and achy, have a fever, and swollen salivary glands on the side of the face. Others may feel extremely ill and be unable to eat because of jaw pain, and a few will develop serious complications. Men and adolescent boys can develop pain or swelling in their testicles, which rarely results in sterility. Inflammation of the protective membranes covering the brain and spinal cord and loss of hearing can also occur, and in rare cases, this hearing loss can be permanent. The most serious complication is inflammation of the brain, which can lead to death or permanent disability.
 

Q: Why are school exclusions necessary?

A: Currently, several schools in multiple school districts are experiencing mumps outbreaks. Spokane Regional Health District, based on WAC 246-100-036 and WAC 246-110-020, has the authority to work with schools to enforce exclusions for staff and students if there are two or more confirmed disease cases within the same building. These exclusions often only apply to the affected building.

Exclusion is enforced 10 days after the initial exclusion letter is sent out. The health district works with affected schools to notify affected families and staff.

Q: What is an exemption and how does it relate to exclusions?

A: Several immunizations, including two doses of measles-mumps-rubella (MMR) vaccine, are required before a child may attend school or child care.

Washington state law allows for limited exclusions from these vaccinations. A licensed health care provider must sign a Certificate of Exemption in order for a parent or guardian to exempt their child from immunization requirements due to religious, personal, philosophical, or medical reasons. The signature verifies that the provider gave the parent or guardian information about the benefits and risks of immunization. A parent or guardian can also turn in a signed letter from a health care provider stating the same information.
 
Specific to religious exemptions, a health care provider doesn't need to sign the form for parents or guardians who demonstrate membership in a church or religious group that does not allow a health care provider to provide medical treatment to a child.

During an outbreak of vaccine-preventable disease, specific to children with an exemption on file, Washington State Administrative Code 246-110 allows a health officer to exclude these children from school or child care if the child has not been fully immunized.

Children who are not up-to-date on their immunizations may be required to stay home for an extended period of time (21 days or more) if there is a disease outbreak.

Parents or caregivers who sign the Certificate of Exemption acknowledge that:

  • Their child may not be allowed to attend school or child care during an outbreak of the disease that their child has not been fully vaccinated against.
  • Exempting their child from any or all required vaccine(s) may result in serious illness, disability, or death of their child or others and that they understand the risks and possible outcomes of their decision to exempt their child.
     

Q: I don’t believe in vaccinations and I have an exemption form on file with my child’s school. I just received a letter telling me my child would be sent home because of the mumps outbreak. Why is my healthy child being penalized?

A: Washington state law allows parents/caregivers to obtain a religious, personal, philosophical, or medical exemption after consult with a licensed health care provider. Parents/caregivers must initial a declaration that they understand that the child may not be allowed to attend school or child care during an outbreak of the disease.

The health district and schools are responsible for the safety of students and are required to implement safety and health procedures to protect them, including minimizing the risk of communicable disease.


Q: My child has an exemption but just received their first dose of MMR vaccine. Can they attend school now?

A: A previously unvaccinated child who now has one dose of MMR vaccine can return to school immediately. The child is now considered in "conditional status" that applies for a maximum of 30 days. The child must receive their second dose of MMR to stay in school after these 30 days end. Those in school with only one dose, who have exceeded the 30 day conditional status are considered non-compliant.
 

Q: Why are school districts making everyone show proof of immunization even if a person does not work/attend affected school?

A: School districts have the option to increase the level of exclusion to protect the school community, including implementing district-wide exclusion for staff and students. Students with any valid exemption on file for the vaccine used to prevent the disease involved in the outbreak (i.e., MMR vaccine for mumps outbreak), can be excluded for the duration of the outbreak as stated on the exemption form. This is a risk acknowledged by the parent/legal guardian’s signature on the exemption form.

Because the mumps virus has the potential to infect the brain and cause permanent deafness, and the mumps vaccine does not have serious side effects, the benefits of the mumps vaccine outweigh its risks.
 

Q: I am a staff member at a school with an exclusion order, what do I do now?

Locate MMR vaccination records:

  1. Contact your healthcare provider for a copy of your immunization history. Ask if these immunizations have been entered into the statewide immunization database known as the Immunization Information System (IIS). If not, request that they be added. Providers can then print a complete record from the IIS. This record is a lifetime record to which you can gain direct access through MyIR.
  2. Sign up for MyIR through the Washington State Department of Health to view, download, and print your and your family’s immunization records. All Washington residents born after 1996 have been automatically added to the IIS. Adult records may be more difficult to locate, although the IIS does have many records for patients who have received vaccines at pharmacies or for patients whose healthcare provider has added their vaccines to their IIS record.

Or, get MMR dose:

Seek MMR vaccine at a local pharmacy or healthcare provider’s office. Most insurances cover this vaccination either in full or a majority of the cost.

If you have no insurance or insurance does not cover any vaccines, please call Spokane Mobile Clinic at 509-552-6292 for assistance in obtaining MMR at a reduced rate.

Or show other proof of mumps immunity, which include:

  • laboratory evidence of immunity
    • Seek a blood titer to determine your level of immunity to disease. If it meets guidelines for immunity, you can furnish this proof of immunity to your employer and healthcare provider. SRHD does not recommend titer as the first choice since it is costly and takes up to a week for results. There are no contraindications in receiving a MMR vaccine for anyone who is unable to demonstrate immunity.
  • birth before 1957
  • documentation of physician-diagnosed mumps

Contact Spokane Regional Health District, who may be able to assist you if above options are exhausted.

Q: What is acceptable documentation of previous vaccination for an affected adult (i.e. staff, volunteer, etc.) of a school with an exemption order?

YES
Physical documentation (original or copy) of previous immunization:

  •     Immunization record
  •     Certificate of immunization
  •     Medical records

NO
Written note from parent or self or notes from childhood baby book. Self-reported doses and history of vaccination provided by a parent or other caregiver are not considered to be valid. Only written, dated records can serve as evidence of vaccination.

If an adult is having difficulty locating these documents, the quickest and most effective next step is likely receiving a dose of MMR vaccine if not contraindicated.
 

Related resources:

Mumps Fact Sheet pdf (English) (Spanish) (Marshallese) (Vietnamese) (Ukrainian) (Chinese)
SRHD Mumps MMR Fact Sheet
SRHD Mumps Infographic (pdf)
SRHD Mumps Poster (pdf)
DOH Mumps Web Page
CDC Mumps Website



 

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March 28, 2017