Mumps Advisory September 12, 2014 An adult male living in Anaheim has been diagnosed with mumps. The case has no recent history of international travel or exposure to a known case of mumps. Orange County has 0-3 cases of mumps reported each year, and a mumps case occurring without a history of travel or known contact to a mumps case is unusual. Providers should consider the diagnosis of mumps in patients with an appropriate clinical presentation, particularly in those with a history of international travel. Providers should notify Orange County Public Health Epidemiology at 714-834-8180 with any suspect cases . The incubation period is usually 16 to 18 days, but cases may occur 12 to 25 days after exposure. Prodromal symptoms are nonspecific and may include myalgia, anorexia, malaise, headache and low-grade fever. The most common manifestation is unilateral or bilateral swelling of one or more of the salivary glands, usually the parotid glands (parotitis). Parotitis tends to occur within the first 2 days and may be first noted as earache and tenderness on palpation of the angle of the jaw. Symptoms tend to decrease after 1 week and usually resolve after 10 days. Complications include orchitis (testicular swelling), which may occur in as many as 50% of postpubertal males. 10% have symptoms of aseptic meningitis. Treatment is supportive care. Laboratory Testing Testing for the mumps virus can be performed by sending serum for mumps IgM and IgG and buccal swab specimens for mumps polymerase chain reaction (PCR) and virus culture to Orange County Public Health Laboratory. Mumps IgM response may be absent or short lived in immunized patients. Orange County Public Health can help coordinate testing of patients. Infection Control Mumps virus is transmitted by exposure to respiratory secretions or droplets of infected persons, and is generally transmitted via face-to-face contact. Communicability is probably highest from 2 days before to 5 days after onset of parotitis; the virus has been isolated in saliva from 7 days before through 9 days after onset of swelling. Suspect cases should be cared for using standard and droplet precautions. Vaccination Mumps vaccine is given as part of measles, mumps and rubella (MMR) vaccine. All children are recommended to receive a first dose of MMR at 12-15 months and a second dose at 4-6 years of age. Post-licensure data estimate the effectiveness of one dose of mumps vaccine at approximately 80% and two doses at 90%. Health care providers can be presumed to be immune with any of the following evidence: documented administration of 2 doses of MMR vaccine, birth before 1957, positive serum mumps IgM, or laboratory confirmed disease. See http://ochealthinfo.com/phs/about/dcepi/epi/disease/mumps or www.cdc.gov/mumps/prev-control-settings/index.html for further information.