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Mumps in Washington State (updated 9/7/06)

The Washington State Department of Health has received reports of 4 confirmed cases of mumps in Washington in 2006.  The first two cases (King County) were identified in early February and were related to international travel.  On April 14 CDC issued a health advisory related to a multi-state outbreak of mumps.  The other two Washington cases (both in Whatcom County) were identified in April/May as a result of increased surveillance and testing in Washington State in response the Midwest outbreak.  Neither of the Whatcom County residents had traveled, nor did they have any link to the outbreak in the Midwest.  There has been no known transmission of mumps to other persons from these cases.

Mumps Testing at Washington State Public Health Laboratory

The Washington State Public Health Laboratory is currently offering the following tests to assist in the diagnosis of mumps:

  • real-time RT-PCR assay for the detection of mumps virus, and

  • tissue culture for mumps virus  

The Communicable Disease Epidemiology Section of the Washington State Department of Health will facilitate testing for any persons who meet the clinical case definition for mumps:

"an illness characterized by acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary gland lasting 2 or more days, and without other apparent cause (as reported by a health professional)"

The index of suspicion that the symptoms may be caused by mumps virus should be increased if there is a history of recent travel either internationally or to the states where the outbreak has occurred, or if there has been known contact with another individual with parotitis.

For each person that meets the above criteria we are requesting submission of all of the following specimens, if possible:

  • urine       (submit to WA PHL)

  • buccal     (submit to WA PHL)

  • serum     (The specimen should be submitted commercial laboratory, as WA PHL does not currently offer mumps serologic testing. Once parotitis is present, both IgM and IgG for mumps-specific antibody should be requested.  If the commercial results indicate recent mumps infection, we will recommend that the LHJ retrieve the serum sample so that it can be sent for confirmation at the CDC laboratory.)

The urine and buccal specimens are collected for the purpose of viral isolation, but will also be tested by polymerase chain reaction (PCR). 

Clinical information to submit with the specimens must include demographics, immunization history, date of onset of parotitis.  Information about laboratory tests used in the diagnosis of mumps and a full list of reporting information and variables to include can be found at http://www.cdc.gov/vaccines/vpd-vac/mumps/default.htm .  

Health jurisdictions in Washington State should contact Chas DeBolt, Communicable Disease Epidemiology Section (206-418-5500), to report mumps cases and/or to request testing.

Mumps Immunity and Mumps Vaccination Recommendations

On May 17, 2006, the Advisory Committee on Immunization Practices (ACIP) updated criteria for mumps immunity and mumps vaccination recommendations. Updated ACIP recommendations for mumps immunization and determination of immunity are available on CDC's website:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5522a4.htm


Key changes to 1998 ACIP recommendations on mumps -- May 17, 2006

Acceptable Presumptive Evidence of Immunity

  • Documentation of adequate vaccination is now 2 doses of a live mumps virus vaccine instead of 1 dose for:
    -- School-aged children (i.e., grades K-12).
    -- Adults at high risk (i.e., persons who work in health-care facilities, international travelers, and students at post-high school educational institutions).

Routine Vaccination for Health-Care Workers

  • Persons born during or after 1957 without other evidence of immunity: 2 doses of a live mumps virus vaccine

  • Persons born before 1957 without other evidence of immunity: consider recommending 1 dose of a live mumps virus vaccine.

For Outbreak Settings

  • Children aged 1-4 years and adults at low risk: if affected by the outbreak, consider a second dose* of live mumps virus vaccine.

  • Health-care workers born before 1957 without other evidence of immunity: strongly consider recommending 2 doses of live mumps virus vaccine

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* Minimum interval between doses = 28 days

   

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Washington State Department of Health
Communicable Disease Epidemiology
1610 N.E. 150th Street
Shoreline, WA 98155
Phone (206) 418-5500
FAX (206) 418-5515
24-hour contact 1-877-539-4344
 

Last Update : 07/10/2007 11:33 AM
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