MCH Prepares for Mumps Outbreak

An outbreak of mumps in our neighboring state of Iowa has received national media attention, and the virus is spreading in Nebraska. According to Family Practice Physician Carol Weckmuller, MD, Memorial Community Hospital in Blair is following guidelines set forth by the Nebraska Health and Human Services System, Epidemiology Department, to reduce the spread.

Mumps is a highly contagious virus spread by airborne transmission with mucus or droplets from the nose or throat of an infected person, usually when the person coughs or sneezes. Dr. Weckmuller said anyone can get the mumps, but it is more common in infants, children and young adults.

“The most common symptoms are fever, headache, and swollen salivary glands under the jaw,” she explained. “The disease can lead to hearing loss and aseptic meningitis or an infection of the covering of the brain and spinal cord. In 20 to 30 percent of males who have reached puberty, it can cause painful, swollen testicles.”

According to the Nebraska Epidemiology Department, symptoms may appear 12 to 25 days after infection, but usually within 18 days. An infected person is able to spread the disease from three days prior to the onset of symptoms to four days after.

Vaccine to prevent mumps isn’t usually targeted toward adults. Two doses of mumps-containing vaccine, given as combination MMR (mumps, measles and rubella) vaccine, are routinely recommended for all children. The first dose is given on or after the child’s first birthday and the second is given at 4 to 6 years of age.

“At the Blair Clinic, we have received a number of calls from people wanting to know what they should do about the mumps outbreak,” Dr. Weckmuller said. “To date, the Nebraska Department of Health and Human Services is not recommending mass immunizations.”

However, the state does recommend protection for healthcare workers. Because there may be an increased risk for mumps in Nebraska, infected persons are likely to seek treatment at healthcare facilities. Non-immune healthcare workers exposed to susceptible persons may need to be excluded from patient care for up to two weeks.

“In order to avoid significant disruption in healthcare delivery from exposure to the mumps, the state is recommending all healthcare institutions ensure that their employees are immune,” Dr. Weckmuller explained.

MCH Employee and Occupational Nurse Lana Pleak, RN, CDE, is leading the hospital’s efforts to ensure that all MCH healthcare workers are protected against the mumps. “At MCH, letters have been sent to all employees whose medical records do not show proof of two MMR vaccines or a positive mump IgG (Immunoglobulin),” Pleak explained.

“Employees who fit the criteria are asked to have blood drawn by April 21 to see if they have antibodies to protect them from mumps. If they do not have the antibodies, the hospital will provide them with MMR immunization shots.”

Dr. Weckmuller said that for the general population, physicians from the Nebraska Department of Epidemiology agree that people over age 65 are generally thought to be immune. People 19 to 45, who went to school in Nebraska, are assumed to have had only one MMR dosage and are encouraged to get a second if they do not have two documented doses.

“People age 45 to 65 are in a bit of a gray zone and currently, there are no recommendations to follow regarding immunizations,” Dr. Weckmuller said. “At MCH, our providers are considering these patients on a case by case basis, and titers (a test that measures the presence and amount of antibodies in the blood) could be drawn or an MMR may be given.”

According to Three Rivers District Health Department, the organization is investigating four cases of suspected mumps in Dodge County. These cases, all under the age of 30, are considered suspect because lab confirmation has not yet been made.

According to the official Nebraska Government Website, as of April 12, 2006, healthcare providers in Nebraska have reported 71 suspected mumps cases. Eleven of these cases have been laboratory confirmed. Cases have been reported in 17 counties. The Iowa Department of Public Health reports 605 cases of mumps so far this year. Officials say many people with mumps in Nebraska had connections to Iowa.

Dr. Weckmuller stressed that the best way people can protect themselves is to practice good hygiene. “Covering your mouth when you cough or sneeze and regularly washing your hands is important to prevent the spread of a number of diseases.

“It is also important for everyone to be aware of this virus’ signs and symptoms, because while people with a history of being vaccinated against mumps have a lower chance of getting mumps, it is still possible to contract it, even if you have been vaccinated.”

Dr. Weckmuller said MCH and its clinics will continue monitoring guidelines set forth by the State of Nebraska Department of Health and Human Services. Efforts to educate the community and healthcare workers are also underway. “Working with our infection control nurse, Annette Spooner, MCH has scheduled free community presentations to provide the latest information on the mumps outbreak.”

The first community presentation is a Lunch & Learn scheduled Friday, May 5 from Noon to 1 p.m. The second is scheduled Thursday, May 11 from 7 to 8 p.m. Both presentations will be held in the hospital’s conference rooms. For more information or to register for either of these free community presentation, call the MCH Community Relations Department at (402) 426-1464.