Mumps

Description

Mumps is a viral illness characterized by fever, swelling, and tenderness of one or more salivary glands, usually the parotid and sometimes the sublingual or submaxillary glands.

Occurrence

Before the vaccine was licensed in 1967, 100,000–200,000 mumps cases are estimated to have occurred in the United States each year. Incidence declined to approximately 5,000 cases per year from 1980 to 1990. Since 1995, <1,000 cases have been reported annually. The decline since 1995 is believed to be a result of the widespread use of a second dose of measles, mumps, and rubella (MMR) vaccine. Mumps primarily affects school-aged children and young adults.

Risk for Travelers

The risk for exposure to mumps outside the United States can be high. Because only 38% of countries use vaccine, mumps remains a common disease in many parts of the world.

Prevention

Mumps vaccine contains live, attenuated mumps virus. It is available as a single-antigen preparation or combined with live, attenuated measles or rubella vaccines, or both. Combined MMR is recommended whenever one or more of the individual components are indicated.

Although vaccination against measles, mumps, and rubella is not a requirement for entry into any country (including the United States), persons traveling or living abroad should ensure that they are immune to all three diseases. Immunity to mumps is of particular importance for children approaching puberty and for adolescents and adults who have not had mumps. Persons can be considered immune to mumps if they have documentation of receipt of one or more doses of a mumps-containing vaccine on or after their first birthday or physician-diagnosed mumps, or laboratory evidence of mumps immunity. Most adults born before 1957 are likely to have been infected naturally and generally can be considered immune, even if they did not have clinically recognizable disease. However, mumps or MMR vaccine may be given to older persons if there is reason to believe they might be susceptible.

The first dose of MMR should be routinely administered when an infant is 12–15 months of age. A single dose of MMR vaccine induces antibody formation to all three viruses in at least 95% of susceptible persons vaccinated at least 12 months of age. A second dose is expected to induce immunity in most persons who do not respond to the first dose. The second dose should be separated from the first dose by at least 28 days. (See Vaccine Recommendations for Infants and Children for a discussion of mumps immunization schedule modifications for infants who will be traveling.)

Adverse Reactions

Refer to Travelers' Health Information on Measles (Rubeola) for information on adverse reactions following MMR vaccine.

Precautions and Contraindications

Refer to Travelers' Health Information on Measles (Rubeola) for information on precautions and contraindications for MMR vaccine.

— Susan Reef, Laura Zimmerman