There are at least 7 possible cases of mumps exhibiting signs of parotitis (swollen salivary glands under ears causing swollen jawline). Mumps is the only known cause of epidemic parotitis, and so the working assumption is that this is mumps. Lab confirmation is very tricky – it often requires retesting a few weeks later to confirm, and even then it doesn’t always show up. In addition to being in touch with the local boards of health, I spoke at length with the CDC’s team leader for mumps, measles, rubella and polio. We had been in contact in March when I was alerting them to Pesach travel patterns and the risk of spread. She was able to share with me her experiences in dealing with the 2009-2010 epidemic in NY/NJ.
Practically speaking, what does this mean for everyone? What should we be doing?
First, we need to keep everything in perspective. Mumps is usually very mild, especially for people who have had their shots. This is certainly a good time to get caught up on shots. People who have resisted vaccinations might want to reconsider. Adults born after 1956 who are unsure of their vaccination status or know they only had 1 shot, and don’t think they ever had mumps, may wish to consider getting a dose of MMR vaccine. Babies under 12 months are considered to be at very low risk. Women in their 1st trimester who get mumps might be at somewhat additional risk of fetal death, but the evidence for this is weak. There really aren’t any high risk groups – except adolescents and young adults who have never been vaccinated.
With all that in mind, it is still annoying to get sick, even if it isn’t “serious”. Symptoms can last up to several weeks, so we do want to take simple precautions to try and limit spread of the virus.
For those wondering why people who are vaccinated are still getting mumps, see the Mumps page. Basically, the vaccine isn’t perfect, but even when it doesn’t “prevent” mumps, it reduces symptoms.
Practical Steps.
Mumps is transmitted by saliva. Coughing, sneezing, talking, handling objects that are then touched by others. Knowing that over the chag there will be crowded sukkahs, simchas beis hashoevas, simchas torah and sometimes sleeping quarters, there are a few things to keep in mind.
1. Minimize crowding. OK, easier said than done. But for people who know they were exposed, you need to make some effort. Telshe bochurim who have not yet had symptoms are not “in the clear” until at least after the chag. They can still become symptomatic, and by then they have already been contagious for 2 days. Anybody who has been exposed to someone who was contagious, should be cautious starting 10 days following exposure (earliest one may become contagious). Avoid crowded situations when possible, and if starting to feel any of the symptoms, even just headaches or muscle aches or fever, play it safe and avoid gatherings.
2. If you have known exposure and begin to feel symptoms, don’t wait for your jaw to make you look disfigured, consult your doc. Early diagnosis means early isolation (sorry) but reduced spread.
3. Avoid sharing bottled drinks, cups, utensils, toothbrushes, etc….People who know they have been exposed (Telshe guys, my son included, listen up!) should try to clean up after themselves! Seriously, this avoids the situation where others may end up sharing your cups,etc…
4. Wash often, with soap! It is really remarkable, but washing frequently with soap is the greatest defense against infection. In a study at an army camp, the commanding officer ordered everyone to wash their hands thoroughly with soap at least 5 times a day. Infections were cut nearly in half.
It is too soon to tell if this is going to quickly pass. We do know that the chag will quickly pass, so be sure to enjoy and pack in the simcha to get us til Chanukah.
Gut Yom Tov!
mendel