Background
Between late October and early November 2004, three outbreaks of mumps have been reported to the National Disease Surveillance Centre. Two of these outbreaks are associated with third level institutions and the third is a community outbreak. The main age group affected is those aged between 15-24. The three reported outbreaks constitute approximately 40 cases, which is a marked increase as only 39 cases were reported for the entire year up to mid-October. There have been recent reports of mumps outbreaks in UK universities.
Complications of mumps
- 15% who get mumps will get viral meningitis (Adults are more at risk for symptomatic meningitis than children)
- Parotitis may be absent in up to 50% of such patients
- Encephalitis is rare
- Orchitis occurs in up to 50% of post-pubertal males and oophoritis in 5% of post-pubertal females, (oophoritis may mimic appendicitis)
- Pancreatitis occurs in 2-5% of cases
- Sensorineural hearing loss occurs in 1 in 20,000
Transmission & Immunisation
- Transmission is airborne or via direct contact with droplet nuclei
- Early triage and isolation may reduce the danger of cross infection to other susceptible patients or staff while in the ED
- RCPI Immunisation guidelines (2002) recommend that all health care workers born after 1978 should have proof of immunity or evidence of 2 doses of MMR
- Please notify the Director of Public Health at (021-4923501) of any cases that present to the Emergency Department
- NDSC have advised that diagnostic samples including serology and salivary samples should be taken and sent to the NVRL
Management of Mumps Contacts
If you admit any patient particularly male aged 18 – 25 with the following symptoms please consider the possible diagnosis of MUMPS & Isolate in a single side room with the door closed.
It is spread from person to person by respiratory secretions & is most contagious from 7 days prior to 9 days post onset of symptoms. (Ave 5 day’s pre onset)
- Fever low grade / Flu like symptoms
- Facial swelling / Parotid tenderness/swelling
- Scrotal tenderness/swelling
Particular care must be taken of women who are within their 1st trimester of pregnancy & advice sought from their midwife.
Also anyone who is immunocompromised needs discussion with Virology if they present or are a contact case.
Links
Director of Public Health at (021-4923501)