Hospital: Report by IDSS, facsimile, phone or mail
Lab: Report by IDSS, facsimile, phone or mail
Physician: Report by facsimile, phone or mail
Local Public Health Agency (LPHA): Report by IDSS, facsimile, phone or mail.
Iowa Department of Public Health
Disease Reporting Hotline: (800) 362-2736
Secure Fax: (515) 281-5698
A. Etiologic Agent
Mumps is caused by the mumps virus (genus Paramyxovirus, family Paramyxoviridae).
B. Clinical Description
Mumps is a systemic disease characterized by swelling of the salivary glands, which usually lasts several days. However, about one-third of infections do not cause clinically apparent salivary gland swelling. Respiratory symptoms are common. Encephalitis occurs rarely, and permanent sequelae or death is uncommon. Infection in adulthood is likely to produce a more severe disease, including mastitis, which occurs in up to 31% of females aged > 15 years, and orchitis, which occurs in 20% –30% of post-pubertal males. Other rare complications include arthritis, renal involvement, myocarditis, cerebellar ataxia, pancreatitis, and hearing impairment. Mumps infection during the first trimester of pregnancy can increase the risk of spontaneous abortion, although no evidence exists that it causes congenital malformations. While death due to mumps is rare, more than half the fatalities occur in those > 19 years of age.
Mumps should not be ruled out in someone who is vaccinated if he or she has clinically consistent symptoms.
Note: Swelling of the salivary glands can also be caused by infection with cytomegalovirus, parainfluenza virus types 1 and 3, influenza A, Coxsackie A, echovirus, lymphocytic choriomeningitis virus, HIV, and non-infectious causes such as drugs, tumors, immunologic diseases, and obstruction of the salivary duct.
Humans are the only known reservoirs.
D. Modes of Transmission
Mumps is transmitted by droplet or direct contact with nasopharyngeal secretions of an infected person, and by the airborne route.
E. Incubation Period
The incubation period is usually 16 – 18 days, with a range of 12 – 25 days
F. Period of Communicability or Infectious Period
Virus has been isolated from saliva (from 7 days before the onset of parotitis to 9 days afterwards) and from urine (six days prior to fifteen days after). Infectiousness occurs between 3 days before symptom onset until four days after or until symptoms resolve. Unapparent infections can be communicable.
Mumps occurs worldwide. In the United States, it is endemic year-round, historically peaking in winter and spring; however seasonality no longer is evident, due to widespread immunization. Eighty-five percent of adults have serologic evidence of immunity. About one-third of the infections do not cause apparent parotitis but those infected can still transmit disease; most infections in children < 2 years of age are subclinical. The incidence of mumps in the U.S. has declined since the vaccine came into use in 1967. In 1986 and 1987, there was a relative resurgence of mumps, apparently due to the absence of comprehensive state immunization requirements as well as, in some instances, vaccine failure. The number of mumps cases reported in the U.S. declined steadily from 1989 to 2005, but a multi-state outbreak of Mumps in 2006 resulted in over 6000 reported cases, including almost 2000 cases in Iowa. Outbreaks in highly vaccinated populations still occur, probably due to vaccine mismanagement or vaccine failure.
H. Bioterrorism Potential
I. Additional Information
The Council of State and Territorial Epidemiologists (CSTE) surveillance case definitions for Mumps can be found at: www.cdc.gov/osels/ph_surveillance/nndss/phs/infdis.htm#top
CSTE case definitions should not affect the investigation or reporting of a case that fulfills the criteria in this chapter. (CSTE case definitions are used by the state health department and the CDC to maintain uniform standards for national reporting.)
American Academy of Pediatrics. Red Book 2003: Report of the Committee on Infectious Diseases, 26PthP Edition. Illinois, American Academy of Pediatrics, 2003.
CDC. Vaccination of health care workers: www.cdc.gov/vaccines/adults/rec-vac/hcw.html
CDC. Updated Recommendations for the Isolation of Persons with Mumps. MMWR. 2008, 57(40); 1103-1105
CDC. Manual for the Surveillance of Vaccine-Preventable Diseases, CDC, 2002.
CDC. Measles, Mumps, and Rubella—Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1998, 47:RR-8.
Heymann, D.J., ed. Control of Communicable Diseases Manual, 20thP Edition. Washington, DC, American Public Health Association, 2015.
CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. Tenth Edition. March, 2008.