Revenge of the Mumps: New Vaccine Needed?

On September 22, 2006, Stephanie Paredes knew that she was very, very sick.

"I woke up one day feeling so sick, everything was sore, and I felt sick for a whole week," Paredes said. "Then I woke up one day with a really high fever — so high that I was shivering and couldn't stop."

An 18-year-old, first-year student at the University of Virginia, she had no idea what kind of disease she possibly could have caught. But she took her parents' advice to stay home and rest until it passed. Finally, after a week of debilitating illness, Paredes woke up one morning feeling suddenly and inexplicably better.

That is, until she reached up to touch her face.

"My face felt huge," she recalled. "I had a panic attack and ran to the bathroom. When I saw my swollen face in the mirror, I screamed."

Oddly enough, Paredes was exhibiting symptoms of an illness most commonly associated with childhood: the mumps. And while she was one of the first students diagnosed with mumps on her campus, she wasn't the last. Paredes later learned that about 50 more students and teachers at the school also contracted the mumps after she had.

But she did not contract and spread the disease due to her failure to receive proper immunizations. Indeed, like many of the other students on her campus who contracted the disease, she received the two-dose measles, mumps and rubella (MMR) vaccine when she was a child.

Now, new research suggests that the mumps outbreak that began early in 2006 — the largest outbreak of mumps in the United States in two decades — was probably due more to vaccine failure than the failure of people to get their recommended immunizations.

Researchers at the Centers for Disease Control and Prevention looked at mumps cases in the United States in 2006. They studied the 6,584 reported cases of mumps and found that in most cases, the vaccine from childhood no longer provided enough protection in adulthood.

In light of the findings, doctors say a more effective childhood vaccine — or additional booster shots — may be needed to wipe out mumps in the United States.

Still, the researchers noted that the vaccine is not useless; on the contrary, it probably helped prevent a much larger, more dangerous outbreak.

"Two doses of mumps vaccine are very effective and high coverage rates with two doses of the mumps vaccine in the U.S. prevented a much larger outbreak from occurring," said Dr. Jane Seward, lead study investigator and deputy director of the CDC's Division of Viral Diseases. "The U.K., by comparison, had fifty times higher incidence with their outbreak [of mumps] because of less vaccination coverage."

Anatomy of an Outbreak

Mumps is a viral infection spread from person to person, most commonly through sneezing or coughing. The infection usually begins with swelling and tenderness of one or more of the salivary glands, which lasts about a week. Complications can include inflamed testicles or ovaries, as well as inflammation of the lining of the brain and the pancreas.

Like most viral illnesses, the treatment for mumps primarily involves bed rest and over-the-counter pain and fever medications until the illness has run its course.

Before widespread vaccination, there were about 200,000 cases of mumps and 20 to 30 deaths reported each year in the United States. But these numbers were cut drastically by immunization efforts.

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