Since mid April 2009 the Boston Public Health Commission has been notified of 9 cases of suspected Mumps in students at Northeastern University. Among the earlier cases were several students who had recently traveled to Ireland where there is currently a mumps outbreak. As required by state law, college students must be immunized against mumps, unless exempt for medical or religious reasons. In the past the requirement was for a single MMR (combination measles, mumps and rubella vaccine) but since 2007 Harvard and most other local Boston schools have required 2 immunizations for all new incoming students. The change in this requirement reflects the recognition that during a 2005 mumps outbreak among college students in the Midwest only about 80% of students who had received a single MMR were immune. The rest needed an additional immunization to provide full mumps immunity.
Mumps is an acute viral infection characterized by a non specific prodrome with myalgia, loss of appetite, fatigue, headache and fever. These symptoms are followed by acute onset of unilateral or bilateral tender swelling of the parotid or other salivary glands. Usually 60-70% of those infected have this typical acute parotitis, others are associated with nonspecific or primarily respiratory symptoms but 20% may be asymptomatic. Complications can include inflammation of the testicles, ovaries or breasts, meningitis, spontaneous abortion and deafness.
The incubation period is usually 14-18 days (range 14 to 25 days) from exposure to onset of symptoms. Patients are infectious from 3 days before until 9 days after symptoms begin. Transmission is via direct contact with respiratory secretions or saliva. Treatment is symptomatic and supportive with patients kept in isolation. Quarantine / exclusion from school or work is mandated by the Department of Public Health for those who are ill as well as non immune contacts. If a significant number of cases should be identified within the Harvard community, students who have not been immunized or otherwise have proven mumps immunity may be asked to leave the university.