The Delaware General Health District reported Monday it had not been notified of any new cases of mumps in the county. The seven cases previously reported to DGHD remain suspect, or unconfirmed beyond clinical symptoms, as lab results are still pending.
A central Ohio mumps outbreak, centered in Columbus and around The Ohio State University, continued to spread, however. Columbus Public Health reported 111 cases of mumps have been reported as of Monday afternoon, 89 of which are part of the OSU outbreak.
DHGD said those who are highest risk – those who have never been vaccinated or those who have received only one dose of the vaccine – should get vaccinated.
Because of the growing number of cases in Franklin County and the six suspect cases in Delaware County, DGHD is urging all residents to take precautions.
“We don’t want residents to panic, but we want residents, especially those at higher risk, to get their vaccination,” DGHD Director of Nursing Joyce Richmond said. “Because of our proximity to Franklin County, we want our residents to take precaution and take the steps necessary to prevent the spread of mumps.”
Adults born during or after 1957 often received one dose of the measles, mumps, rubella vaccine (MMR); a second MMR may be given for enhanced protection. Children should be vaccinated with MMR on or after their first birthday, followed by a second dose at 4 to 6 years of age.
“If you have never been vaccinated against the mumps or have had only one dose of MMR, talk to your doctor about vaccination or call the health department,” Richmond said. “Folks born before 1957 most likely have natural immunity.”
Cases at OSU have occurred in men and women between the ages of 18 and 48, while the other cases have shown up in residents of Columbus and Franklin County between the ages of 4 and 50.
“Mumps is a reportable disease, which means physicians are mandated to contact the health department to report a suspect case and to let us know if they are sending blood in for lab work,” said DGHD spokesperson Traci Whittaker. “We work with our local healthcare providers throughout the investigation, including receiving updated lab results as they become available.”
The Ohio Department of Health defines a mumps outbreak as three or more probable or confirmed cases clustered in a time and place, and the cases are likely related. Because the cases in Delaware County remain suspect, an outbreak has not yet been declared.
Mumps cases are considered suspect when symptoms of parotitis or acute salivary gland swelling is present without another apparent cause. A case may also be considered suspect if the laboratory test is suggestive of mumps without clinical information, whether or not it has a likely link to a confirmed or probable case.
Cases are considered probable if a laboratory test confirms an antibody against the mumps or if the case is linked to a probable case, confirmed case or defined group during an outbreak. A case is confirmed if it presents clinically as the mumps and laboratory tests confirm the virus.
Mumps is caused by a virus and is contagious through droplets of saliva or mucus from the mouth, nose or throat of an infected person. Unlike the flu, transmission requires close contact, such as the close living quarters of a dormitory or military barracks, or the sharing of silverware.
Symptoms include fever, body aches, fatigue, swelling of salivary glands, or pain with chewing or swallowing.
Up to 15 percent of people with mumps may also experience stiff neck and headache.
Men may also experience orchitis, a testicular inflammation that causes pain, swelling, nausea, vomiting and fever. Some women may experience symptoms of inflammation of the ovaries and breasts.
Symptoms usually begin 14 to 18 days after catching the virus, but the virus can be spread to others before symptoms even occur, according to the Centers for Disease Control and Prevention (CDC). Transmission is likely before the salivary glands begin to swell and within five days after the swelling starts.
Dr. Joseph Gastaldo of Riverside Infection Consultants and a physician at Grady Memorial Hospital said that some patients do not show the classic symptoms of salivary gland swelling and some do not show symptoms at all. He said about a third of cases fall into the subclinical category, but that these patients are still contagious.
“Just because you do not have the classic symptoms does not mean mumps is ruled out,” he said.
That natural immunity comes from the likelihood that most people born before 1957, when vaccination began, had the mumps. A person born after 1957 who has previously had mumps is also often considered immune.
If symptoms do occur, residents are encouraged to contact their primary care provider. Residents can contact their primary care provider or the Delaware General Health District for vaccine availability at 740-368-1700.
DGHD also recommends prevention through frequent hand washing, covering mouth and nose during a cough or sneeze, and not sharing cups or utensils. CPH recommends staying home for five days after symptoms begin.
From 2004 to 2013, Delaware had five cases of mumps reported – the most recent of which was in 2009 – and all were classified as suspect. No confirmed or probable cases of mumps were reported between 2004 and 2013 in Delaware County, and no mumps outbreaks were recorded in Delaware County during that time.
Rodriguez said Columbus averages about one case a year. He said CPH is continuing to investigate cases in the reporting counties in central Ohio and is in contact with DGHD about its investigations.
The last outbreak in Ohio occurred in 2010 in Cuyahoga and Lake counties, with 18 reported cases.
More information about mumps is available from the CDC at www.cdc.gov/mumps.