Over the past few years, there have been outbreaks of diseases we all assumed had been eradicated – chicken pox, measles, and, more recently, mumps. According to a report from the Centers for Disease Control and Prevention (CDC), there were over 4,000 mumps cases in the USA in 2016. Mumps outbreaks may be the new normal thanks to clusters of unvaccinated kids.
The mumps vaccination program started in 1967 – before that there were about 186,000 cases reported each year (and that number might be low because of underreporting). Once mumps vaccinations were commonplace, the incidence of the disease fell by over 99%. For those who think that better sanitation or whatever caused decreases in diseases, I think that 1967 is fairly recent, and it’s clear that the vaccine itself started the precipitous drop in mumps outbreaks. Since the start of the vaccine era, annual mumps cases in the USA hovered below 1,000 during most years. But over the last 10 years, there has been a noticeable uptick in annual cases, with a high of over 6,000 cases in 2006.
Let’s examine the mumps outbreaks and see what may be the cause. Spoiler alert – expect Andrew Wakefield’s name to appear.
All about mumps
Mumps is caused by the mumps virus, known as Rubalavirus. It is a highly contagious disease that is transmitted through mucous from sneezing, coughing or passive touching. College classrooms and dormitories are perfect vehicles for the transmission of this and other highly contagious diseases, like what happened at Harvard University earlier this year.
Mumps is best known for the puffy cheeks and swollen jaws that result from inflamed salivary glands. Back before the MMR vaccine (for mumps, measles and rubella), the mumps look was well known. Now, most people have never experienced contracting the disease or seeing others with it.
Aside from the swollen facial appearance, other common symptoms of mumps include fever, headache, muscle aches, tiredness, and loss of appetite. Generally, these symptoms are very similar to the flu, except for the swollen salivary glands.
Symptoms usually appear 16-18 days after infection, but it can be shorter or longer than that. Some cases of the disease are so mild, that the individual doesn’t even know they have the disease, but still can transmit it to others. Most people with mumps recover completely in a few weeks.
Mumps seems rather benign. Except that it isn’t. Mumps has some very serious complications, especially for adults:
- inflammation of the testicles (orchitis) in males who have reached puberty. This happens in about 15-40% of men who have reached puberty and contracted the disease. This condition rarely leads to fertility problems, but it is a risk of contracting mumps as an adult male.
- inflammation of the brain (encephalitis) is rare, but about 1% of those cases are fatal.
- increased risk of spontaneous abortion of the fetus in pregnant women who contract the disease.
- inflammation of the tissue covering the brain and spinal cord (meningitis) occur in about 10% of cases.
- inflammation of the ovaries (oophoritis) and/or breasts (mastitis) in females who have reached puberty arise in about 5% of cases.
- profound deafness is very rare consequence of mumps.
Yes, the risk of most of the more serious issues are very small indeed. But, it is still there. Of course, that risk approaches zero after vaccination against mumps.
Why the rise in mumps outbreaks?
As I mentioned above, many of the recent mumps cases have occurred in college campuses. The close quarters of students, living in large dormitories and spending time in classrooms, allow for the disease to spread rapidly. Most universities require vaccinations for mumps. Unfortunately, many schools are often more liberal with granting vaccine exemptions than other educational systems, like public schools.
Even though a large majority of students have had the two doses of the MMR vaccines, and these vaccines are generally very effective, there are reports of fading immunity. Like other vaccines such as pertussis, there is evidence that the mumps vaccine also has shown some waning immunity. It’s probably been 10-15 years since many of these students have had their last MMR vaccine, so it’s possible that effectiveness has dropped by a few percentage points. The CDC is considering a third mumps vaccination to prolong immunity in older children – let’s hope they do.
But let’s be honest, many of us know that part of the reason for these outbreaks can be laid at the feet of Mr. Andrew Wakefield, the cunning fraud. Wakefield’s article in the Lancet, which was disowned by his coauthors and eventually retracted by the journal, has been the basis for the unscientific belief that vaccines, specifically the MMR vaccine, causes or is related to autism spectrum disorder. Let me be really clear – there is absolutely no evidence that vaccines are either correlated to or cause autism. Period.
Of course, Wakefield continues to push his dangerous narrative through his propaganda film, disguised as a fraudumentary, Vaxxed. As more people buy into the these lies, the more children are going to be left susceptible to once-rare infectious diseases like mumps.
Donald Trump needs to appoint a new CDC director, who, along with the Surgeon General, often give full-throated support to vaccinations. They generally are real scientists and physicians who know that all of the evidence supports the overwhelming safety and effectiveness of vaccines. If President-elect Trump (very hard to write) follows up on his Twitter Rage against vaccines, then I’m going to be writing more and more about outbreaks of vaccine preventable diseases. I don’t want to do that.
Vaccines prevent diseases. This is really not subject to debate. Vaccines are relatively safe. Also, there’s not much of a debate on that.
Mumps is dismissed as a minor infection not worthy of serious consideration. Catch it, and the belief is that it doesn’t do much harm. Except, that’s a bad assumption – it can have some serious, permanent complications. Why would you risk your own health or those of your children, based on the lunatic ramblings of a discredited conman, Wakefield?
Parents, if you’ve got kids, get them vaccinated according to the CDC schedule. If you’ve got children going to college, then talk to your physician about giving boosters and getting additional vaccines (like for meningitis). Maybe consider a third MMR vaccination. And if you’re a college student reading this? You’re officially an adult – make sure you’re all caught up.
Vaccines save lives. Bet on it.