Mumps – What You Should Know

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Mumps has been in the headlines lately, and for a good reason.  We are in the midst of a significant outbreak in several areas of our state, and cases of mumps have recently shown up in Northeast Arkansas. Here are a few facts about this disease:

  • Mumps is a viral illness spread by coughing and salivary contact.  It is present throughout the world and is uncommon in the USA because we immunize for it.  The virus infects our respiratory tract and salivary glands, lasts for several days, and usually resolves without complications. After a 2-3 week incubation period, children and adults typically develop cough and congestion, sometimes fever and headache, and about two thirds have salivary gland inflammation with tender, firm swelling over one or both cheeks.  When it is suspected, mumps can be tested with a cheek swab – the result may take several days.  
  • Thought the disease is usually relatively mild and self-limited, it can cause occasional severe complications including swollen testicles in adolescent or adult males, viral meningitis, encephalitis, arthritis, or other glandular inflammation.  For women in early pregnancy, there may be a slight increased risk of spontaneous miscarriages.
  • There is no specific treatment for mumps, so the only effective approaches are containment and prevention.  Infected children can pass on the virus well before, and for about 1 week after the symptoms show up, so isolation of sick or highly susceptible individuals is important.  Mumps vaccine is part of every child’s routine immunization regimen and is usually given at 1 and 4 years of age.  Most, but not all children who’ve had both doses are fully immune.  

More information, including detailed isolation advice, is presented in a recent Arkansas Department of Health Newsletter (see below), and you may feel free to contact us if you have questions or concerns.  

 

About Prevnar-13

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The Prevnar vaccine was first introduced in 2000, and has been modified several times. The most recent is called the Prevnar 13 and is administered at 2, 4, 6, and 12-15 months.  It protects against a bacteria called Streptococcal pneumoniae , which can cause anything from ear infections to more serious infections like pneumonia, bacteremia or blood infections, and meningitis or infections of the brain and spinal cord. It’s easily spread from person to person, and children under 2 yrs of age and adults older then 65 yrs of age are most susceptible to this infection.

Before this vaccine was available, this bacteria caused 5 million ear infections, 13,000 blood infections, and 700 cases of meningitis and 200 pediatric deaths a year. Of those that survived the meningitis, a significant number of them were deaf or neurologically devastated. See link from a family who want to show others what this horrible disease can do to a child.

Outcome

Since the Prevnar vaccine hit the market, the diseases caused by this bacteria have been reduced 88%. The disease this vaccine prevents can be so aggressive and horrible, that it’s hard to understand why anyone would conceivably put their child at risk by not vaccinating.

This post and attempt at education is done in memory of those families who lost a normal and healthy child to this horrible disease, either through death or from neurological devastation. They did not have the opportunity to vaccinate their child, but you do!

Below is a video of a family with a child living with Pneumococcal Meningitis.

Measles

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What is measles?

Measles is a viral infection that begins with a fever that lasts for several days, followed by a cough, runny nose, and conjunctivitis (pink eye).  The rash starts on the face and upper neck, spreads down the back and trunk, and then extends to the extremities (arms and legs) to include the hands and feet. After about 5 days the rash then fades in the same order it appeared.

That all sounds fairly benign, so why should we worry about the measles?
Here’s why!

  • 1: 4 = require hospitalization
  •  1: 1000 = Get encephalitis(inflammation of the brain)
  •  1 or 2: 1000 = Will die from this illness either from pneumonia or encephalitis
  • Pregnant Unvaccinated Women or Women who’s antibodies to the vaccine are no longer protective= are at risk if they acquire measles during pregnancy for Miscarriage, Still birth, Prematurity, or Congenital Rubella Syndrome which consists of heart problems, Microcephaly(small head), hearing and vision problems, learning problems, and the list goes on.

How is measles spread?

  • A person with measles is contagious for 4 days before developing symptoms and remains contagious until 4 days after symptoms evolve.
  • The measles virus lives in the mucous of the nose and throat, and is spread when people sneeze or cough.
  • Droplets from coughing enter the air and can contaminate a space for up to 2 hours after person leaves
  • Incubation period(time from exposure to dev of disease) is 7-21 days.

Memphis had 3 distinct outbreaks and now 7 confirmed cases. The cases were not related to foreign travel and the health department could find no relationship between the outbreaks but are still investigating.

So what about the measles vaccine!

  • Introduced in 1963, and is combined with Mumps and Rubella to give the MMR (Measles, Mumps, and Rubella) vaccine. In 2000, Measles was felt to be eliminated in the United States, but there are still pockets of disease secondary to people traveling outside of the US and bringing it home or in populations which opt out of vaccines.
  • There is no scientific proof that the measles vaccine causes Autism, and the vaccine does not contain mercury.  The fear of both of these things has caused families to not vaccinate.
  • Nationally, 91.9% of children between 19-35 months of age have had at least one MMR vaccine as of 2013. However, Arkansas’s numbers were at 88.3% for the country (near the bottom but not the worst). The saddest part of these statistics, is that our state is at the very bottom of the list for this age group having received all of its vaccines at 57% (means only 57% of kids in Arkansas between 19-35 months of age are completely immunized).
  • At present the recommendations are that children receive 2 doses of the MMR vaccine. The first dose to be given between 12-15 months of age, and this would protect 93% of those exposed from getting measles. The second dose normally is given between 4-6 years of age,with entrance to school and raises the protection level to 97%(this means if you were exposed to measles you should be protected against not getting it 97% of the time). If the health department deems necessary, they will change timing of second vaccine and request it to be given 28 days after first.
  • Those less then 5 yrs of age are the one of the most susceptible groups, either because they are too young to vaccinate or have not gotten their second dose of the vaccine.

What about babies who aren’t vaccinated because they are too young?

Babies get passive immunity from their mothers (antibodies pass through the placenta), but no one is quite sure how long these last for. Thus this age group is very much at risk.

What other groups can’t receive the vaccine?

Pregnant women, those on steroids and other immunosuppressive medicines can not receive the MMR vaccine. This includes those individuals who have undergone transplants or are bring treated for cancer.

So the major take home point is that we need to get our children immunized with the MMR vaccine to protect them, but also to protect those in the community who are too young, pregnant, or unable to be vaccinated for other medical reasons. Stay informed by checking your local news and visiting our website for updates.

Gardasil HPV Vaccine Safety Assessed

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From Forbes

The largest review of the available evidence on the quadrivalent, or four-strain, HPV vaccine Gardasil, has found no evidence of any serious short-term or long-term safety issues. Bringing together the findings from clinical trials, post-licensure studies and data presented at scientific meetings but not yet published, the researchers focused particularly on autoimmune diseases, nervous system disorders, anaphylaxis, blood clots and stroke – but none of them is caused by the vaccine, they found.

Read more…