Mumps Epidemic Spreads; More Vaccine Is Promised
By NINA SIEGAL
Published: April 20, 2006
IOWA CITY, April 19 — In the largest mumps outbreak in the United States in
more than 20 years, almost 1,000 people have contracted the disease in the
Midwest, the Centers for Disease Control and Prevention in Atlanta announced
The epidemic began in Iowa, where the State Department of Public Health has
reported 815 suspected or confirmed cases. It has spread to at least seven
So far, no one has died from the disease, a flu like viral infection that
causes swelling of the neck and chin and usually lasts 5 to 10 days. Twenty
people have been hospitalized, said Dr. Julie L. Gerberding, director of the
Centers for Disease Control.
Because of the effectiveness of the vaccine for measles, mumps and rubella,
introduced in 1967, most people think of the mumps as a childhood illness
that had been eradicated in the United States. But the current outbreak is
challenging those assumptions.
About half of the cases in Iowa involve college-age students, most of whom
have been vaccinated, said the state epidemiologist, Dr. Patricia Quinlisk.
Federal and state health investigators have not pinpointed the origin of the
epidemic, but the first cases were identified in December on a college
campus in either Iowa City or Dubuque. State officials said they would not
name the campus because such information was medically privileged.
Dr. Gerberding said the disease had spread quickly because of the dense
concentration of students in affected cities and because the vaccine is not
perfect. It has about an 80 percent efficacy rate for people who have been
inoculated with one dose, and a rate of about 90 percent for people who have
received the recommended two doses.
"We have absolutely no information to suggest that there's a problem with
the vaccine," Dr. Gerberding said. "What's going on here is basically a
number of people who haven't received both doses, coupled together with
people who have received the vaccine but are susceptible anyway, living in
crowded conditions like college dormitories or mixing up with other students
at spring break or during holidays, and setting up a cascade of transmission
that's going to take a while to curtail."
In recent years there have been 250 to 300 mumps cases annually in the
United States, said Dr. Jane Seward, acting deputy director of the division
of viral diseases for the C.D.C. The last significant outbreak was in 1989,
when Kansas had 269 cases. This time, the states with the most cases, after
Iowa, are Kansas, Illinois and Nebraska.
Chase Hardin, 19, a freshman at the University of Iowa, in Iowa City, had a
stiff neck in early March, but did not think anything of it until "it looked
like someone had stuck an orange in the side of my neck."
"I had no clue that I could get that," said Mr. Hardin, who was vaccinated
as a child. "I thought it was something of the past."
Christine F. Cassa, a University of Iowa freshman, got the mumps a few weeks
ago, along with four or five other students on her dormitory floor. She said
she had heard of about a dozen cases in her 900-student dormitory, Burge
"The dorms are so like close quarters," Ms. Cassa said. "You're around so
many people, and you don't think about what you're touching and what you're
drinking, and people share a lot of stuff."
Since December, the university's student health service has confirmed 55
cases, said Lisa James, associate director of student health.
Because of the wide range of symptoms, from achy limbs to swelling,
officials did not initially consider mumps a possibility.
"Now we're testing a lot of students, even with mild symptoms, especially if
the students say they've been in contact with someone who's had it," Ms.
James said. Students who have symptoms are told to isolate themselves for at
least five days.
Officials say it could be worse. "We're seeing really very low attack
rates," Dr. Seward said. "If we didn't have the high two-dose coverage, we'd
be seeing thousands of cases, or tens of thousands of cases."
Dr. Gerberding said the main step the C.D.C. was taking was to provide an
additional 50,000 doses of the mumps vaccine, half donated by Merck.
The Iowa Public Health Department is trying to contain the outbreak through
public education and inoculation.
"It's hard to say what comes next," said Dr. Quinlisk, the state
epidemiologist. "When mumps was around, it tended to be a winter and spring
disease, and it tended to go down in the summer. We'll be waiting to see if
Mother Nature gives us a little help."