Measles Mumps Rubella Vaccination

Measles Mumps Rubella Vaccination

17 June 2013

Information for NSW GPS

1.Many young adults lack immunity to mumps, measles or rubella.
2. There are clusters of mumps cases in several regions of NSW.
3. MMR vaccine is free in NSW for people born after 1965 and is especially important for those planning overseas travel or pregnancy.

Current situation: 15 cases of mumps were notified in May, bringing the total number of notified cases in 2013 to 39. It is likely there are many more cases that have not been laboratory confirmed.

As with recent measles outbreaks, mumps is usually introduced to NSW by returning travellers. Young adults, 18 - 39 years, are most affected. This is probably because they did not receive two doses of mumps vaccine in childhood.

Transmission

  • Aerosol or droplet. Also direct salivary transmission
  • Incubation period ranges from 12 - 25 days
  • Cases are infectious from seven days before parotitis to nine days after. Peak infectivity is two days before onset of illness to four days after.

Clinical symptoms and signs

  • Fever, swelling and tenderness of one or more salivary glands. Also headache, anorexia and fatigue
  • Orchitis (usually unilateral) in up to 30% of post-pubertal males, sterility is extremely rare
  • Other manifestations include meningitis, encephalitis, pancreatitis, respiratory symptoms (common in children under 5 years) and spontaneous first trimester abortion.

Diagnosis

  • Serology - IgM detection or a significant increase in IgG in the absence of recent vaccination
  • Buccal or throat viral swab collected within 7 days of onset of symptoms for culture or PCR.

Case management

  • Supportive - analgesia, antipyretics
  • Exclude from work, school or child care for 9 days from the onset of swelling
  • Notify your local Public Health Unit (PHU) on 1300 066 055

Prevention

  • Routinely immunise infants at 12 months and children at 4 years with a free MMR vaccine (from 1 July the second dose should be given at 18 months as MMRV)
  • Vaccinate unimmunised people born after 1965 for a total of two free doses of MMR vaccine; this is especially important for young adults planning overseas travel or women planning pregnancy

Further Information:

NSW Website: www.health.nsw.gov.au/Infectious/factsheets/Pages/Mumps.aspx

Dr Jeremy McAnulty
Director, Health Protection NSW
13 June, 2013