Getting the mumps used to be a milestone of childhood. Children would come down with them, most would recover, and that would be that. Vaccines changed all that, and now mumps is very unusual.
Recently there have been several outbreaks, and the CDC has issued statements on where they are and what should be done. The latest incident, in Texas, is a bit more concerning because it's possible that children from all over the country may have been exposed.
Vaccinations for mumps became routine in 1967, and before immunization was available, there were close to 186,000 cases each year. That number has decreased by 99%, but changes to the vaccine schedule, along with a trend of lower rates of vaccination, and a rise in some autoimmune conditions that prevent immunizations for some children have resulted in more outbreaks of mumps. In 2012 there were a total of 229 cases reported to the CDC. In 2016, that number was 6, 366. The CDC does not require towns, cities, counties or states to report mumps cases, so the numbers could actually be higher.
At a recent national cheerleading convention, attended by more than 23,000 cheerleaders, 2,600 coaches, and hundreds of family and staff members, someone who attended came down with a case of the mumps. The competition took place in Dallas from February 23-25th. The incubation period is normally about 14 to 18 days after exposure. However, it can take up to a month in some cases. More importantly, the mumps is contagious three to five days before a patient comes down with swollen salivary glands, fever or other symptoms. It's spread by contact with saliva and droplets that are airborne when a person infected with the virus sneezes or coughs. It can also be spread by using the same cups or utensils as an infected person. With so many children and adults at this one event, the potential for outbreaks in other parts of the country, when the competitors return home, is a very real possibility.
The Texas Department of State Health Services, issued a statement about the exposure, writing, "This letter is to inform you that you or your child may have been exposed to a person with mumps at the National Cheerleaders Association (NCA) All-Star National Championship on Feb. 23 to Feb. 25, 2018, at the Kay Bailey Hutchison Convention Center in Dallas, Texas. We are sending this letter to make you aware of this exposure and to provide additional information about mumps." While the majority of children are vaccinated, many are not. Also, immunity from the vaccine can decrease over time. The standard schedule for mumps vaccination is two doses, after which the vaccine is considered 88% effective. One dose will provide about 78% effectiveness. Patients exposed to mumps can get a booster from their healthcare provider for an extra bit of insurance, since the CDC advises that immunization during a mumps outbreak can protect against strains circulating in that outbreak.
The Texas exposure is significant because it's a close contact setting. Much like outbreaks that occur on college campuses, because of shared dorm space, bathrooms, and dining facilities, a gathering like the cheer competition has the potential to expose a large number of people in a very short time. Texas health officials advised anyone with symptoms that include a low-grade fever, aches, cough or congestion, and swollen glands to contact their healthcare provider immediately and inform them of their exposure. The video below has additional information.