Mumps in college

Morbidity and Mortality Weekly Report summarizes a mumps outbreak that occurred in 2011 on a university campus in California:

On September 29, 2011, the California Department of Public Health (CDPH) confirmed by polymerase chain reaction (PCR) three cases of mumps among students recently evaluated at their university’s student health services with symptoms suggestive of mumps. An investigation by CDPH, student health services, and the local health department identified 29 mumps cases. The presumed source patient was an unvaccinated student with a history of recent travel to Western Europe, where mumps is circulating. The student had mumps symptoms >28 days before the onset of symptoms among the patients confirmed on September 29. Recognizing that at least two generations of transmission had occurred before public health authorities were alerted, measles, mumps, and rubella (MMR) vaccine was provided as a control measure. This outbreak demonstrates the potential value of requiring MMR vaccination (including documentation of immunization or other evidence of immunity) before college enrollment, heightened clinical awareness, and timely reporting of suspected mumps patients to public health authorities.

All 29 cases were epidemiologically linked to the university. One of the cases was the source patient’s roommate who had received two doses of MMR (measles, mumps, rubella) vaccine. Other outbreaks of mumps have occurred in populations in which many individuals had received 2 doses of MMR.

Data collected during previous mumps outbreaks on college campuses indicate that extended person-to-person contact, in combination with waning vaccine-induced immunity, might make colleges and universities high-risk settings for outbreaks, even when 2-dose MMR vaccination coverage is high

CDC suggests that all colleges and universities consider requiring documentation that students have received 2 doses of MMR vaccine before matriculation.

The mumps vaccine was licensed in the US in 1967, resulting in a significant decline in the number of cases. However outbreaks continue to occur, even in immunized populations, when the virus is introduced by overseas travelers. The vaccine is included in national health programs of only 62% of countries, and immunization rates have declined in many European countries, leading to outbreaks of measles and mumps.