Mumps (child care and schools)
What is Mumps?
Mumps is an infectious disease which is caused by a virus. Mumps typically starts with a few days of fever, headache, muscle aches, tiredness, and loss of appetite, and is followed by swelling of salivary glands that usually lasts between 3-7 days. The most common complication in adolescent and adult males is swollen testicles. However, mumps rarely leads to sterility. Other complications may include meningitis (inflammation of the tissue surrounding the brain and spinal cord), inflammation of the ovaries, and deafness. Approximately one-third of individuals infected with mumps do not develop symptoms but are nevertheless contagious. Mumps is usually more contagious in adults.
Signs and symptoms
- Swollen glands in front of and below the ear or under the jaw
- Fever (usually low-grade)
- Headache
- Earache
- Muscle aches
- Lack of appetite
- In males, painful swelling of the testicles may occur. Females may have swelling of the ovaries, which may cause abdominal pain.
Incubation period
12-25 days (usually 16-18 days)
Contagious period and spread
- A person is contagious from two days before to five days after the start of swelling.
- Transmission is by nose/throat secretions and direct contact with saliva from an infected individual. Infected individuals who do not have symptoms can still infect others.
- Infectious droplets can travel up to three feet when an infected person talks, coughs, or sneezes.
- Approximately 20% of infected individuals will not have symptoms, but they can still infect others.
Public health reporting requirements
- Report confirmed or suspect mumps to the facility director, school nurse, or child care health consultant.
- Confirmed and suspected cases should be reported to the local or state health department within four days of diagnosis.
Vaccination
Routine child/adolescent recommendations:
- Measles, mumps, rubella (MMR) vaccine is routinely given to children at 12-15 months of age, with a second dose at 4-6 years of age.
- Unvaccinated children and adolescents should receive two doses, at least four weeks apart.
Colorado school-required vaccines:
- Child care/preschool: One dose of MMR for children who are 16 months of age and older and two doses prior to kindergarten entry.
- School (K-12): Two doses of MMR are required.
- College/university: Two doses MMR are required for students born on or after Jan. 1, 1957.
- A complete school-required vaccine exemption provided to the child/adolescent/adult’s school may be accepted in place of an age-appropriate MMR vaccination series.
- Laboratory confirmation of positive titers to measles, mumps, and rubella is an acceptable alternative to age-appropriate vaccination.
Routine adult/other recommendations:
- Adults with no evidence of immunity for mumps should receive at least one dose.
- Evidence of immunity included people born before 1957 (except for health care personnel), documentation of receipt of MMR vaccine, or laboratory evidence of immunity or disease.
- Certain adults may need two doses. Adults who are going to be in a setting that poses a high risk for measles or mumps transmission should make sure they have had two doses separated by at least 28 days. These adults include students at post-high school education institutions, health care personnel, and international travelers.
Treatment
There is no specific treatment for mumps.
Exclusion
- Exclude all infected students/children and/or staff until five days after swelling onset.
- Children should not transfer to new schools or facilities during the exclusion period.
- Exclusion of unimmunized children may be considered in consultation with your local public health department. If unimmunized, exposed children are excluded for this reason, they may be readmitted once they receive the MMR vaccine. Otherwise, unimmunized people should be excluded until at least 26 days after onset of swelling of the last case.
Role of teachers, caregivers, and family
- Encourage routine vaccination. Review and ensure all children have received MMR vaccine according to current immunization recommendations.
- Recommend suspected mumps cases visit a health care provider for confirmatory testing.
- Report the infection to the local or state health department. If the health professional who makes the diagnosis does not inform the local health department that the infected child is a participant in a child care program or school, this could delay controlling the spread.
- Report the infection to the staff member designated by the child care program or school for decision-making and action related to the care of ill children. That person will work with public health to alert possibly exposed family and staff members and parents/guardians of unimmunized children to watch for symptoms and notify the health consultant.