On alert for mumps

Getting the mumps was once a childhood rite of passage. But it’s rare in modern-day Los Angeles County, where the vast majority of young children are vaccinated against it, along with measles and rubella.

So with nine cases so far this year—six confirmed and four of those in the past two months—the Public Health department isn’t taking any chances. Mindful of an outbreak that started last year in Orthodox and Hasidic Jewish communities in New York and New Jersey, the department is putting out the word that mumps is communicable, potentially dangerous—and preventable.

The county had just seven confirmed cases in all of 2009, the same number in 2008 and only five in 2007, according to Dr. Jonathan E. Fielding, the county’s director of public health. In a public health advisory issued Tuesday, May 11, Fielding said symptoms include “swelling of salivary glands, fever and inflammation of the testes in teenage and adult males.”

He urged those with symptoms to stay out of group settings and see a doctor. And he noted that the best protection against the virus is the measles-mumps-rubella vaccine.

While the vaccine is most commonly given to children, medical officials say adults who have not been vaccinated should also do so.

“A few of the cases seem to have some relationship with the outbreak in the Hasidic community in New York,” Fielding said Thursday. But piecing it all together is a complicated matter of medical investigation. “Somebody came through South Africa,” Fielding said.

Dr. Nelson El Amin, medical director of the county’s immunization program, said there was evidence that some of the L.A. cases “may be related to travel related to Passover.”

“Not all are among the Hasidic population. Some are,” El Amin said.

He declined to be more specific, other than to say the L.A. patients ranged in age from infancy to adulthood and were from the northern and “Metro West” areas of the county.
“I can tell you that the majority of those who got it have not been immunized. I don’t believe any of them have been immunized as kids.”

The Centers for Disease Control and Prevention have been tracking the New York area cases as well as an outbreak at a small college in Iowa and among “a bunch of guys in Omaha” who went to a reunion basketball game and came down with the mumps, among other cases, spokesman Jeff Dimond said. The agency has posted on its website a mumps Q & A and “fast facts” on symptoms.

While the Los Angeles numbers may be small, the level of concern is not.

“We’ve been on heightened alert,” El Amin said. “Our job is to jump on things when there might be a trend.”

Posted 4-13-10