Increased cases of Mumps in McHenry County

The following in a memo released by the McHenry County Dept of public health on October 15th 2013.

This memo is to alert you of an increase in mumps cases in McHenry County. As of October of this year, there have been 4 cases reported. In 2009 there was 1 case of mumps reported and between 2010 –2012 there were no cases reported.
We are encouraging all healthcare providers to suspect mumps in any patient that presents with the following symptoms (despite their immunization status), test, and report:

  • Swollen and tender salivary glands under the ears on one or both sides (parotitis)
  • Fever
  • Headache
  • Tiredness
  • Muscle Aches Loss of appetite
    

Mumps Laboratory Testing & Specimen Collection

It is very important to obtain laboratory confirmation for cases and suspect cases of mumps. Due to cross reacting antibodies and other issues, sensitivity and specificity of commercially available IgM tests are problematic. The Centers for Disease Control and Prevention (CDC) and the IDPH do not recommend mumps IgM testing by commercial laboratories for confirmation or elimination of a diagnosis of mumps. A positive laboratory confirmation for mumps virus with reverse transcription polymerase chain reaction (RT-PCR) or culture in a patient with acute characteristics of the mumps illness are the only laboratory tests that will yield a “confirmed” mumps case by CDC and IDPH case definition. Therefore, the collection of clinical specimens for mumps virus isolation on all individuals with suspected mumps is extremely important and should be done.

A positive laboratory confirmation for mumps virus with reverse transcription polymerase chain reaction (RT-PCR) or culture in a patient with acute characteristics of the mumps illness are the only laboratory tests that will yield a “confirmed” mumps

A buccal swab is the best type of sample and is the preferred specimen for viral isolation. Collect a buccal swab up to 5 days after symptom onset, preferably within 3 day after onset. In unvaccinated persons, virus may be isolated from 7 days before until 9 days after parotid swelling. Maximal viral shedding, however, generally occurs just prior to and within the first 3 days of parotitis onset. In vaccinated persons, buccal swabs should be collected within 1 to 3 days of parotitis onset, otherwise viral detection in RT-PCR or culture may have low yield. Massage the parotid gland area (the space between the cheek and teeth just below the ear) for about 30 seconds prior to collection of the buccal secretions. The parotid duct (Stenson’s duct) drains in this space near the upper rear molars.

Reporting

According to the Illinois Adm. Code, Title 77, Section 690.100, any suspect case of mumps must be reported to the McHenry County Department of Health within 24 hours by calling 815–334–4500.

References