An outbreak of mumps here in recent weeks may not spread much further, health officials believe, but it serves as a reminder that the infection once a rite of passage for generations of swollen-cheeked schoolchildren stubbornly refuses to go away — despite a vaccine.
Ten cases of mumps in adult men, ranging from their early 20s to 80, were reported in Bexar County last week. Nine were inmates at the Bexar County Jail, and the 10th and oldest was a close contact of an inmate.
Medical records show at least several had been vaccinated or had contracted mumps years ago. Two required hospitalization. An 11th, unrelated case was reported in May.
Only 35 other cases have been reported throughout Texas this year — 16 of those in adults.
“People who have been immunized are coming down with it,” said Roger Sanchez, senior epidemiologist with the Metropolitan Health District. “We have two guys that gave us excellent (documented) histories of having had mumps, and they came down with it.”
Less than two decades ago, mumps was on a very short list of diseases that experts identified as possible to eradicate. That now seems unlikely anytime soon. A 2006 outbreak that began in Iowa and another still smoldering in New York and New Jersey have infected thousands.
The New York outbreak began in 2009 when an unvaccinated 11-year-old boy traveled to England, where mumps cases are widespread because of disproven fears that the combined measles, mumps and rubella vaccine causes autism.
That boy returned home and infected others at a religious-oriented camp — an outbreak that by January had infected more than 1,500 people. Most of them had been vaccinated, and almost all were linked to the same religious community. That makes it similar to many outbreaks that occur with long periods of exposure in confined spaces such as classrooms, dormitories and jails.
The mumps vaccine is only 85 to 90 percent effective, said Dr. Greg Wallace, a medical officer with the viral division of the Centers for Disease Control and Prevention.
“So if you have enough exposure to the virus, it is possible for people who get vaccinated to develop the disease,” he said.
The good news is that mumps is a lot harder to catch than measles, although both are spread by coughs and sneezes, he added.
“Even when there are these pockets of mumps outbreaks, they tend to stay in whatever community it took hold,” he said. “And why it sometimes takes hold and sometimes it doesn’t, we don’t know.”
Also, mumps isn’t typically as serious an illness as measles, for example, although in rare cases it can cause encephalitis. However, it can make people miserable through swelling of the salivary glands or — in older boys and men — of the testicles, a complication that can cause sterility.
“We say that people don’t care about mumps until they get it,” Wallace said. “It’s not pleasant. It can be asymptomatic, but you can have a fairly painful course, depending on where you get infected.”
While the MMR vaccine became widely used in the mid-1970s, and a booster shot was added in 1989, experts are debating whether another booster might help. Two studies are under way in New York and Guam that might shed light on the question, Wallace said.
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