A mumps outbreak at San Diego State University has grown to 15 cases, 14 confirmed and one probable, the County of San Diego said Sept. 30. That is triple the five cases reported Sept. 18.
All cases are linked to a single athletic team plus one associated case, according to SDSU Student Health Services. Local media have identified the team as the Aztecs football program. Neither the university nor the county has named the team.
County health officials are recommending a third dose of the MMR vaccine for close contacts. For students, families, and athletes, the outbreak is a reminder that mumps can still spread in close quarters, even among people who were vaccinated as children.
From Five Cases to Fifteen in Under Two Weeks
KPBS reported that the outbreak stood at three confirmed and two probable cases on Sept. 18. Twelve days later, the count reached 15. SDSU says it is conducting daily screening, testing, and contact tracing with the county.
All of the infected people had previously received two doses of MMR vaccine, county health officials told KPBS in a separate report. The county's Sept. 30 release does not list vaccination status. Head coach Sean Lewis declined to discuss affected players, citing federal privacy laws.
Because mumps symptoms can take 12 to 25 days to appear after exposure, more cases are possible. The Aztecs were scheduled to host Texas State on Oct. 3.
Locker Rooms and Dorms Give Mumps an Opening
Mumps spreads through face-to-face contact within about 3 feet, through coughing, sneezing, or even talking, the county said. Sharing water bottles, utensils, or drinks can also spread it, and that is a routine part of life on many sports teams.
Dorms and shared apartments add more close contact. Students who live with teammates or share bathrooms and kitchens can avoid sharing cups and utensils while the outbreak continues and stay home if they feel ill.
Team settings bring all of these together. "They travel together, they get in buses together, certainly in their locker rooms, they probably hang out together after practice," Dr. George Sakoulas, an infectious disease specialist at Sharp Memorial Hospital, told KPBS.
People are contagious from about two days before their glands swell until five days after, according to the CDC. Early symptoms can feel like a cold or flu, so infected students may keep going to practice or class. "The first two or three days, they feel like, 'oh, I got a headache and a little bit of a fever, I may have the flu, I may have something else, OK, I'll plow through it,'" Sakoulas said.
A Third Dose for Close Contacts
Two doses of MMR vaccine are about 86% effective against mumps, according to the CDC. That protection is strong but not complete, and it can decrease over time. Outbreaks in vaccinated college populations have been reported for years.
That is why national vaccine advisers recommend a third MMR dose for people at increased risk during an outbreak. The county says the extra dose reduces the chance of infection among close contacts. It does not help people who are already infected.
County Public Health Services has run clinics on campus for symptom screening and boosters. Those clinics are open only to SDSU students identified as potential close contacts. A free booster clinic was held Oct. 1 at the Calpulli Center, and students can check with Student Health Services about any additional sessions.
Sakoulas said people vaccinated in the last two years get mumps about tenfold less often than people vaccinated 20 years ago. That is his estimate, not a county figure. "You try to get through by kind of providing a little bit of a booster in that local environment where that outbreak is happening," he said.
Most people recover from mumps within two weeks. Complications can include swelling of the testicles or ovaries, meningitis, and hearing loss. Sakoulas said about a quarter to a third of males past puberty who get mumps develop painful testicular inflammation, called orchitis.
Symptoms and Next Steps
Mumps usually starts with fever, headache, muscle aches, tiredness, and loss of appetite. A few days later, many people develop puffy cheeks and a tender, swollen jaw from inflamed salivary glands.
Anyone with symptoms should stay home, avoid close contact with others, and call a health care provider, SDSU says. The county advises people with symptoms to self-isolate until they can get tested and receive results. People with mumps are typically isolated until five days after swelling begins.
Students with questions can call SDSU Student Health Services at 619-594-4325. Parents of students can check vaccination records and talk with their child's doctor about whether a booster is recommended. Severe headache, stiff neck, confusion, or sudden hearing changes need prompt medical attention.
The county advises anyone who thinks they were exposed but was not notified to watch for symptoms and contact a health care provider. People who are unsure of their two-dose status can ask a clinician and catch up if needed.
Key Questions Answered
How large is the SDSU outbreak? There are 15 cases, 14 confirmed and one probable, as of Sept. 30, up from five on Sept. 18.
Who has been infected? All cases are linked to one athletic team, reported as the football team, plus one associated case.
Were the students vaccinated? County officials told KPBS that all infected people had received two MMR doses.
Who should get a third MMR dose? The county recommends it for close contacts identified during the outbreak.
What are the symptoms? Fever, headache, fatigue, and swollen, tender jaw or cheeks.
How long are people contagious? From about two days before swelling begins until five days after.
Published by Medicaldaily.com
