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To County Health, Physician, Nurse, Hospital, Laboratorian, and KDHE Health PHIX Users:

KDHE has posted the report "Increase in Number of Suspected Mumps Cases Being Reported - Summary and Laboratory Guidance on Mumps" on PHIX.

The Kansas Department of Health and Environment is receiving an increased number of suspected mumps reports. Iowa, our neighbor to the east, is recording an increase in confirmed and probable mumps cases. Since Jan. 1, 2006, through Mar. 24, 2006, 187 probable and confirmed cases of mumps have been reported. Because clinical diagnosis of mumps may be unreliable, cases of suspected mumps should be laboratory confirmed. A suspected or confirmed case of mumps is reportable to the health department.

Patients presenting with glandular swelling without other apparent cause should be tested for mumps, if suspected. Mumps should not be ruled out in someone who is vaccinated if they have symptoms clinically consistent with mumps.

Mumps clinical description: An illness with acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary gland, lasting > 2 days, and without other apparent cause.

Suspect mumps testing:

1) Isolation of the Mumps Virus: Specimens should be submitted with a completed KDHEL Universal Request Form. Test request forms, specimen collection and shipment instructions can be found at KDHEL Web site at:

http://www.kdheks.gov/labs/downloads/Manual_of_Health_and_Lab_Tests.pdf.

a) Throat swab for viral culture may be collected from date of onset of symptoms to three days after onset of symptoms. Carefully rub the posterior pharynx with a dry, sterile, cotton swab or viral culturette swab. Break off the swab into a tube of VTM or return swab to the culturette holder for the respective collection systems. Specimen must be stored at 4 degrees C pending shipment and shipped with frozen gel packs in an insulated shipper rated for Diagnostic Specimens. Do not freeze specimens and:

b) Urine clean catch collected up to three days post symptom onset, in a screw-cap, sterile container. Ship on the day collected with frozen gel packs in an insulated shipper rated for Diagnostic specimens. Do not freeze specimen.

2) Specimen of choice for typing the virus by PCR: Cerebrospinal Fluid (CSF) collect 1 to 2 ml. of CSF and transfer to a sterile tube and store until shipment at 4 degrees C.

3) Serologic Testing: collect at least 2 ml blood specimen in a red top or serum separator tube (SST) OR 1 to 2 ml serum with a completed KDHEL Universal Request form and ship either a) with culture specimens cold (with frozen gel packs in a shipper rated for Diagnostic Specimens) or, b) at ambient temperature; however if delivery to KDHEL is delayed by more than 24 hours past specimen collection, refrigeration is recommended. Test request forms, instructions for collection and shipment of specimens can be found at the KDHEL Web site at:

http://www.kdheks.gov/labs/downloads/Manual_of_Health_and_Lab_Tests.pdf.

a) Acute IgM serum- should be collected within five days after symptom onset. A second specimen collected 7-14 days after the initial specimen may be requested as needed.

Expected notification of results of specimens submitted:

1. Viral Culture - Approximately two weeks for culture negatives

2. IgM serum - Every reasonable attempt is made to perform IgM serologies that arrive in the Virology Lab before 3:00 p.m. on the day received. IgM test results are normally available 2-3 hours after specimen arrival in the Virology lab.

Disease Prevention Measures:

Vaccinate all susceptible people within the same community. At this time, there are no recommendations for vaccinating infants less than 12 months, who are close contacts of a laboratory confirmed case. Isolate ill people through nine days after the onset of symptoms (this includes the first day of symptoms as day zero, totaling nine days after the onset of symptoms as the period of communicability). Public health authorities will follow up on any reported case of suspected or confirmed mumps, as required by law.

For questions, please contact the Kansas Immunization Program at785-296-5591.