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Mumps

General information


Mumps is an acute viral illness transmitted by direct contact with saliva or droplets from the saliva of an infected person.
  
Symptoms begin with a headache and fever for a day or two before the disease is characterised by swelling of the parotid glands which may be unilateral (one side) or bilateral (both sides). However, at least 30% of cases in children have no symptoms.
  
Child with mumpsComplications of symptomatic mumps include swelling of the ovaries (oophoritis), swelling of the testes (orchitis), aseptic meningitis and deafness. Cases may have no salivary gland involvement but develop symptoms elsewhere (orchitis, meningitis). Despite common belief there is no firm evidence that orchitis causes sterility, although the affected testis may shrink in size. 
 
Other symptoms may include pancreatitis, neuritis, arthritis, mastitis, nephritis, thyroiditis and pericarditis. Mumps was the commonest cause of viral meningitis in children prior to 1988, when vaccination was introduced.
 
There is no treatment but mumps infection can be prevented by the measles-mump-rubella (MMR) immunisation.
 
Mumps is one of a number of notifiable diseases in the UK. Any doctor who suspects that a patient has measles is required by law to report it.
 
More information about mumps is available from the following websites:

Epidemiology


Mumps incidence peaks in winter and spring but has been reported throughout the year. Mumps was the cause of about 1200 hospital admissions each year in England and Wales before the introduction of MMR in 1988.
  
Mumps was made a notifiable disease in the UK in October 1988. Notified cases of mumps in England and Wales remained fairly stable at low levels from 1995 to 1999, with fewer than 2000 notifications recorded annually, rising from 1691 in 1999 to 2162 in 2000, of which only 703 were confirmed.
 
A large increase in both notifications and laboratory confirmed cases in England and Wales was observed in 2003 (1541 confirmed cases) which continued into 2004 (8129 confirmed cases) and peaked in 2005 at 43,378 confirmed cases. There were 4420 confirmed cases in 2006 and 1476 confirmed cases in 2007. An increase in mumps confirmations in England and Wales to 2405 was recorded during 2008 and 7662 in 2009 although confirmations decreased in 2010 (3965) and 2011 (provisionally 2465). 
 
Nearly 90% of confirmed cases in 2005 were in people between 15 and 24 years. This age group either never received any MMR vaccine as they were too old when it was introduced, or received only one dose.
 
In Wales, the same trend has been observed, with a large rise in confirmed cases starting in 2003 (455), rising to 808 in 2004 and peaking in 2005 at 3757 confirmations with those aged between 15-24 years accounting for over 93% of cases. As a result, the NPHS in conjunction with the Welsh Assembly Government, established a Wales-wide MMR catch-up campaign aimed at people born between 1 January 1980 and 31 August 1994 and who may have missed out on full immunisation against mumps. Over 60,000 doses were given to young people as part of the campaign.
 
 
In 2007, there were 14 confirmed cases but an increase in mumps confirmations was seen in 2008 with 55 confirmed cases and in 2009 with 363 confirmed cases; two thirds of these cases were in individuals aged between 15-24 years old. There were 85 confirmed cases recorded for 2010, 75 during 2011 and 88 for 2012.
 
    

Mumps in Wales: 1996-2012


Number of confirmed cases of mumps, notifications and rate of confirmed mumps per 100,000 population in Wales from 1996-2012
 
 mumps: Rate of confirmations and notifications in Wales 1996-2012
 
Source: Health Protection Agency, May 2013 http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733841496
 
   
Number of confirmed mumps cases, notifications and rate per 100,000 in Wales: 1996-2013*
Year
Number of laboratory-confirmed cases
Rate of confirmed mumps per 100,000 population
Number of notifications
Rate of notified mumps per 100,000 population
1996
1
0.03
69
2.4
1997
10
0.4
74
2.6
1998
3
0.1
68
2.4
1999
2
0.07
53
1.8
2000
9
0.3
51
1.8
2001
53
1.8
65
2.2
2002
106
3.6
166
5.7
2003
455
15.5
1002
34.2
2004
808
27.4
1737
59.0
2005
3757
127.2
5503
186.3
2006
292
9.9
913
30.8
2007
14
0.5
302
0.5
2008
55
1.8
334
11.2
2009
363
12.1
853
28.4
2010
85
2.8
367
12.2

2011

77

2.6

402

13.4

2012

88

2.9

360

12.0
2013* 76 2.5 152 5.1
* data for 2013 until 31 March 2013
 
Confirmed cases of mumps in Wales by age 1996-2013*
  
 
Age in years
Year
<1
01-04
05-09
10-14
15-19
20-24
25-29
30-34
>=35
Not known
Total
1996
0
1
0
0
0
0
0
0
0
0
1
1997
0
1
1
2
0
0
0
1
4
1
10
1998
0
0
2
0
0
0
0
0
1
0
3
1999
0
0
0
1
0
0
0
0
1
0
2
2000
0
0
0
4
2
0
1
0
2
0
9
2001
0
0
3
17
18
3
0
2
8
2
53
2002
0
1
3
51
34
9
1
1
6
0
106
2003
0
7
21
114
255
49
11
4
16
2
455
2004
1
12
23
105
413
169
29
19
19
18
808
2005
0
10
31
100
2383
1124
32
21
49
7
3757
2006
0
1
7
29
120
83
11
10
27
4
292
2007
0
0
2
0
2
4
1
0
5
0
14
2008
0
2
1
1
17
20
7
1
6
0
55
2009
0
6
12
20
105
136
33
10
40
1
363

2010

0

3

1

3

20

26

14

3

14

1

85

2011

0

3

3

2

18

28

6

6

11

0

77

2012

0

0

2

4

27

29

10

3

13

0

88

2013* 0 2 5 2 16 30 14 2 5 0 76
* data for 2013 until 31 March 2013
 

Sources of surveillance data for Wales


Mumps is a notifiable disease. Notifications of suspected mumps cases in Wales are compiled into a monthly notifications report by CDSC Wales. 
 
Before 2011, these data were compiled into the statutory weekly Statutory Notifications of Infectious Diseases (NOIDs) report by the Health Protection Agency (HPA) Centre for Infections (now known as Public Health England) in Colindale, North London. The NOIDS reports are available to download from the HPA website. Since July 2010 the proper officers in Wales are obliged to disclose notifications made to them to Public Health Wales NHS Trust instead of NOIDS although in practice, many notifications in Wales are still also passed to NOIDS for completeness. 
 
Oral fluid samples are requested from all patients in Wales (and England) with suspected mumps if confirmation hasn't been obtained by other means (i.e. a hospital blood test if the patient is an in-patient). Samples are sent to the HPA Immunisation and Diagnosis Unit in Colindale for confirmation of mumps infection. The HPA are responsible for collating data and reporting the numbers of confirmed cases of mumps for Wales and England.
 
These are the data that are used to produce the trends graph and accompanying data tables on this website.
 
It should be noted that the HPA temporarily limited mumps oral fluid testing in 2005 in those born between 1981 and 1986. This was because it was thought likely that virtually all cases in this age group would be genuine mumps cases during this time. As a result of this the number of laboratory confirmed cases for 15-24 year olds would be artificially low. For the purpose of reporting, all notified cases of mumps in this 15-24 year old age group during 2005 are counted as confirmed. Oral fluid testing of this age group recommenced in January 2006.
 

GP surveillance of mumps in Wales 


A volunteer sample of 42 general practices in Wales (covering over 10% of the population of Wales) have reported cases of measles, mumps, rubella, shingles, chicken pox, pneumonia and influenza each week by paper form to CDSC Wales since 1986.
 
Data items are: age, sex, disease, practice, year and week. Data is analysed by time, person, place and feedback is by weekly news-sheet to participating practices and public health professionals in Wales and Europe. Rates are presented as cases per 100 000 practice population.
 
Public Health Wales has been working with the NHS Wales Informatics Service’s Primary Care Informatics Programme to automate the surveillance scheme and make it easier for participating practices.  The new scheme uses the ‘Data Quality System’. This software, sponsored by Welsh Assembly Government and endorsed by GPC Wales, has a general practice based module, ‘Audit +’, and a central web-based repository of anonymous aggregated data that will support public health surveillance. This central repository, ‘AuditWeb’, is hosted at NHS Wales Informatics Service (NWIS). A core Audit+ module allows for transfer of data on cases of certain diseases as anonymised aggregated data. This process is scheduled to take place overnight outside of practice working hours and is fully automated. As is the case of all modules reporting to Audit Web, no personal identifiable information is extracted.
 
Since week 40 2010 (week ending 10 October), the sentinel GP practices are reporting data collected using the automated data collection system Audit+.
Data for mumps consultations in Wales from the GP sentinel surveillance scheme is illustrated in the figure below. This graph clearly reflects the epidemiological trends decsribe in the 'Epidemiology' section further up this page.
 
Weekly mumps consultations in Wales from GP surveillance scheme: 1987-2012
The latest GP surveillance newsletter can be viewed from the link: GP Surveillance Newsletter
 

Immunisation against mumps


Mumps can be prevented by the MMR immunisation with a first dose at 12-15 months and a second dose (booster) at 3-5 years.
 
Additionally, young adults and teenagers born 1980 or later who may have missed out on MMR vaccination as children are also encouraged to get immunised. A complete course of the two doses will protect over 95% of children against measles, mumps and rubella. The introduction of MMR vaccine in 1988 effectively halted the three yearly cycles of mumps epidemics.
 
The uptake of MMR (and other childhood) vaccination in Wales is recorded in the COVER (Coverage of Vaccination Evaluation Rapidly) report. This is published on both a quarterly and annual basis.  Quarterly trend reports for each LHB and GP practice-based reports are also published. Use the links below to access all COVER reports from 2003-2008.
 
The uptake of MMR (and other childhood) vaccination in Wales is recorded in the COVER (Coverage of Vaccination Evaluation Rapidly) report. This is published on both a quarterly and annual basis.  Use the link below to access all COVER reports from 2003 onwards.
A complete course of the two doses will protect over 95% of children against measles, mumps and rubella. The introduction of MMR vaccine in 1988 effectively halted the three yearly cycles of mumps epidemics.
 
The MMR vaccine has been used for nearly 40 years (it was introduced in the US in the 1970s), is currently used in over 100 countries, and more than 500 million doses have been given. Studies from around the world have shown MMR to be a highly effective vaccine, with an excellent safety record.The MMR vaccine is essential in preventing illnesses that have a real potential to cause damage to those infected.
 
More information about the MMR vaccine is available from the NHS Choices website.
   

Requests for further surveillance data


If further surveillance data for measles in Wales is required, it may be possible to provide it on special request. Please use the surveillance data request form  provided from this link.
 

Links to other mumps surveillance


 


Last updated: 17/05/2013