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Published Date: 2019-08-01 21:53:53
Subject: PRO/AH/EDR> Mumps update (10): USA (TX) outbreak update
Archive Number: 20190801.6601222
MUMPS UPDATE (10): USA (TEXAS) OUTBREAK UPDATE
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 30 Jul 2019
Source: Precision Vaccinations [edited]
https://www.precisionvaccinations.com/ice-says-they-quarantine-people-exposed-mumps-and-offer-related-vaccines


About 100 new mumps cases have been identified in Texas immigrant-holding facilities in the last 5 weeks, according to reporting by News 88.7 in Houston, Texas.

According to this Houston Public Media report on 29 Jul 2019, the new mumps cases include all federal facilities that hold immigrants, including Immigration and Customs Enforcement (ICE), Customs and Border Protection, and shelters that hold unaccompanied migrant children.

"To have this many cases concentrated in this relatively small population is distinctly unusual in the United States," said Dr. Jody Rich, professor of Medicine and Epidemiology at Brown University and a volunteer with Physicians for Human Rights. "We should be vaccinating all at-risk people as early as possible, particularly if we are about to confine them in a closed space with a bunch of other unvaccinated people in the setting of an outbreak."

This mumps virus information was gathered through the Freedom of Information Act and confirmed mumps cases in at least 16 different detention facilities in Texas.

Previously, on 14 Jun 2019, federal authorities confirmed about 4276 individuals were in medical quarantine in 39 immigrant detention centers related to large numbers of mumps and chicken pox cases.

Some of these mumps cases may have originated from countries such as Honduras, which announced significant mumps outbreaks during 2018.

"From an operational perspective, the impact is significant in the short and long term and will result in an increase in cohort detainees' length of stay in detention, an inability to effect removal of eligible detainees, and postponing scheduled consular interviews," said Nathalie Asher, executive associate director for ICE Enforcement and Removal Operations (ERO).

"Preventing the spread of communicable diseases while in ICE custody is something we have demonstrated success doing," Asher previously said.

Routine vaccination of US-bound refugees before travel to the United States is not legally required. However, routine vaccinations are strongly recommended and offered overseas to protect the health, prevent travel delays due to disease outbreaks, and, for children, allow more rapid integration into schools after arrival in the United States.

The CDC vaccination schedule is modified periodically (May 2019) based on changing Advisory Committee on Immunization Practices recommendations, logistics, or availability.

Unfortunately, these are not the only mumps cases being reported in Texas during 2019.

The Texas Department of State Health Services (DSHS) confirmed as of [Thu 1 Jul 2019] that there have been 385 total mumps cases during 2019.

Due to a high vaccination rate in Texas, the number of mumps cases has been traditionally low, says DSHS. In 2017, only 470 cases of mumps were reported in Texas.

As an example of Texas being a proactive vaccination state, DSHS launched Operation Lone Star for its 21st year in July 2019.

In 2018, DSHS and partners delivered approximately 43 000 health services and vaccinations to 9346 people in southern Texas during this event.

According to the Centers for Disease Control and Prevention (CDC), there is a recurring mumps risk related to vaccine effectiveness "waning." According to a Harvard study in 2018, the measles-mumps-rubella (MMR) vaccine-derived immune protection against mumps persists, on average, for just 27 years after the last-administered vaccine dose.

In response to this information, the CDC released new guidance suggesting when a 3rd dose of mumps vaccine is appropriate to administer.

Nationwide, from January [2019] to 19 Jul 2019, there have been 45 states and the District of Columbia reporting mumps infections in 1799 people, which is actually good news compared to previous years.

From January 2016 to June 2017, health departments reported 9200 mumps cases, including outbreaks at schools, universities, athletics teams and facilities, church groups, workplaces, and large events.

The mumps virus is easily spread by droplets of saliva or mucus from the mouth, nose, or throat of an infected person, usually when the person coughs, sneezes, or talks.

CDC officials say that "it's never too late to be immunized." In the USA, there are 2 approved mumps vaccines, MMR-II and ProQuad.

[Byline: Don Ward Hackett]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Outbreaks of mumps in immigrant-holding facilities is not new information. The ProMED-mail post of 6 Jun 2019 reported nearly 300 confirmed cases of mumps in ICE facilities and other immigration detention centers across the country, with the most cases concentrated in Texas, Mississippi, Arizona, and Georgia. Mumps virus transmission continues in Texas and likely in other states as individuals are held in close confinement under conditions that facilitate transmission of the virus. Dr. Jody Rich's advice to vaccinate all at-risk people as early as possible, particularly if we are about to confine them in a closed space with a bunch of other unvaccinated people in the setting of an outbreak, is prudent and good preventive medicine practice.

In the previous Mumps update (Mumps update: (09): USA (FL) quarantine; archive no. 20190609.6508541), Mod.UBA commented, "Mumps is a viral illness caused by a paramyxovirus, a member of the Rubulavirus family. The average incubation period for mumps is 16-18 days, with a range of 12-25 days. The mumps virus replicates in the upper respiratory tract and is transmitted person-to-person through direct contact with saliva or respiratory droplets of a person infected with mumps. The risk of spreading the virus increases the longer and the closer the contact a person has with someone who has mumps. The infectious period is considered from 2 days before to 5 days after parotitis onset, although virus has been isolated from saliva as early as 7 days prior to and up to 9 days after parotitis onset. Mumps virus has also been isolated up to 14 days in urine and semen.

"When people are ill with mumps, they should avoid contact with others from the time of diagnosis until 5 days after the onset of parotitis by staying home from work or school and staying in a separate room, if possible (https://www.cdc.gov/mumps/hcp.html).

"If not strict quarantine, the suspected mumps cases should, prior to testing, be isolated/confined to separate living areas with hand hygiene and social distancing during the infectious period, since the high concentration of people in the camps can potentially result in outbreaks. - Mod.UBA]"

- Mod.TY

HealthMap/ProMED-mail map:
Texas, United States: http://healthmap.org/promed/p/245]

See Also

Mumps update (09): USA (FL) quarantine 20190609.6508541
Mumps update (08): USA (CO, TX), Asia (Malaysia) 20190526.6487675
Mumps update (07): Europe (Ireland), USA (IN, PA, UT) 20190420.6429994
Mumps update (06): USA (PA) outbreak update 20190330.6394589
Mumps update (05): UK (England) USA (PA) university 20190327.6384687
Mumps update (04): USA (PA) outbreak 20190321.6379783
Mumps update (03): USA (PA, TX), Europe (Ireland) 20190305.6350670
Mumps update (02): USA (CO, TX), Europe (Ireland) 20190221.63294342018
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