WILLMAR -- As an outbreak of mumps spreads across Iowa, local health care providers are stepping up their vigilance for any signs of the disease here.
Local clinics say they're working diligently to ensure that doctors, nurses and urgent care staff are on the alert for potential cases.
The heightened surveillance also includes increased testing on anyone with the swollen salivary glands, fever and earache characteristic of mumps.
Suspected cases will be reported to the Minnesota Department of Health, said Jo DeBruycker of the Health Learning Center at Affiliated Community Medical Centers.
"They're wanting to know all possible cases so they can track it," she said. "We are trying to get a sense of how big this is in Minnesota."
ADVERTISEMENT
The first cases began showing up in Iowa in December. As of April 12, the Iowa Department of Public Health had received 605 reports of suspected or confirmed mumps cases, mostly among young adults.
Additional cases are under investigation in eight neighboring states, including Minnesota.
So far, there have been no confirmed reports locally, said Chery Johnson, assistant nursing director at Kandiyohi County Public Health.
A handful of suspected cases have turned up, however, and they're being investigated, DeBruycker said.
Local providers began gearing up for mumps surveillance more than two weeks ago, after a physician at Affiliated read about the outbreak in Iowa and brought it to the staff's attention, she said.
"This provider was mindful... We started looking at it a little ahead of others," she said.
Johnson said awareness is critical, especially for a disease that seldom occurs.
"We forget what it even looks like. When we don't see it as often, the physicians aren't even thinking of it," she said.
ADVERTISEMENT
Increased travel over the Easter weekend has health providers braced for the possibility that more reports may emerge over the next few weeks.
The incubation period for the mumps virus is generally around 16 to 18 days but can be as long as 25 days.
"A couple weeks from now we still have to have this on our radar screen," DeBruycker said.
Public health officials aren't sure why the Midwest is experiencing a surge in mumps. "Why this is happening is really puzzling people," DeBruycker said.
Vaccination has made the disease far less frequent -- but the vaccine is not 100 percent effective, resulting in a small number of mumps cases in the United States each year. State health officials have said the number of cases being seen in Iowa is consistent with what would normally be seen in a vaccinated population.
The origin of the outbreak in Iowa hasn't been pinpointed, although the genotype is similar to a virus traced to outbreaks in Great Britain and in New York. Nor is it clear whether the cases in neighboring states are connected or are occurring naturally.
Experts aren't sure why so many of the Iowa cases are among the college-age population; one possibility is that the virus spreads more easily among these students because they live in close proximity.
Minnesota public health officials have been urging people to make sure their children are up to date on immunizations. The first dose of the MMR vaccine, which is for measles, mumps and rubella, is recommended for toddlers after their first birthday. A second dose is recommended for children between ages 4 and 6.
ADVERTISEMENT
The state Health Department isn't urging for older adults to be revaccinated, Johnson said. "So far they are sticking with the standing recommendation."
Most Minnesotans over age 65 are probably immune because they have already had mumps, she said.
Symptoms of mumps include swollen glands on one or both sides of the neck alongside the ears, headache, earache and low-grade fever. About 20 percent of people have no symptoms.
Complications are rare, but a small percentage of people can develop meningitis, swelling of the testicles or permanent deafness.
"If you have what you think might be symptoms, you probably should check with your local physician," Johnson said.
Because the virus is spread through respiratory droplets, it's important for people to isolate themselves if they think they are infected, DeBruycker said.
Care consists mainly of symptom relief and waiting for the illness to resolve itself, a process that takes around 10 days.
"There is not a lot you can do other than time. People have to take themselves out of circulation. It's an important thing in this case," DeBruycker said. "Remember that the virus is spread by contact with respiratory secretions. We have to think about people being exposed if they're within three feet."
