Background
Mumps is a disease resulting from infection by the mumps virus. The disease is characterised by swelling of one or both cheeks or sides of the jaw, also known as parotitis, along with:
- fever
- headache
- swollen glands
Mumps infection can also lead to serious complications including:
- aseptic meningitis
- encephalitis
- inflammation of the testes
- pancreatitis
- oophoritis
- permanent deafness
The most effective strategy for preventing the transmission of mumps is vaccination with the measles mumps rubella (MMR) vaccine.
More information on mumps can be found on the NHS inform website.
Guidance
Guidance on mumps: risk in pregnancy, infection in healthcare settings and the MMR vaccine can be found on the Public Health England website.
For all infection prevention and control guidance visit the A-Z pathogens section of the National Infection and Prevention Control Manual.
Data and surveillance
Surveillance update for January to March 2019
Mumps was a common childhood disease before the introduction of the MMR vaccine with more than 85% of adults having evidence of previous mumps infection. Following the introduction of the MMR vaccine in 1988, the incidence of mumps substantially decreased. However, since 2004 there has been ongoing widespread increased incidence of mumps throughout the UK with the number of laboratory confirmed cases peaking in 2005. As shown in Figure 1, smaller outbreaks have occurred in 2009, 2012 and 2014 to 2015. Most of the individuals affected were adolescents and young adults and had not had an opportunity to receive two doses of MMR – they had received one or none at all.
Figure 2 shows that in the last four years, the number of laboratory confirmed mumps cases each year has been variable, ranging from 216 cases in 2016 to 817 in 2015. In late 2014 to 2015 a widespread outbreak occurred which mainly affected those in higher education with many cases having evidence of receiving two doses of MMR vaccine.
The observed increase in cases during this period may represent poor initial immune response to the mumps component of the MMR vaccine, waning immunity or a combination of both within fully and partially vaccinated individuals.
In 2018, there were 280 laboratory confirmed mumps cases, a decrease compared to 2017 in which there were 385 cases reported. From 1 January to 31 March 2019, 156 laboratory confirmed mumps cases were reported. Mumps activity was similar to the same period in previous years where no outbreaks were occurring.
Age distribution of cases
Figure 3 shows that the majority of mumps cases in the past four years have been in those aged between 17 to 34 years, consistent with the age groups which are likely to be under immunised with a mumps containing vaccine.
From January to March 2019 in Figure 4, the incidence of mumps was highest in those in the 17 to 20 year-old age group at 27.8 cases per 100,000, followed by the 21 to 24 year old age group (13.0 cases per 100,000) and the 25 to 34 age group (3.2 cases per 100,000).
Laboratory confirmed cases by NHS boards
Figure 5 shows that the incidence of mumps varied greatly between NHS boards in the first quarter of 2019 with the highest incidence in NHS Orkney (40.6 cases per 100,000) followed by NHS Borders (14.8 cases per 100,000) and NHS Lothian (5.35 cases per 100,000). Note that due to the small population of NHS Orkney, even small increases in cases can lead to large fluctuations in incidence.
Limitations
There are limitations caused by a reliance on laboratory reports as this will represent a considerable underestimate of community circulation of mumps as many cases may be undiagnosed or based on clinical confirmation only. It should also be noted that differences in sampling and testing practices may account for variation across the NHS boards.