Controlling Spread of Mumps

Table of Contents

This section provides detailed control guidelines that are an integral part of case investigation.

A. Minimum Period of Isolation of Patient

Exclude patients from school or work for 5 days after onset of illness (this includes the first day of illness)

B. Protection of contacts to a case (includes outbreak situations)

Identify and immunize susceptible people within the same community.  Susceptible persons are defined as those who have not had two MMRs or MMRVs.  Note: mumps (MMR or MMRV) vaccination will not prevent infection in a person who has been recently exposed, but vaccinating may prevent future outbreaks.

Case: Exclude from work or school for 5 days after onset of symptoms (this includes the first day of illness). The suspect case may return to normal activities on the 6th day or once symptoms have resolved, whichever is later.

Contacts: All contacts should be evaluated for vaccination status.  If a person does not have 2 doses, refer for vaccination.  If person has a contraindication or refuses vaccination, educate on personal protective measures and symptoms of mumps.  Contacts may continue normal activities in the absence of symptoms.  Note: mumps (MMR or MMRV) vaccination will not prevent infection in a person who has been recently exposed, but vaccinating may prevent future outbreaks.

Conduct active surveillance for mumps for 2 incubation periods (50 days) after onset of the last case.

Mumps vaccine, preferably MMR or MMRV, should be administered to all susceptible persons.  As with any vaccine, there will be some individuals who will not gain immunity after the receipt of the mumps vaccine.  Because effectiveness is not 100%, a second dose of mumps-containing vaccine is recommended for individuals who have previously received only one dose.

Furthermore, birth before 1957 does not guarantee mumps immunity;  mumps vaccine should be considered for those born before 1957, especially in outbreak situations. 

C. Managing Mumps in Healthcare Settings

Proof of immunity: Birth in the U.S. before 1957 does not guarantee mumps immunity. Therefore, all healthcare workers should have documentation of at least one dose, preferably two doses, of mumps-containing vaccine on or after the first birthday or serologic proof of immunity. An effective routine MMR or MMRV vaccination program for healthcare workers (in addition to standard precautions) is the best approach to prevent nosocomial transmission.

Isolation of patients:

  • Patients should be placed on Droplet Precautions for the duration of their hospitalization.
  • Unusual circumstances may need consultation with the Iowa Department of Public Health.

Exposed susceptible patients should be placed on Droplet Precautions from the 12th day after the earliest exposure through the 26th day after the last exposure. They may be taken off precautions on the 27th day.

Exclusion of staff:

  • Personnel who become sick should be excluded from work at least 5 days after the onset of symptoms (this includes the first day of illness) or until symptoms resolve, whichever is later. These staff should be excluded from high-risk (i.e. patient’s requiring a protective environment such as cancer unit, burn unit, bone marrow recipients, special-care nursery) patient contact at least 9 days after the onset of symptoms (counting the day of symptom onset as day zero) or until symptoms resolve, whichever is later.
  • Personnel who have been exposed to a mumps case and are susceptible (have no serological evidence of immunity) should be vaccinated and should remain home from the 12th day after the 1st exposure through the 26th day after their last exposure.  Consult with IDPH for special situations.
  • Note: All new staff should be assessed for mumps immunity.

Surveillance: Conduct active surveillance for mumps for 2 incubation periods (50 days) after onset of the last case.

D. Preventive Measures

Personal Preventive Measures/Education

Vaccination with MMR or MMRV of all susceptibles is the best preventive measure against mumps.  Susceptibles are defined as anyone who has not had 2 doses of MMR or MMRV.  Good personal hygiene (which consists of proper hand hygiene, disposal of used tissues, not sharing eating utensils, etc.) is also important.  For more information on the measles, mumps and rubella vaccine, see the ACIP vaccine information statement.

Iowa Dept. of Public Health, Revised  7/15