Who cares about mumps? You should!

Until the 1970s, mumps was one of the most common pediatric infectious diseases. Childhood mumps, which most often manifested as fever and bilateral par-otitis, was generally not very severe but could result in meningoencephalitis, and in adult men, it could lead to painful or-chitis. Fortunately, this latter complication was generally unilateral and rarely led to decreased fertility [1]. With the advent of a live, attenuated mumps virus vaccine in 1967, there was a very rapid decrease in the number of mumps cases, such that only 266 cases were reported to the Centers for Disease Control and Prevention (CDC) in 2001. Along the way to what seemed like total elimination of the disease, there were occasional resurgences in mumps cases, primarily among teenagers and young adults who had gone through primary school before the mandate for childhood immunization with the trivalent measles, mumps, and rubella (MMR) vaccine. This resurgence was thought to occur primarily among persons who had received an earlier killed virus vaccine preparation or who had not been vaccinated during childhood , either because of family religious beliefs or because the threat was, by that time, deemed to be so minor that vaccination did not seem to be necessary. The unvaccinated population had presumably escaped earlier infection because of herd immunity and the resultant paucity of opportunity for exposure to the wild-type virus. High school and college immunization programs were instituted, and again the incidence of mumps plummeted. However, during the winter-spring of 2006, an outbreak originally involving 219 people occurred in the United States, with its epicenter in Iowa, where, up to that time, the average annual number of reported cases reported was 5 [2]. The outbreak that started in Iowa spread to 45 other states and ultimately involved almost 5800 confi med or probable cases in the subsequent 10 months [3]. Air travel was implicated as an important element in the breadth and rapidity of infection transmission [4]. The strain of mumps virus isolated was found to have the same genotype (genotype G) as that which had caused a major outbreak in the United Kingdom the previous year that had involved ∼56,000 patients, primarily young adults. Complications seen in the 2006 outbreak included 27 reports of orchitis, 11 cases of meningitis, and 4 cases of en-cephalitis, and 4 patients became deaf. As with many " childhood diseases, " the severity is heightened in infected adults. Since 1977, …