An outbreak of mumps in Thiruvananthapuram district.

Kerala State has established surveillance of diseases of public health importance using the model of 'district level disease surveillance' (DLDS) developed in the North Arcot district in Tamil Nadu(1). Physicians of both public and private sector health care facilities report 15 notified disease and other disseases at their discretion, through a pre-formatted, self-addressed business reply post card. The card also contains space to enter the basic demographic information and place of residence of all persons with reported illnesses. Space is also provided on the card to enter the date of onset of disease and the date of reporting. The disease reports are received in the office of the District Medical Officer (Health) on all working days. Each card is scrutinized and all data are captured in pre-formed tables, for analysis. Thiruvanantha-puram, the southern-most district in Kerala commenced DLDS on January 1, 2002 and the adjacent district of Kollam started it in June 2002. During January, February and March we received a large number of reports of mumps in Thiruvananthapuram district, clearly indicating the occurrence of an outbreak. Cases were from all parts of the district. Anecdotally there was information of mumps outbreak in the southern parts of Kollam, but DLDS had not been initiated in that district at this time. The diagnosis made by the pediatricians and physicians was accepted since mumps is relatively easy to diagnose based on clinical features of actue parotitis, unilateral or bilateral. The epidemic curve is presented in Fig 1, with the beginning of the outbreak in the last week of January, the peak in the second week of February, and the last cases in the third week of March. The age distribution of cases is presented in Fig 2. There was no case below 1 year but there were 52 cases between 1 and 5 years, 29 in boys and 23 in girls. The largest number was in the year-group of 5 to 9, with 98 cases, 54 in boys and 44 in girls. In the age group of 10-14 years there were 25 cases, 15 in boys and 10 in girls. There were very few cases beyond 14 years: one boy and 3 girls 15-19 years old had mumps. Two women in their 20's and one woman in her 30's had mumps and the oldest subject with the disease was a man 42 years old. Age was not recorded for one male and …