Effects of Mumps Outbreak in Hospital | CDC EID

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Volume 16, Number 3–March 2010
Research
Effects of Mumps Outbreak in Hospital, Chicago, Illinois, USA, 2006
Amanda L. Bonebrake, Christina Silkaitis, Gaurav Monga, Amy Galat, Jay Anderson, JoEllyn Tiesi Trad, Kenneth Hedley, Nanette Burgess, and Teresa R. Zembower
Author affiliations: University of Illinois at Chicago, Chicago, Illinois, USA (A.L. Bonebrake); University of Chicago Hospitals, Chicago (A.L. Bonebrake); and Northwestern Memorial Hospital, Chicago (C. Silkaitis, G. Monga, A. Galat, J. Anderson, J.T. Trad, K. Hedley, N. Burgess, T.R. Zembower)

Suggested citation for this article

Abstract
In 2006, nearly 6,000 mumps cases were reported in the United States, 795 of which occurred in Illinois. In Chicago, 1 healthcare institution experienced ongoing transmission for 4 weeks. This study examines the outbreak epidemiology and quantifies the financial affect on this organization. This retrospective cohort study was conducted through case and exposure identification, interviews, medical record reviews, and immunologic testing of blood specimens. Nine mumps cases resulted in 339 exposures, 325 (98%) among employees. During initial investigation, 186 (57%) of the exposed employees had evidence of mumps immunity. Physicians made up the largest group of noncompliers (55%) with mumps immunity testing. The cost to the institution was $262,788 or $29,199 per mumps case. The outbreak resulted in substantial staffing and financial challenges for the institution that may have been minimized with readily accessible electronic employee vaccination records and adherence to infection control recommendations.

Mumps, a highly contagious illness caused by a paramyxovirus, causes influenza-like symptoms and salivary gland swelling. Although rare, complications may include encephalitis, meningitis, orchitis, and oophoritis. The virus replicates within the upper respiratory tract and is transmitted through direct contact with respiratory droplets or saliva and through fomites. The incubation period ranges from 12 to 25 days; persons who contract mumps are considered infectious from 3 days before symptoms appear through 9 days after symptoms appear. Although no specific treatment exists, the disease is preventable through use of measles, mumps, rubella (MMR) vaccine usually provided to children ≈1 year of age with a booster dose administered before children start school. Clinical diagnosis is confirmed by laboratory testing that includes culture, serologic analysis, or real-time reverse transcription–PCR (RT-PCR) (1,2).

During January 1–October 7, 2006, 45 states reported 5,783 confirmed or probable cases to the Centers for Disease Control and Prevention (CDC). Six states, including Illinois, were responsible for 84% of reported cases. Mumps is generally more common among unvaccinated children, but nationally this outbreak occurred primarily among college-age persons (3). In Chicago, reported mumps cases began to increase in March 2006. By the end of the year, the Chicago Department of Public Health had 73 confirmed and probable cases. More of these cases were in an older age group (20–29 years) than was nationally observed (4).

Most healthcare worker (HCW) cases were concentrated in 1 hospital, Northwestern Memorial Hospital (NMH), Chicago Illinois, USA, which experienced ongoing transmission during April 23–May 23, 2006. The situation created resource and economic challenges to the organization. We examine the control and effects of this outbreak in a tertiary care center.

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Suggested Citation for this Article
Bonebrake, AL, Silkaitis C, Monga G, Galat A, Anderson J, Trad JT, et al. Effects of mumps outbreak in hospital, Chicago, Illinois, USA, 2006. Emerg Infect Dis [serial on the Internet]. 2010 Mar [date cited]. http://www.cdc.gov/EID/content/16/3/426.htm

DOI: 10.3201/eid1603.090198