Mumps—Child Care and Schools

What are the signs or symptoms?

• Swollen glands in front of and below the ear or under the jaw (no swelling or symptoms in one-third of infections).

• Fever.

• Headache.

• Earache.

• In teenaged boys, painful swelling of the testicles may occur. Girls may have swelling of the ovaries, which may cause abdominal pain.

• Complications include meningitis, deafness (usually permanent), glomerulonephritis (kidney inflammation), and inflammation of joints.

What are the incubation and contagious periods?

• Incubation period: Usually 16 to 18 days but may be up to 12 to 25 days after exposure

• Contagious period: From several days before to 5 days after onset of swelling of glands

How is it spread?

• Respiratory (droplet) route: Contact with large droplets that form when a child talks, coughs, or sneezes. These droplets can land on or be rubbed into the eyes, nose, or mouth. The droplets do not stay in the air; they usually travel no more than 3 feet and fall onto the ground.

• Contact with the respiratory secretions from or objects contaminated by children who carry the mumps virus.

How do you control it?

• Mumps is a vaccine-preventable infection. Immunize according to the current schedule—when a child is 12 to 15 months of age and with a second dose at 4 to 6 years of age.

• Review immunization status of all children.

• Unlike some infections, such as measles, mumps vaccine given after an unimmunized child is already exposed to mumps has not been shown to prevent infection. However, vaccinating nonimmune contacts of a child with mumps may prevent ongoing transmission and stop a possible outbreak.

What are the roles of the teacher/caregiver and the family?

• Report the infection to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts possibly exposed family and staff members and parents of unimmunized children to watch for symptoms and notifies the health consultant.

• Report the infection to the local health department. If the health professional who makes the diagnosis does not inform the local health department that the infected child is a participant in a child care program or school, this could delay controlling the spread.

• Refer to the individual's health professional and involve the health consultant to provide education to staff members and families.

• Ensure up-to-date immunization of children, staff members, volunteers, and family members, according to the current immunization schedule.

Exclude from group setting?

Yes.

• Mumps is a highly communicable illness for which routine exclusion of infected children is warranted.

• Exclusion of unimmunized children may be considered in consultation with local public health authorities. If unimmunized, exposed children are excluded for this reason, they may be readmitted on receiving mumps immunization. If they remain unimmunized, they should be excluded until at least 26 days after onset of swelling in the last case.

Readmit to group setting?

Yes, when all the following criteria have been met:

• Five days after onset of swelling

• When the child is able to participate and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group

Comment

Most cases of mumps now occur in young adults.