Auckland Regional Public Health Service

Cornwall Complex, Floor 2, Building 15

Greenlane Clinical Centre, Auckland
Private Bag 92 605, Symonds Street,
Auckland 1150, New Zealand
Tel: 09 623 4600 Fax: 09 623 4633
Website: www.arphs.govt.nz

MUMPS – HEALTH PROFESSIONAL ALERT

6th October 2016

IMPORTANT NOTICE: MUMPS CASES IN THE AUCKLAND REGION

There have been three confirmed cases of mumps notified in the Auckland Region since mid-September
2016. PLEASE:

1. Notify ALL SUSPECTED CASES of mumps to Auckland Regional Public Health Service (ARPHS) by phone
on 09 623 4600.

ARPHS will:

a. Follow up all cases of mumps

b. Follow up all household contacts

c. Follow up other contacts (e.g. school, work etc. and work with you on waiting room contacts)

d. Continue to liaise with institutions e.g. schools.

e. Prioritise follow up of high risk contacts

f. Provide updates and media releases as appropriate.

2. Isolate suspect cases immediately preferably before they enter the waiting room. Advise ongoing
isolation until lab results are known.

3. Arrange appropriate lab testing for suspect cases. PCR is preferred if within 9 days of facial swelling
onset.

4. Check and administer MMR immunisation opportunistically for all patients born after 1 January 1982
and for those travelling overseas.

5. Ensure all of your staff are immune.

Auckland outbreak case summary

1. Three confirmed cases of mumps have been notified in Auckland since mid-September 2016. Two of
these cases acquired mumps from an overseas visitor. The third case contacted mumps from one of the
original two cases while sharing a school classroom.

2. Mumps continues to circulate overseas which creates a risk for non-immune travellers.
 Auckland Regional Public Health Service
Cornwall Complex, Floor 2, Building 15
Greenlane Clinical Centre, Auckland
Private Bag 92 605, Symonds Street,
Auckland 1150, New Zealand
Tel: 09 623 4600 Fax: 09 623 4633
Website: www.arphs.govt.nz

Frequently Asked Questions for Health Professionals

1. What has changed?

Nothing, ARPHS and the DHBs remain normally managing mumps cases and their contacts – our aim is to
quickly contain all mumps cases and their susceptible contacts to avoid community transmission.

2. How do I manage a suspected case of mumps?

Isolate the case until 5 days from the start of facial swelling.

High quality practice infection control measures should be used when dealing with suspect mumps cases.
High quality infection control in this case means good hand hygiene. It does not mean utilising masks, gowns
or gloves unless there is uncertainty around the mumps immune status of the health professional
performing the assessment.

Notify on suspicion

 Please call 09 623 4600. This is a 24 hour service.

 ARPHS needs the following information:

1. Your details: Name, treating doctor’s name, contact number (in case more information is
needed)

2. Case details: Name, address, contact number, age, ethnicity, NHI

3. Clinical history: Date of onset of swelling, hospitalisation date (if occurred)

4. Any laboratory test(s) arranged

5. Immunisation status: Include dates of mumps immunisations if available (usually MMR)

6. Is the patient linked to other notified patients, and if so the name(s)

7. Early childhood centres or schools the patient attends

 If the notifying doctor is not the patient’s normal GP, then the normal GP should be notified as
soon as practical.
 Auckland Regional Public Health Service
Cornwall Complex, Floor 2, Building 15
Greenlane Clinical Centre, Auckland
Private Bag 92 605, Symonds Street,
Auckland 1150, New Zealand
Tel: 09 623 4600 Fax: 09 623 4633
Website: www.arphs.govt.nz

3. What laboratory tests do I order now?

 Laboratory testing is recommended for all suspected cases. Investigation using a red viral buccal
swab for PCR is preferred

 Serology for mumps is more difficult to interpret, particularly early in the illness when public health
control needs to commence.

 If laboratory tests are requested, it is the responsibility of the requesting clinician to follow-up the
results and inform the patient.

4. What do I tell a patient with suspect mumps?

Tell them that you will notify ARPHS and discuss symptoms and next steps. Most suspect cases will be
advised isolation (see below) while lab results are awaited. Confirmed cases, or those APRHS think are likely
after discussion with the notifying doctor will be contacted by ARPHS to:

 Advise isolation for five days after the onset of facial swelling. If they are in the prodrome, i.e. no
swelling yet, but contact of mumps with fever and respiratory symptom(s), then the isolation period
starts immediately and will be longer, ending five days after onset of facial swelling (as above). If
there is no swelling, and the prodrome is longer than 4 days, consider other diagnoses.

For contact and general queries, front line health professionals should provide patients and contacts with
advice as necessary, and direct them to www.arphs.govt.nz/health-information/communicable-
disease/mumps. Factsheets for health professionals, institutions and the public are also available from the
ARPHS website.

5. What do I do if someone presents and asks for a MMR?

 If patients were born after 1 January 1982 and do not have documented previous mumps or two
doses of mumps containing vaccine, then offer MMR vaccination.

 The groups who are most likely to be under-vaccinated are:

o Infants under 15 months

o Teenagers and young adults (10 – 30 years old).

o Overseas born people who may only have had one mumps containing vaccine, or had
mumps containing vaccine <12 months old.
 Auckland Regional Public Health Service
Cornwall Complex, Floor 2, Building 15
Greenlane Clinical Centre, Auckland
Private Bag 92 605, Symonds Street,
Auckland 1150, New Zealand
Tel: 09 623 4600 Fax: 09 623 4633
Website: www.arphs.govt.nz

 Encourage vaccination for caregivers born after 1 January 1982 who care for infants.

 Enquire if there is any possibility of pregnancy before administering MMR to woman of childbearing
age. MMR should not be given in pregnancy.

 If MMR is administered, advise to avoid pregnancy for four weeks following.

 If a parent presents to you asking that their child is vaccinated before 15 months:

o Immunisation of children under 15 months of age is not routinely recommended.

o However if children are at high risk of being in contact (e.g. if they have siblings or friends
who have been exposed to mumps), then offering an MMR between 12-15 months is
reasonable.

o Discuss with ARPHS if in doubt.

6. How do I make sure my staff are protected?

 Continue proactive immunisation actions for your staff.

 All staff born after 1 January 1982 who have not had two doses of mumps containing vaccine, or
who are unsure of their immunity, should be offered two doses of MMR vaccine 28 days apart.

7. Where do I get more information?

 ARPHS

 Ministry of Health

 Immunisation Advisory Centre

o 0800 IMMUNE (0800 466 863) or www.immune.org.nz

 Healthline

o 0800 611 116

 Healthpoint

o www.healthpoint.co.nz