An unvaccinated student at Forest Hill Collegiate has been confirmed with a case of mumps. Ashley Carter reports on Toronto public health’s and the TDSB’s reaction.
I’ve been vaccinated so why did I get the mumps? If I got the mumps, am I immune forever? How can an entire NHL team get sick with the virus?
A resurfacing mumps outbreak that’s making its way through university campuses, hockey teams, and bars across the country is leaving Canadians with many burning questions.
“We’ve seen several outbreaks over the past five years. This shouldn’t be happening. There should be fewer outbreaks and the outbreaks shouldn’t be as big,” Dr. Isaac Bogoch, a tropical infectious disease specialist at Toronto General Hospital and the University of Toronto, said.
“Mumps isn’t going away and unlike something like the measles, where we can predict where it’s going to happen, mumps can crop up and happen at any time. The best thing to do is keep yourself protected,” Jason Tetro, a Canadian microbiologist and author of The Germ Files, advised.
Tetro, Bogoch, Dr. Gerald Evans, chief of infectious diseases at Kingston General Hospital, answered your most common questions about the mumps outbreak.
Question: I already got the mumps. Could I get it again?
Answer: No, the experts say.
“If you get natural mumps, say, when you’re a little kid, there seems to be natural immunity. It’s not the way you want to get immunity, but it’s probably lifelong,” Evans said.
If you’re around age 56 or older, it’s just assumed you may have already come across the mumps and are immune, Bogoch said.
Question: I got vaccinated but I still got the mumps. What happened?
The mumps is likely one of the viruses with the highest vaccination rates, according to the experts. In Canada, it’s built into the MMRV vaccine that’s doled out to children to protect against measles, mumps, the chicken pox and rubella.
While it’s incredibly potent in shielding against measles and chicken pox, it’s efficacy is about 80 per cent for one dose and 88 per cent for two doses when it comes to mumps.
This leaves you with a small window of risk of getting sick.
“Vaccines aren’t perfect but they are really, really good. Two doses offer about 90 per cent protection. That’s a reduced risk so you’re very, very unlikely to get infected but it’s not impossible,” Bogoch said.
“But I can look you in the eye and say with confidence that two doses will protect 90 per cent of people from the mumps,” he said.
So even though you may have gotten two doses, your coverage isn’t 100 per cent. To top it off, by adulthood vaccine efficacy seems to wane. In as a little as a few years, you can lose upwards of 25 to 30 per cent of efficacy and within 10 years, you might lose upwards of 85 per cent of efficacy.
You should get the shot anyway: it offers the best protection and if you end up with the virus, the vaccine reduces the severity of infection.
Is a certain group more vulnerable?
There’s a reason why the mumps outbreak is striking at university campuses, downtown Toronto bars and hockey teams – a certain age group is most susceptible.
People born between 1970 and 1992 appear to be at most risk. That’s because it was during this time frame that health officials administered only one dose of the vaccine instead of two. Returning to a second dose under provincial vaccine structures wasn’t re-introduced until the early 1990s.
“People who are falling sick now are young adults in their 20s and 30s and represent a cohort of people who got only one shot at age one. If I were a five or seven-year-old right now, I wouldn’t be worried at all,” Evans explained.
This is why health officials are calling on this group to visit their family doctors to make sure their vaccination records are up to date. If you hadn’t received a second shot of the MMRV shot, now’s the time to roll up your sleeve for that added protection, the experts say.
“If I were you I would be getting a second shot,” Evans told Global News.
Right now, Canadian kids traditionally get their first dose of MMRV at around 12 months old and again at the four to five age range.
Question: How did an entire NHL team get sick, too?
Five Vancouver Canucks players are grappling with symptoms of mumps – they even missed games as they dealt with their illnesses. Keep in mind, in 2014 the outbreak struck 12 NHL players from Sidney Crosby, Corey Perry to Ryan Suter.
(Crosby, born in 1987, likely received only a single shot of the MMRV vaccine. He got his top up before heading to the Winter Olympics in Sochi.)
It makes sense, the experts say. Mumps is highly contagious, just like the chicken pox or the measles.
There’s a reason why some infectious diseases spread like wildfire through sports teams, cruise ships, daycares and old age homes, for example.
It’s all about being within close proximity of people shedding the virus or sharing items with them.
“This is why you start seeing it on hockey teams. I don’t know if you’ve ever seen what happens in a hockey game but there’s spitting and snorting and you see the splash of fluids and you don’t know what it’s supposed to be,” Tetro said.
“There’s a lot of sharing going on. It’s not romantic but it’s still bodily fluids making the rounds,” Tetro explained.
The same goes for bars, university campuses and military barracks, where outbreaks have spread.
“It’s the perfect environment for droplets of germs and saliva. You share drinks or utensils, you’re kissing or you’re sneezing. You’re in close contact in a closed environment,” Evans said.
What is mumps and what are the symptoms?
For starters, mumps is a viral infection, but it’s mostly preventable with the help of vaccines.
It has an incubation period of about two weeks and about a third of people who get infected with the virus don’t even show symptoms. You could be shedding the virus for up to three days without even knowing you’re sick.
But once the illness ramps up, the symptoms will kick in. You’ll encounter a fever, headache or earache, tiredness, sore muscles, dry mouth, trouble talking, chewing or swallowing and a loss of appetite.
And then there’s the trademark puffy cheeks and neck that comes with mumps as it seeps into the salivary glands. This is known as parotitis.
“That’s the hallmark chipmunk cheeks we associate with the mumps,” Tetro explained.
It gets into your lymph ducts and can spread to the testicles in men, the pancreas and the ovaries for women, Tetro warned.
For most people, mumps will run its course in about seven to 10 days but in rare cases it’ll cause complications. These concerns run from deafness, meningitis and even inflammation in the testicles or ovaries that can be tied to decreased fertility.
“These aren’t common but they’re also not uncommon complications,” Bogoch said.
Why is the outbreak resurfacing now?
Vaccine efficacy and the fact that a generation of Canadians didn’t receive two doses is a good start for explaining why we’re seeing outbreaks across the country now.
There has been little tinkering with the MMRV vaccine since its inception in the 1970s. It protects against the A strain of mumps but over the past decade, health officials have seen the proliferation of the G strain, Tetro warned.
“When you get the vaccine you’re going to have some ability to fight off this G strain but it might not be enough unless immunity is working at its top level,” he explained.
Bogoch said that while the makeup of the virus may be slightly different than the vaccine, data suggests it shouldn’t affect vaccine effectiveness.
Finally, some parents are forgoing vaccination for their kids altogether, Bogoch said.
“One of the major issues with this current outbreak is that many people who are getting the mumps just aren’t vaccinated or they’re only getting one shot from decades ago,” he said.
How can I protect myself and my family?
Your best bet is to get vaccinated, the experts say.
“No it’s not 100 per cent but it’s very, very good. It’s a very safe and very effective vaccine to prevent mumps,” Bogoch said.
If you’re not sure what your vaccination status is, visit your doctor to pull up your records or he or she can order a titre test, in which a doctor draws blood from an individual and has a lab check what the patient has immunity against or is susceptible to. This will uncover any missing vaccines or booster shots you may need.