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Mumps transmission in hospitals
M Wharton1, S L Cochi, R H Hutcheson
1Division of Field Services, Centers for Disease Control, Atlanta, GA.
Abstract:
Although sporadic transmission of mumps within hospitals to patients and staff is well documented, outbreaks of mumps within hospitals have only rarely been reported. The widespread mumps outbreaks that occurred in Tennessee in 1986-1987 provided an opportunity to assess the extent of the problems caused by mumps in hospitals. Information was obtained from 146 (95%) of 154 infection control practitioners in the state. Infection control problems caused by mumps were reported from 17 (12%) of 146 hospitals. The 17 hospitals in which these incidents occurred were located in counties that accounted for 67% of the reported mumps cases statewide during this period. Although most cases of mumps in health care workers were community-acquired, six health care workers in three different hospitals developed mumps following nosocomial exposure. In two institutions, nine patients contracted mumps while hospitalized. Both were long-term-care facilities housing adolescents, who had substantial contact with a community where mumps outbreaks were ongoing. This study suggests that mumps poses a small but real risk to both patients and staff in hospitals, particularly in long-term-care facilities caring for adolescents and young adults. In communities where mumps activity is ongoing, hospitals should consider identifying potentially susceptible staff members at risk for infection and offering vaccine. Likewise, susceptible patients in long-term-care facilities should be immunized.
Insights
Mumps outbreaks in hospitals are rare but can occur, especially in long-term care facilities. Vaccination is recommended for susceptible hospital staff and patients during community mumps activity.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Sporadic mumps transmission in hospitals is known, but large outbreaks are uncommon.
- Widespread mumps outbreaks in Tennessee (1986-1987) offered a chance to study hospital-associated mumps.
- Hospitals face infection control challenges during community mumps epidemics.
Purpose of the Study:
- To assess the extent of mumps-related infection control problems in hospitals during a statewide outbreak.
- To identify specific hospital settings and patient populations at higher risk for mumps transmission.
- To evaluate the risk of nosocomial mumps transmission to healthcare workers and hospitalized patients.
Main Methods:
- Surveyed 154 infection control practitioners in Tennessee, achieving a 95% response rate (146 participants).
- Collected data on mumps-related infection control incidents reported by hospitals.
- Correlated hospital incidents with county-level mumps case data.
Main Results:
- Mumps infection control problems were reported by 17 out of 146 (12%) hospitals.
- Hospitals reporting issues were in areas with high community mumps prevalence (67% of statewide cases).
- Six healthcare workers acquired mumps nosocomially; nine patients contracted mumps in two long-term care facilities housing adolescents.
Conclusions:
- Mumps presents a low but significant risk to hospital patients and staff, particularly in adolescent/young adult long-term care settings.
- Hospitals in mumps-active communities should consider vaccinating at-risk staff.
- Immunization of susceptible patients in long-term care facilities is advised during community mumps outbreaks.