Management and Control Issues Related to Two Mumps Outbreaks in Houston: Future Implications

Clin Infect Dis. 2023 Feb 8;76(3):e1416-e1420. doi: 10.1093/cid/ciac650.

Abstract

Background: Mumps is a highly contagious disease spread by airborne droplets, making control especially difficult in congregate, crowded settings such as shelters and jails. A mumps outbreak in Honduras, starting in 2018 among adults who were unvaccinated, spread northward with Central Americans migrating to the United States. We describe 2 mumps outbreaks in Houston during 2019 among migrants at the Houston Contract Detention Facility (HCDF) and among inmates at the Harris County Jail (HCJ).

Methods: We investigated cases of acute onset parotitis. Three or more mumps cases in a facility was considered an outbreak. Confirmed cases had positive polymerase chain reactions (PCR). Probable cases were linked epidemiologically to a confirmed case in the same unit and a positive serology for serum anti-mumps immunoglobulin M (IgM) antibody. Outbreak control measures included enhanced surveillance, isolation of housing units, educational outreach, and immunization with Measles, Mumps, Rubella (MMR) vaccine.

Results: At HCDF, during a 10-month period, we investigated 42 possible cases. Of the possible cases, 28 were lab-confirmed with 9 probable, 4 ruled out, and 1 vaccine reaction. All were migrants. At HCJ, during a 3-month period, we investigated 60 suspect cases; 20 cases were lab-confirmed, 13 probable and 27 ruled out. All but 2 were inmates. Only about a third of those offered MMR vaccination accepted.

Conclusions: Successful outbreak resolution required close cooperation with HCDF and HCJ with ongoing surveillance, isolation of units with cases and MMR vaccination. Such facilities will have outbreaks; regular communications with local public health could improve response.

Keywords: Texas; detainee; jail; migration; mumps.

MeSH terms

  • Adult
  • Disease Outbreaks / prevention & control
  • Humans
  • Immunization
  • Measles-Mumps-Rubella Vaccine
  • Mumps* / epidemiology
  • Mumps* / prevention & control
  • Rubella*
  • United States
  • Vaccination

Substances

  • Measles-Mumps-Rubella Vaccine