Starting in 2023, the resurgence of the mumps outbreak in several states in India raised the question: Is there an emerging public health problem with the disease now enough to ensure prevention through immunity? Public health experts are debating this issue.
In Kerala, for example, cases of mumps have performed well, especially in recent months. Starting with an average of 2,500 cases per year, cases soared to 74,907 in 2024. The trend seems to be continuing, with 16,504 cases reported this year as of March 25 this year and more than 4,000 were reported this month alone.
Public health experts say that as the susceptible populations are reduced due to natural immunity gained through infection, the outbreak will break out in the next few months. However, as the number of cases in the community increases, the number of cases related to mumps may also increase.
This is the fact that 85 schools and several tribal hotels must be closed in 2024, prompting Kerala to explore the possibility of introducing a mumps vaccine as part of the immunization program.
Understand mumps
mumps is a self-limiting, airborne viral disease that mainly causes fever and headaches in children and adolescents, and pain and swelling of salivary glands (parocytum) on both sides of the face. Patients usually recover from rest and symptom treatment within about two weeks.
Although mumps is a preventable vaccine disease, the mumps vaccine has never been part of the country’s universal immunization program due to its low mortality rate. From a public health perspective, measles, a more contagious and severe disease, has been considered a priority for elimination.
Doctors say that although the disease is known to have some effect on the reproductive organs, there is no nationally representative data on the incidence of the disease, nor information on the actual long-term incidence of mumps.
“Tumors may not be as harmless as the prevalence rate in previously uninoculated communities, especially if we don’t have exact numbers. Although we don’t have exact numbers, there are reports that medical school disease allows kerala’s medical school disease after known complications such as sterile meningitis, encephalitis and acute pancreatitis, when does it taste a little bit. Do you run through the community?”
In a research paper,It’s right when introducing mumps vaccines in India’s universal immunization program? ‘, appeared in the 2016 issue Indian Pediatricsauthors Sr Vaidya and VS Hamde said mumps is indeed a major public health issue in India, but it has not attracted attention due to the lack of surveillance and documentation systems.
Although the public health significance of the virus associated with mumps is not well documented, pediatricians say the virus is well known to affect gonads (genital hormone glands), causing male and ovarian inflammation (ovarian inflammation) (ovarian inflammation) (inflammatory of the ovaries). Severe and long-term complications (such as infertility) are considered rare, but it is not certain that the virus does not cause testicular damage, which may lead to a decrease in sperm count in the long run.
In the article’Mumps: Clinical aspects and mechanisms‘wu et al. appeared in Field of Immunology (2021), researchers noted that Foguana is a common complication of mumps, which occurs in 40% of all mumps cases in young people
What is mumps?
Mumps is an acute disease in children and young people. Humans are the only known mumps virus host that spreads through direct contact or through air droplets in the upper respiratory tract of an infected individual.
If both adolescents and adults are likely to be affected, but children aged 5-9 often report scum. After about 2 to 4 weeks of incubation, mumps begin with nonspecific symptoms such as myalgia, headache, discomfort, and low-grade fever. Within a few days, these symptoms subsequently appear unilateral or bilateral swelling of the parotid salivary glands, and other salivary glands are affected in 10% of cases.
Usually, mumps is a mild self-limiting disease that disappears without sequelae. However, complications may occur, such as encephalitis or sensory deafness. Among young men with mumps, 20% of young men have developed fructitis (a painful inflammation of the testicles).
Source: Who
MMR vaccine
At present, India’s Universal Immunisation Programme (UIP provides the MR vaccine, which protects against measles and rubella. Under the UIP, the MR vaccine is administratored to infants at 9 months and at 18-24 months. A vaccine for mumps has been available for over 50 years however, and, in several countries, as well as in private hospitals in India, it is provided in combination with the MR vaccine, as the Mumps-Measles-Rubella (MMR) vaccine.
Following a meeting held by Kerala’s National Immunization Technology Advisory Group (Stagi), other chief secretary (Health) and the Director of Health Services have written a separate letter to the Joint Health Ministry to request that mumps vaccine be included in the UIP vaccine through the MMR vaccine to prevent future amumps vaccines.
And it’s not only Kerala, but several states that have experienced a huge mumps outbreak since last year have also made similar demands to the center, and in the UIP program, it will replace the MR vaccine with the MMR vaccine. In December last year, the Tamil Nadu health department also wrote to the Union Health Ministry in this regard: Now, the state has at least 150 mumps records per month.
“However, introducing a new vaccine into the community is a long process, as countless factors (vaccine availability, price, supply, and most importantly, possible side effects of vaccines) will have to be studied. This issue is a problem with the National Immunization Technology Advisory Group (Ntagi) and we hope it will happen soon, and we hope it will encounter it soon.”
Currently, IAP advocates the use of MMR vaccines and includes them in IAP’s immunization program. Most private hospitals follow the IAP vaccination schedule.
The official position of the World Health Organization is that the standards of all national immunization programs are the standards of all national immunization programs and should be contacted with all children with separate measles vaccines or in combination with measles-candy powder (MR), measles-girl-rubella (MMR) or measles-girl-rubella-Varisceli (MMRV).
Although there is no study on the effectiveness of mumps vaccine in India, globally, protection for two doses is estimated to be between 70-95% if vaccination coverage is high.
What is Kerala planning to do?
In 2014, Kerala replaced the second dose of measles vaccination in UIP with the MMR (mumps-measles-rubella) vaccine itself, part of a state-level initiative against rubella. But in 2017, when the Alliance Ministry of Health tried to replace the single measles vaccine with the MR vaccine at 9 months and 18-24 months, Kerala stopped the MMR vaccine it offers and adopted the MR vaccine for routine vaccines.
Dr Riaz said that in Kerala, most cases of mumps are now seen in the age group of 5-9, so at least three doses of the vaccine are needed for full protection. The three dose schedule advocated by IAP was strengthened at nine and 18 months and five years. The Centers for Disease Control and Prevention, the United States and who recommends a two-dose schedule.
The advice of Stagi in Kerala is that the state temporarily retains the MR vaccine at 9 months, while MMR replaces the 18-24-month MR dose. The MMR dose was followed by five years later.
“This involves an estimated additional spending of Rs 15 crore per year and we are exploring whether local autonomous agencies can find funding for this or whether we should provide free MMR vaccines to the BPL (below the poverty line) category. This is a big decision for Kerala. A senior health official said.
The way forward
The researchers noted that the global incidence of mumps surged in 2017-19, with concerns about the disease changing from children to young people. However, there is not much documentation on whether mumps contracted in childhood may cause infertility or testicular damage.
Currently, mumps are mainly reported in unimmunized children and adolescents, so improving general immune coverage is important. Isolating patients for three weeks and using masks can prevent the spread of the disease in the community. Identifying the source of the infection may not be easy, as the spread occurs before the onset of symptoms. In about 30% of the cases, individuals remain asymptomatic.
Most importantly, in order to enable people to learn to identify diseases and understand the importance of isolation to prevent community transmission, the public awareness campaign is to enable people to learn to recognize diseases.
publishing – March 30, 2025 at 01:47 pm IST
