Dec 2, 2010 - Physicians: The board of health needs prompt filing of case reporting forms of reportable diseases. For your convenience, the confidential reportable disease form as well as the list of Ohio Reportable DIseases is available for download here.
Dec 1, 2010 - There have been at least 2 probable cases of mumps at the Hebrew Academy Boys Elementary division. Rabbi Dessler has been vigilant in following the guidance of the Cuyahoga County Board of Health. Since early September there has been a trickle of cases every couple of weeks. It could stop any time, but it might continue for a while. There are a few important points to be made:
1. Perspective. Serious complications in mumps are uncommon. It is uncomfortable, and the 5 days of isolation are a nuisance even if the symptoms are mild. Adults miss work if they get mumps, and may also miss work if a child gets mumps. Since serious complications are so uncommon, this is more of a public health issue than a medical issue. We wish to minimize spread of the virus.
2. We know that 1st and 5th grade boys at HAC were likely exposed to the virus. A person infected with mumps is contagious from about 2 days prior to appearance of symptoms. They do not know they are contagious for 2 days, during which time others are exposed. If a child became infected at the time of exposure, they will not become symptomatic for 12-25 days, with most cases being 2-3 weeks. Based on the dates of exposure, friday Dec 3 is about the earliest that a person infected from these exposures could become contagious (2 days before symptoms), and Dec 21 would be about the last day for symptoms to appear. However, there may be other cases now or in the interim, so there could be future exposures to the virus. Of course, there had to be people exposed outside of school. Therefore, our community should suspect mumps when there is swelling along the jawline or in front of the ears and consult a doctor. Since mumps has been confirmed in local cases tested during convalescence, anyone who fits the clinical picture for mumps is called a "probable" case as it can be linked epidemiologically to a confirmed case.
3. Mumps is the only known cause of epidemic parotitis (swelling along jaw or in front of ear), so if there is the characteristic swelling, the assumption is that it is mumps - even if they test negative, which is common. People who do have mumps are still more likely to test negative when tested early. JCHi arranged for convalescent testing of 6 local cases at the CDC, and all 6 were positive - including at least one who had previously tested negative.
4. Family member with mumps? Take precautions! At least 5 parents of local cases became infected after their child was sent home for isolation. Check the mumps page for more information on what to do if someone in your home has mumps.
5. The vaccine works, but it isn't perfect. It greatly reduces the number and severity of cases. Mumps is extremely contagious. Without vaccination we would be having a huge number of cases.
6. Wash your hands!! With soap! It is remarkable how effective frequent handwashing with soap is for fighting infections. Tell your kids!
7. Someone who has been exposed should stay away from people with suppressed immune systems, such as cancer and transplant patients.
8. Stay informed. Sign up for Health Alerts and get e-mails when there is an urgent health matter.
Nov 4 2010 - Samples from 6 local cases were sent to the CDC labs for testing. All 6 tested positive. This merely confirms what was already presumed to be true - this is mumps. There continue to be a trickle of cases. For some this has been a painful experience. There have been cases of adults in the community (not just teens), so anyone experiencing a swollen or painful jawline, should consult with their physician and take precautions not to spread this virus. If we prevent exposure to large numbers of people, the outbreak is likely to peeter out.
Update on mumps, Oct 21 2010
So far there are 14 probable cases of mumps - 10 high school age boys (all but 1 from Telshe) and 4 adults with high level contact with 1 or more Telshe cases. It is impossible to say how long this will last, or whether this will become anything more than a trickle. At this point there really is nothing special for anyone to be doing. I continue to work with health departments, local doctors and the CDC on this matter, and will endeavor to keep relevant parties and the public informed as needed.
UPDATE (Oct 4 2010):
The father of one of the cases came down with what appears to be mumps. This was 2 to 2-1/2 weeks following exposure to his son, a normal incubation period for mumps. I am not aware of other cases of Telshe HS boys becoming symptomatic over bein hazmanim, but with the boys not at the yeshiva it is much harder to keep track of. I am trying to coordinate information, so I can keep our local physicians up to date and inform the community as needed. Anyone with information to share is encouraged to contact me ( mailto:email@example.com ).
Please remember that bochurim who were exposed prior to or on Yom Kippur may still become symptomatic, so parents are urged to consult a physician if possible symptoms appear. Also, anyone exposed since Yom Kippur is entering the period of time when they may become symptomatic.