Monday 11 November 2019

Dear Dr Nina: Are my children at risk of mumps infection?

Ask the Doctor

You are right to be concerned about mumps
You are right to be concerned about mumps

Nina Byrnes

Q I am quite alarmed and confused about the recent outbreak of mumps. There are quite a few teenagers in my area who have been diagnosed with it, including our babysitter. Does this mean that she wasn't vaccinated? If she hasn't been vaccinated, are my children at risk? I have a three-month old, a two-year old and a six-year old, all of whom have been vaccinated.

Dr Nina replies: Mumps cases are on the rise and this is indeed something to be concerned about. There were 278 cases reported in the first six weeks of this year compared to 43 for the same time period last year. Most of the cases are occurring in teenagers and young adults. This group of people had a much lower uptake of the MMR vaccine in childhood, secondary to the now discredited Wakefield study which associated the MMR vaccine with autism. The children (now young adults) have been left vulnerable to circulating measles, mumps and rubella infection.

Herd immunity refers to the percentage of people that need to be vaccinated in order to contain the spread of infectious diseases. Mumps is highly contagious. In Ireland, uptake of the vaccine varies but has been shown to be a slow as 87pc in some of our more affluent areas. We need to do better. A herd immunity of 95pc is considered ideal. There will always be certain people who cannot be vaccinated due to illness, age or other conditions but unfortunately there are also people who choose not to vaccinate their children. There has been much debate recently about how best to achieve herd immunity in our population but there is no doubt the best protection is vaccination. The evidence is very strong. Vaccines dramatically reduce the incidence of dangerous disease and they save lives.

Mumps can cause significant disability. It leads to pain, fever, swollen glands and more rarely inflammation of the testes or lining of the brain (encephalitis). What is even more concerning is that those not receiving their two doses of MMR vaccine are also susceptible to measles, a disease which may result in hospitalisation in up to 25pc of cases.

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If your children have received all their vaccines, your two- and six-year-old should be protected. Your three-month old baby would hopefully be protected via passive immunity passed in milk if you are breastfeeding, but they will not receive the MMR vaccine until they are a year old. The reason this age is chosen is it is a live vaccine and our bodies respond best to these after about one year of age. The second MMR vaccine is given in junior infants in school at around age four. About 85pc of children are immune after one vaccine dose and it is felt that about 99pc of people are immune after two doses. MMR vaccine can be given from six months of age but as this immunity can wane.

If your babysitter already had mumps then she is now immune. You could express preference that those caring for your children are vaccinated but legally she doesn't have to disclose her vaccination status to you.

⬤ If you have any queries, email askthedoctor@independent.ie

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