Exposure and Response
Clinical Questions & Answers on Mumps
Q: How do you protect patients at a doctor's office?
A: Basic infection control measures apply. They include:
- Plan to separate coughing or ill patients in the waiting area or have a separate area designated. Have a procedure or surgical masks for coughing patients readily available. Have disposable tissues readily available.
- Wear appropriate personal protective equipment (PPE) while performing exams, i.e. surgical masks with a coughing patient (to prevent droplet spread). This is the ideal time to determine immune status of personnel, either documentation of two MMRs, a positive mumps IgG or history of physician diagnosed mumps, or birth before 1957. If vaccination status is not adequate, vaccinate with MMR unless contraindicated. Don't forget it is also important to know the immune status of measles and other vaccine preventable diseases.
- Screen individuals for mumps symptoms when calling-in for an appointment. If clinically compatible with mumps, do not allow them to sit in the waiting area for prolonged periods of time and keep them at least three feet from other patients. Request that they wear a procedure or surgical mask.
- When assessing a patient for possible mumps, staff should follow Standard and Droplet Precautions.
- Any staff member with signs and symptoms of mumps should be sent home and be off work for five days.
See Guidelines for Infection Control in Healthcare Settings for more information.
Q: Should actions be taken after a mumps case visits a doctor's office?
A: If an office assessment has not already been done, determine immunity of the office and medical personnel. This includes documentation of two doses of MMR, a positive mumps IgG, a history of physician diagnosed mumps, or birth before 1957. Administer MMR as needed. Susceptible personnel who have been exposed should be kept from direct patient contact from the 12th day after the first exposure through the 25th day after the last exposure. See Infection Control in Healthcare Settings for more information.
Q: Do HCWs and patients need to wear N-95 masks?
A: No. Properly worn procedure or surgical masks are sufficient. HCWs should maintain Standard and Droplet Precautions when caring for and examining patients with respiratory symptoms. See Prevention & Control of Mumps among Healthcare Personnel for more information.
Q: What are the strategies for controlling mumps outbreaks in schools?
A: For all exposures consider the entire group that could have been exposed. That could be the whole school, whole work setting, etc. It is an opportunity to vaccinate susceptibles rather than individual persons. In the school setting all children K-12 should have documented evidence of receipt of two doses of MMR vaccine with few students on medical or religious exemptions. Do not forget to consider the staff as well.
Q: What is the guidance for staff in a school?
A: Children K-12 should have documented evidence of receipt of two doses of MMR vaccine . Teachers and all staff should have their immune status verified (vaccination, serologic evidence of immunity, a history of physician diagnosed mumps, or birth before 1957). All staff should be educated on hygiene, prevention and signs and symptoms of disease.
Q: Should we quarantine exposed people?
A: Exclusion of susceptible students from schools/colleges affected by a mumps outbreak (and other, unaffected schools judged by local public health authorities to be at risk for transmission of disease) should be considered among the means to control mumps outbreaks. Once vaccinated, students can be readmitted to school. Students who have been exempted from mumps vaccination for medical, religious, or other reasons should be excluded until at least 26 days after the onset of parotitis in the last person with mumps in the affected school.
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