Apr 19, 2006 (CIDRAP News) – The nation’s largest mumps epidemic in decades has reached well over 1,000 cases and will probably grow further before it ebbs, the head of the Centers for Disease Control and Prevention (CDC) said today.Calling the epidemic the largest in more than 20 years, CDC Director Dr. Julie Gerberding said it has grown to 815 cases in Iowa and 350 cases in seven other states. Suspected cases are under investigation in seven additional states, she said. Most of the cases are in 18- to 25-year-olds, many of them college students, the CDC has said.”We will not be surprised if we see more people affected either in the college context or as students spend time with their families or their community friends,” which could lead “more extension [of mumps] into the community,” Gerberding said in a teleconference this afternoon.At least 20 people have been hospitalized in the epidemic so far, but none have died of the viral illness, Gerberding said. The illness typically involves swelling of the salivary glands along with fever, headache, malaise, muscles aches, and loss of appetite.The CDC said last week that many of the young adults who have contracted mumps had previously been vaccinated. Today Gerberding cited two likely reasons for the epidemic: some people received only one dose of the vaccine instead of the recommended two doses, and the vaccine simply isn’t effective in about 10% of recipients.”We have no information to suggest there’s any problem with the vaccine,” she said. “The problem here is lack of complete coverage with the vaccine. . . . There’s a group of students, mainly college students, who are less likely to have received both doses of the vaccine.” The CDC says one dose of measles-mumps-rubella (MMR) vaccine protects against mumps in about 80% of people.In addition, Gerberding said, “Though this is a very good vaccine, it ‘s not perfect. About 10% of people who get both doses still remain susceptible” to mumps.When people live in crowded settings, such as college dorms or other institutions, a case of mumps can trigger “a cascade of transmission,” she added.People who were born before 1957 are considered immune to mumps, because nearly everyone in that age-group had the illness, according to the CDC.For younger people, coverage with two doses of vaccine is important, and especially so for students, others living in institutions, and healthcare workers, Gerberding said.Referring to healthcare workers, she said, “If you haven’t received two doses, it’s very important that you get your second dose.”Gerberding said the CDC has some MMR vaccine on hand and plans to supply 25,000 doses to Iowa. In addition, the vaccine manufacturer, Merck, has donated 25,000 doses, which the agency will use to immunize people in affected areas. The CDC is not expecting a shortage for now, she said.In response to a question, she said there is no sign that waning immunity is a factor in the epidemic. If waning immunity were the primary problem, there would be more cases in older people, she said.The source of the outbreak is unknown, according to the CDC. The strain circulating in the United States is genotype G, the same as the strain circulating in the United Kingdom, where more than 100,000 cases have occurred in the past few years, Gerberding said. But at this point there is no proof that the situations are linked, she said.Besides Iowa, states involved in the outbeak include Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin, the CDC said in its Apr 14 health advisory.In an Apr 7 report, the CDC said the United States has had an average of 265 mumps cases per year since 2001. Gerberding said about 20% of cases are mild or asymptomatic, so people can spread the virus without knowing they have it.The CDC says complications of mumps can include deafness, pancreatitis, meningitis, encephalitis, spontaneous abortion, and inflammation of the testicles, ovaries, or breasts. Aside from deafness, these are more likely in adults than children.See also:CDC. Exposure to mumps during air travel—United States, 2006. MMWR 2006 Apr 11;55(Dispatch):1-2http://www.cdc.gov/mmwr/preview/mmwrhtml/mm55d411a1.htmCDC. Mumps epidemic—Iowa, 2006. MMWR 2006 Apr 7;55(13):366-8http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5513a3.htm
Asian shares fell and Wall Street was poised to retreat from record highs on Tuesday after the news.South Korean President Moon Jae-in said the economy was in an emergency situation and required stimulus as the epidemic had disrupted demand for South Korean goods.Singapore announced a US$4.5-billion financial package to help contain the outbreak in the city-state and weather its economic impact.In Hong Kong, leader Carrie Lam said the government would increase handouts to tackle the outbreak to HK$28 billion ($3.60 billion) from HK$25 billion, as it strives to ease the impact on the Chinese-ruled city’s protest-battered economy.Singapore Airlines Ltd said it would temporarily cut flights in the three months to May, as the epidemic hits demand for services touching and transiting the key travel hub.As global businesses sought to limit exposure to the virus, health authorities around the world searched for medical weapons.The president of the European Union Chamber of Commerce in China, Joerg Wuttke, said the world’s pharmacies may face a shortage of antibiotics and other drugs if the outbreak cannot be resolved soon, and accused Beijing of making supply-chain problems worse.Japan announced plans to use HIV drugs to combat the virus as a growing number of cases posed an increasing threat to the world’s third-largest economy, as well as public health. With 520, Japan has the most cases outside China.With Japan’s economy contracting, raising the risk of a recession, the spread of the virus has prompted Tokyo to put limits on public crowds while some companies are telling employees to work from home.The number of new daily infections in mainland China had not been below 2,000 since Jan. 30, while the daily death toll had not fallen below 100 since Feb. 11.Outside China, there are 827 cases in 26 countries and regions and five deaths, according to a Reuters count based on official statements.Chinese authorities say the stabilization in the number of new cases is a sign that measures they have taken to halt the spread of the disease are having an effect.Global health authorities had to keep on guard against a wider outbreak, said Jimmy Whitworth, a professor of international public health at the London School of Hygiene and Tropical Medicine.”We can hope that the reports of falling numbers of new cases in China do show that the epidemic has peaked in Hubei province, but it is still too early to be sure,” he said, referring to the central province where the outbreak began.World Health Organization Director-General Tedros Adhanom Ghebreyesus said Chinese data “appear to show a decline in new cases” but any apparent trend “must be interpreted very cautiously”.Topics : The head of a leading hospital in China’s central city of Wuhan, the epicenter of the coronavirus outbreak, died of the disease on Tuesday as Apple Inc warned its sales would suffer because of the epidemic, casting a chill on global stock markets.Chinese state television said Liu Zhiming, the director of Wuhan Wuchang Hospital, died at 10:30 a.m, the seventh health worker to fall victim. The hospital was designated to solely treat virus-infected patients.The number of new coronavirus cases in mainland China fell below 2,000 for the first time since January but the virus remains far from contained. The total death toll in China has climbed to 1,868, the National Health Commission said. There were 1,886 new confirmed infections, for a total of 72,436.China’s lockdown of cities and tough curbs on travel and movement have limited the spread of the virus outside the epicenter, but at great cost to the economy and global business.More than two dozen trade fairs and industry conferences have been postponed because of travel curbs and concerns about the spread of the virus, potentially disrupting deals worth billions of dollars.Apple became the latest company to warn of trouble, saying it would not meet its guidance for March-quarter revenue because of slower iPhone production and weaker demand in China.