Disease Outbreaks Blamed on Vaccine Skipping

March 22--Public-health officials and infectious-disease experts say under-vaccination is leading to more outbreaks of diseases that could have long been eradicated, such as the mumps spreading through Ohio State University.

The number of mumps cases at Ohio State has nearly doubled in the past week, rising to 40 yesterday as university and Columbus Public Health officials continue to investigate connections and ways to contain the outbreak.

Columbus typically has one case of mumps each year.

Mumps is transmitted like the flu, through respiratory droplets, and is difficult to contain because symptoms might not appear for weeks.

Vaccines are issued to children in two doses, and they have been required in children who enroll in Ohio grade schools since 1986, said Dr. Teresa Long, Columbus health commissioner.

But parents can seek religious or medical exemptions, and Ohio State does not require proof of vaccinations.

As long as people opt out of vaccinations, outbreaks will continue to crop up, said Dr. Joseph Gastaldo, an infectious-disease specialist at OhioHealth.

"We do have in our country an anti-vaccine movement with really not a lot of science behind it," he said. "The whole vaccine linkage to autism has been completely refuted."

Columbus has dealt with pertussis, or whooping cough, outbreaks in recent years. And New York City public-health officials have said a current measles outbreak there has been spread in medical facilities where it was not recognized fast enough, according to The New York Times.

Local officials have worried that the mumps outbreak could spread beyond Ohio State, but each case outside of campus so far has been linked to the university.

Disease investigators haven't connected the cases beyond the fact that most patients are Ohio State students.

Outside of campus, "We worry the most about those children who have not gotten their second shot," Long said. "Obviously, they're less protected."

The mumps vaccine is about 80 to 90 percent effective, Long said, and about 97 percent of those who have been infected already had been vaccinated.

It's possible that those who received the vaccine did not receive the strain that is circulating now, said Dr. Julie Mangino, professor of internal medicine in the division of infectious diseases and medical director of clinical epidemiology at Ohio State.

The outbreak dates to Feb. 11, the earliest known onset of the illness. But Long said the department hasn't been able to identify the first case or where it came from.

The virus also has a long incubation period, and it can be spread without symptoms presenting themselves.

Symptoms include fever, headache, muscle aches, tiredness, loss of appetite, and swollen and tender salivary glands. In rare cases, mumps can lead to infertility.

The city and university are trying to contain the outbreak to campus by isolating patients and communicating about the virus through emails, social media and posters that encourage hand-washing and cough-covering.

But students often are in settings with many other people, and they risk spreading the disease further by going off-campus -- especially if they don't know they're infected, Mangino said.

"They interface in dormitories, classes, a lot of aggregate settings and situations," she said.

There also are no plans to offer booster shots at this time. Long said viruses such as mumps "tend to burn themselves out."

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@RickRouan

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