ISMA e-Reports, May 5, 2008

ISDH urges doctors to confirm cases of mumps

In the past two months, the Indiana State Department of Health (ISDH) has received increasereports of suspected cases of mumps. But confirmation of the disease is important, according to Joan Duwve, M.D., medical director for the ISDH.

"Knowledge of confirmed cases helps us communicate with parents in the affected community and test kids who may have been exposed," she explained.

Dr. Duwve urges physicians to follow these steps if a patient presents with mumps:

  1. Obtain a buccal swab for PCR detection of mumps virus at the time of clinical diagnosis. This is done by massaging the salivary glands for 30 seconds and then swabbing the parotid or salivary duct area with a viral culture swab. Also obtain acute serum samples for mumps IgM and IgG.
  2. Place the swab in viral transport medium and keep refrigerated until it is sent to the lab. Package the viral swab with cold packs to keep it cool until it gets to the lab.
  3. Isolate the patient at home for nine days after the onset of swelling.
  4. Report the suspected case of mumps to the ISDH immediately while the patient is still in the office by calling (317) 233-1325. Do NOT wait for lab results. ISDH will work closely with you and the patient's contacts to prevent the spread of mumps in your community. 

Dr. Duwve"If the acute IgM is positive, you have a laboratory confirmed diagnosis of mumps," noted Dr. Duwve. "If the acute IgM is negative, but the buccal
swab is positive for mumps virus by PCR, you also have a confirmed case
of mumps."

If test results for mumps are negative, collect a second serum IgM and
IgG in two to three weeks after the first test. In the absence of recent vaccination, a four-fold increase in quantitative IgG titer or a
seroconversion from negative to positive is considered positive for recent infection with mumps.

According to the Indiana Communicable Disease Reporting Rule for Physicians, Hospitals and Laboratories, suspect cases of mumps must be reported to ISDH within 72 hours of clinical diagnosis.

Read more about reporting mumps.