While there have been no cases of mumps in Jefferson, Clallam or Kitsap counties to date, the health officer for Jefferson and Clallam counties has warned, “We are definitely at risk for an …
While there have been no cases of mumps in Jefferson, Clallam or Kitsap counties to date, the health officer for Jefferson and Clallam counties has warned, “We are definitely at risk for an outbreak.”
Dr. Tom Locke sees the two counties’ high rates of vaccine exemption and ongoing mumps outbreak activity since last fall as indicators of danger.
“We have alerted school officials and parents that unvaccinated children will be excluded from school for 26 days or longer, should they be exposed to a mumps case,” Locke said. “This is statewide public health policy.”
Locke addressed the mumps outbreak and the 2016-17 influenza season during his remarks to the Jefferson County Board of Health Feb. 16. He reassured the board that there is no shortage of mumps vaccine, since it is state-sponsored, but noted that it’s most effective when administered in two doses, with a minimum interval of a month in between.
“Some vaccine series include multiple booster shots,” Locke said. “Other vaccines, typically live viruses, are given multiple times to increase the percentage of seroconversion and protective immunity. After the first dose, patients’ immunity is as high as 70 percent. After the second, it’s closer to 89 percent. A third dose yields an increase so low that it’s not considered worth it.”
When board member Kathleen Kler asked about the impact of mumps on fertility, Locke pointed out that testes are actually more vulnerable than ovaries to mumps’ potential sterilizing effects.
“It causes [the testes] to swell, producing greater pressure and a greater likelihood of permanent damage,” Locke said. “Female infertility is less likely than male infertility.”
When Kler asked if Jefferson County would have enough mumps vaccine if there were an even greater spike in mumps cases, Locke elaborated that, at the most, the county might have to wait until the next day after requesting supplies to receive them from neighboring jurisdictions.
According to the state Department of Health, the period from October 2016 through February 2017 marks the largest resurgence of mumps cases in Washington since 2006 and 2007, when cases numbered in the dozens. By contrast, as of 4:30 p.m., Feb. 15, the number of current and probable Washington mumps cases listed on the Department of Health’s site was 469.
“I thought it was an error in the chart when I first saw it,” said John Austin, citizen at large on the Jefferson County Board of Health and a former county commissioner. “That’s a huge jump.”
Because no cases have yet been reported in Jefferson County, Locke sees an opportunity to eliminate a local outbreak before it has a chance to begin.
“The more cases there are, the more chances there are for other people to encounter the virus,” Locke said. “The first rule is primary containment.”
FLU OUTBREAK REVIEWED
While the flu has been less widespread than the mumps, it’s had a profound impact on people. Locke relayed reports by state health officials to the county Board of Health, noting that 172 people have died from the flu in Washington this season.
“That’s a bad flu year,” Locke said. “It’s the worst death count due to the flu since 2010.”
Of those 172, 151 were 65 years or older, which Locke deemed roughly in line with the breakdowns of flu victims by age during previous seasons. However, while Locke has likewise seen corresponding numbers of flu victims 2 years old and younger during previous seasons, the 2016-17 flu season has thus far yielded zero recorded flu deaths in children 5 years old or younger.
“Why is that?” board member Kate Dean asked.
“I’m not sure,” Locke admitted. “What I do know is that all the flu deaths have been due to one form of influenza – the H3N2 strain, the Hong Kong pandemic of 1968 that just never went away. It’s a bad actor. The death rate always goes up when it rolls around. It’s just a nastier infection.”
Locke encouraged the public to get vaccinated for both mumps and the flu.
“Vaccinated individuals can still get common cold viruses and bacterial infections that can mimic flu symptoms,” Locke told The Leader during a separate interview. “What never happens is that the inactivated flu vaccine, the injectable kind, causes a case of influenza. The vaccine contains a very small fragment of virus surface protein. It takes the whole, intact virus to cause an infection.”
Locke conceded that some people experience mild symptoms such as muscle soreness, a low-grade fever or fatigue after a flu shot, but this is just their immune system being stimulated, not a true infection.
“We’re likely past the peak of this flu season,” Locke said. “Many people who were vaccinated did, in fact, get influenza, but many did not get it because they were vaccinated, and that risk of hospitalization and flu complications is lower in vaccinated than non-vaccinated populations.