Dear Doctor: I'm 79 years old and recently contracted mumps. I've never been so ill, and in fact, I am still suffering the aftereffects. Please help other older adults understand whether they should get the mumps vaccine.

Dear Reader: Although mumps is nowhere near as common in the United States as it once was, outbreaks continue to occur. Last year, mumps cases hit a 10-year high with 6,366 reported to the Centers for Disease Control and Prevention. In 2012, there were just 229 cases. By contrast, prior to 1967, when the mumps vaccination program was launched, about 186,000 cases were reported each year. However, that number is probably too low due to underreporting.

Mumps is caused by a virus that spreads via contact with saliva or mucus from the mouth, nose or throat of an infected person. It is carried via airborne droplets from the upper respiratory tract through coughing, sneezing or even talking. The virus can also be transferred through shared items like plates, cups and cutlery, and on objects or surfaces that have been touched by the unwashed hands of the infected person.

As with many contagious diseases, the infected person begins shedding the virus before symptoms become apparent. He or she will continue to be contagious for up to five days after becoming visibly ill. These symptoms include fever, headache, body aches and pains, exhaustion and lack of appetite. Swollen and tender salivary glands in front of one or both ears give sufferers the puffy cheeks and swollen jaw that is associated with the disease. Some patients experience hearing loss, but it is rarely permanent.

Adults who get mumps are at greater risk for complications than are children. These can include inflammation of: the membrane around the brain or spinal cord (known as meningitis), the testicles, breast tissue, ovaries or pancreas. The most serious complication is encephalitis, which is inflammation of the brain itself. It can lead to permanent disability or even death.

Mumps can be prevented with the MMR vaccine, which also confers immunity to measles and rubella. The CDC recommends two doses of the vaccine for children, the first at 12 to 15 months of age, and the second at 4 to 6 years of age. Teens and adults should also stay current on MMR vaccinations. Pregnant women should not get the vaccine, and women should wait at least four weeks after vaccine administration before becoming pregnant.

Because a number of cases of mumps have occurred in people who have had the two-dose vaccine, there is now a debate about whether immunity confers through adulthood. A recent study in the New England Journal of Medicine analyzed data from a mumps outbreak at the University of Iowa during the 2015-2016 school year. Students who had a mumps booster had a 78.1 percent lower risk of mumps than those with the just the two-dose vaccine. To address waning immunity, researchers suggest that a mumps booster may be called for.

We advocate for vaccination and help our patients stay current. And for anyone with questions or concerns about the vaccine, please do talk to your primary care physician.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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