Mumps traced to community in Chilliwack
Outbreak of now-rare illness spreading through region among people who don't believe in vaccination, officials say
ANNA MEHLER PAPERNY
From Wednesday's Globe and Mail
August 27, 2008 at 4:22 AM EDT
VANCOUVER — A mumps outbreak sweeping the Fraser Valley has been traced to a Chilliwack community that refuses to immunize its children for religious reasons, but health officials don't think there's a risk the highly infectious disease will spread provincewide.
There have been about 190 cases of the now-rare mumps virus reported since February, and about two dozen people are infected, said Fraser Health Authority medical health officer Elizabeth Brodkin. The agency normally sees only a handful of infections a year.
The outbreak began when people from Alberta who were infected with mumps visited a Chilliwack community - authorities would not reveal its identity - with low immunization rates. The outbreak has spread throughout the Fraser region.
"There are communities who do not believe in immunization. Sometimes it's for religious reasons. ... They choose not to immunize themselves or their children and they're very susceptible to infections when they come around," Dr. Brodkin said. "Normally you're not even aware of who's immunized until there is an outbreak, and then it's very clear where these pockets of unimmunized people are living."
A working group is to decide in the next couple of weeks whether the outbreak is serious enough to warrant a provincewide response, which might involve targeting vulnerable groups.
David Patrick, director of the B.C. Centre for Disease Control's epidemiology unit, said it's unlikely a provincial response will be necessary because the outbreak isn't spreading much beyond the unimmunized populations.
"What we are not seeing outside of those communities is a chain of transmission," he said. "If we saw sustained transmission, not just the sporadic cases ... then there would be the argument to say, 'Well, are there other people who need a boost?' " Dr. Patrick said diseases like mumps have become so rare that parents often don't think their children need vaccines.
"It's a bit of a circular thing: If you succeed with a vaccine, people don't see the vaccine around for a while and they think we don't need it," he said, adding that people who choose not to vaccinate their children for religious reasons are free to do so but should be responsible and not infect others.
"There needs to be a responsibility that if you are in a susceptible phase of having the illness, you don't spread it to someone else, you do stay at home, and I think that should be society's expectation of people who're going to take a risk that way."
Mumps is highly infectious and is spread through an exchange of saliva. Although two-thirds of people infected will exhibit either no symptoms or seem like they have a bad cold, the other third suffers swelling and inflammation in their salivary glands or other tissue. Permanent effects are rare but include deafness or sterility in people who have swollen reproductive organs. In extremely rare cases, mumps can be fatal.
Although most people born since 1970 have been immunized at least once and children born since 1996 have had two doses of the MMR - measles, mumps and rubella - vaccine, there are still significant portions of the population who have either refused immunization or moved to B.C. and haven't had to get the vaccine.
There was a scare in Alberta last year when the mumps vaccine was thought to have caused allergic reactions, although Health Canada later cleared it of that suspicion.
Nova Scotia had a mumps outbreak last year, when close to 800 people were infected. A report by the N.S. Auditor-General said the province's response was hampered by a lack of planning, questionable handling of vaccines and poor communication with the public.
Reminds me on that BSG episode.
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