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Archive Number 20091120.3996
Published Date 20-NOV-2009
Subject PRO/EDR> Mumps - Israel (02)

MUMPS - ISRAEL (02)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 18 Nov 2009
Source: Haaretz - Israel News [edited]
<http://www.haaretz.com/hasen/spages/1128723.html>


Ministry: Israel in midst of mumps outbreak
-------------------------------------------
Israel is in the midst of a mumps outbreak, the Health Ministry 
announced this week [week of 16 Nov 2009]. Since the beginning of 
September [2009], 105 people have been diagnosed with mumps, most 
between the ages of 10 and 24. During the same period in 2008, only 4 
people were diagnosed with the disease, a contagious virus 
characterized by swollen salivary glands. Only 13 cases were reported 
for the entire year. In 2007, only 6 mumps cases were reported.

Of the current cases, 82 are people from Jerusalem, but the disease 
has also been found in the central region (11 cases), Tel Aviv (5), 
the south (4), and Haifa (2). One of the patients developed 
testicular infection, a complication of mumps, and is hospitalized in 
a Jerusalem hospital.

Itamar Grotto, director of Public Health Services in the Health 
Ministry, believes the increase in the number of cases stems from the 
fact that the mumps inoculation was added to the national vaccination 
program only in 1988, along with measles and rubella. The mumps 
vaccine is given to children in 2 doses -- at the age of 1 year and 
in 1st grade.

"The outbreak is believed to have occurred among Israelis who didn't 
get both doses," Grotto said. Most of the patients are believed to be 
from communities that refuse to be inoculated, particularly the 
ultra-Orthodox. "People who are not inoculated are not exposed to 
children's diseases, because the population around them has been 
inoculated. However, they tend to contract these diseases as adults, 
and at this stage the diseases are more dangerous due to possible 
complications," said Professor David Greenberg, of the Pediatric 
Infectious Disease Unit in the Soroka University Medical Center at 
Ben-Gurion University.

In most cases, mumps runs it course without treatment, but one-tenth 
of patients develop mild forms of meningitis. In other cases, it 
could lead to testicular infection or ovarian inflammation. In men it 
could also lead to deafness or sterility. The Israel Pediatrics 
Association called on parents to make sure their children receive 
both doses of the mumps vaccine, in keeping with the national program.

An increase in mumps cases has also been reported in the United 
States and Canada. At the end of last week [week of 9 Nov 2009], 15 
students at Jerusalem's Or Shmuel Yeshiva came down with mumps, 
apparently after being in close proximity to a student who contracted 
the disease in Brooklyn [currently the site of an ongoing outbreak of 
mumps in the USA, see: ProMED-mail archive references below}.

[Byline: Dan Even]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[The late introduction of universal mumps vaccination in Israel may 
in part explain the extent of the current outbreak of mumps in young 
adults. Additionally the fact that most of the patients are believed 
to be from ultra-orthodox communities, that decline vaccination, may 
explain the high incidence of mumps among Yeshiva students as 
reported in the preceding ProMED-mail report archive no. 
20091119.3990). It is clear that the population of Israel contains an 
appreciable proportion of individuals unvaccinated or partially 
vaccinated, and that the country as a whole is vulnerable to 
introduction of infection from elsewhere (in this case probably the 
USA or Canada).

The HealthMap/ProMED-mail interactive map of Israel can be accessed at
<http://healthmap.org/r/00aH>. - Mod.CP]

[see also:
Mumps - Israel: Yeshiva students, RFI 20091119.3990
Mumps - USA (NY, NJ), Canada (QC) 20091113.3934
Mumps - USA (04): (NY) 20091106.3835
Mumps - USA (03): (NY) 20091023.3655]
...................................cp/mj/dk

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