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Mumps in New Zealand (Update 3)

27 December 2017

On 20 December 2017 the Auckland Regional Public Health Service Link reported a total of 1031 cases of mumps in the continuing outbreak in the Auckland area.

Clinical Director, Dr Julia Peters has expressed concern about low vaccination rates in the 10 to 29 years age group in which the majority of cases has been reported. Around 80 percent of cases in the outbreak have not been not fully vaccinated.

Advice to travellers

  • Mumps is still common in much of Asia, Africa the Indian sub-continent and South America. The risk is greater when living/working with the local population; particularly if in a healthcare setting or for children in areas where vaccine uptake may be poor.
  • More recently there have been outbreaks of mumps in several developed countries including the US, Canada, Japan, Israel and several European countries including the UK.

When to Consider Vaccination

All travellers to outbreak or endemic areas should ensure that they are fully immunised against measles, mumps and rubella.

Child Travellers

The British National Schedule stipulates that children should receive two doses of MMR vaccine; the first at 1 year old and the second between age 3 years and 4 months - 5 years old.

Infants from six months of age travelling to measles endemic areas or to an area where there is a current outbreak should receive MMR (Green Book, chapter 21 link). Points to consider:

  • Administration of MMR vaccine to children under 9 months constitutes off-label (unlicensed) use of the vaccine but should be considered.
  • If the child is under 12 months old, the efficacy of the vaccine may be reduced by the presence of maternal antibodies. This dose should not be 'counted' in the childhood schedule and two further doses should be given at appropriate intervals.
  • For children aged between 1 and 3 years the second dose of MMR can be brought forward to one month (or longer) after the first dose.
  • If the second dose given is less than 3 months from the first and the child is less than 18 months old, a third dose should be given at the usual time for the second dose, i.e. at 3 years and 4 months - 5 years (pre-school dose).

Adult Travellers

  • Most UK residents born before 1970 will have been exposed to these infections and have natural immunity.
  • Those born after 1970 may have had 1 dose of a measles containing vaccine. If they are travelling to areas where risk of measles or mumps is significant, 2 doses of MMR vaccine is recommended to ensure full protection against all 3 viruses.
  • If two doses of MMR are required, then the second dose should be given one month after the first.
  • Public Health England have produced an algorithm for the vaccination of individuals with uncertain or incomplete immunisation status

For further information see Measles, Mumps & Rubella.