College, a petri dish for mumps

From the Los Angeles Times:

"Health officials focus on vaccinating young adults after an outbreak among students.

By Melissa Healy, Times Staff Writer
April 24, 2006

When Iowa college students early this year began turning up in doctors' offices with puffy necks, headaches, fevers and, among some young men, swollen testicles, many physicians missed a diagnosis most doctors could have made in their sleep 25 years ago.

These patients had the mumps — as do at least 1,100 in eight Midwestern states as of Friday. The outbreak is still unfolding, spreading east and west, and beyond the 18- to 25-year-old set.

Their affliction was missed by many physicians unaccustomed to seeing — especially in college students — a childhood disease largely quashed by widespread vaccination in the 1980s.

Now public health officials are trying to understand how this disease, which in rare cases can cause deafness, encephalitis and male sterility, could have regained a foothold in the U.S. after so many years.

The Midwest mumps outbreak has been all the more surprising because it has largely affected the first generation of young adults to have commonly had not one, but two doses of the vaccine that protects against measles, mumps and rubella. Double vaccinations, widespread since a 1989 outbreak of measles, were thought to confer complete mumps immunity to about 90% of recipients.

Experts suspect two factors: spotty vaccination coverage among college-aged kids and the unique bacterial and viral mixing bowl that is dorm life.

The virus that causes mumps appears to have found its perfect home in the college scene — with multiple kids lolling on beds in great heaving groups, swigging drinks in common, kissing and cruising the bars even when they're sick, and — oh, yes — attending classes en masse.

"They eat after each other, drink after each other, share other personal items — we know that living under those settings, people run higher risks of infection," says Dr. Georges Benjamin, executive director of the American Public Health Assn.

Health experts say the outbreak should help focus new attention on the need to vaccinate adolescents against a growing variety of diseases before they leave the nest and dive into this unique germ pool. "