Context: Mumps cases have been spreading rapidly in Kerala since November 2023, particularly in the districts of Malappuram, Kozhikode, Palakkad, and Thrissur, resulting in major community outbreaks.
About Mumps Disease
- It is a viral disease caused by mumps virus, which belongs to the paramyxovirus family.
- It is highly contagious and spreads through respiratory droplets or direct contact with an infected person.
- The disease is known for causing painful swelling of the salivary glands, particularly the parotid glands located near the ears.
- Mumps is a self-limiting, airborne viral disease that primarily affects children and adolescents, causing fever, headache, and painful swelling of the salivary glands.
- Complications of mumps include encephalitis, epilepsy, aseptic meningitis, acute pancreatitis, and potential infertility or a drop in sperm count in males.
- Creating public awareness about the disease and the importance of isolation is crucial in controlling the transmission of mumps.
Symptoms of mumps include:
- Swollen and tender salivary glands
- Fever
- Headache
- Muscle aches
- Fatigue
- Loss of appetite
Complications of mumps can include inflammation of the orchitis, ovaries (oophoritis), pancreas (pancreatitis), and brain (encephalitis). In rare cases, mumps can lead to hearing loss or sterility.
Status of Mumps Disease in India:
- Prevalence: Mumps is still prevalent in India, with occasional outbreaks reported in various parts of the country. However, the incidence has decreased significantly due to the introduction of the measles-mumps-rubella (MMR) vaccine in the national immunization program.
- Vaccination: India introduced the MMR vaccine in its Universal Immunisation Programme (UIP) in 2017. The vaccine is administered in two doses, first at 9-12 months of age and the second dose at 16-24 months of age. The coverage of the MMR vaccine has been increasing steadily since its introduction.
- Despite the availability of a vaccine against mumps, it is not part of the government’s universal immunisation programme. However, children can receive the mumps-measles-rubella (MMR) vaccine against all three diseases at private centres.
Mumps vaccine exclusion from India's Universal Immunisation Program:
- Mumps vaccine is not part of India's Universal Immunisation Programme (UIP) due to the disease's low mortality profile and perceived low public health significance.
- Indian Academy of Paediatrics (IAP) advocates for the use of the MMR (Mumps-Measles-Rubella) vaccine in the UIP.
- Kerala has written to the Central Government about the mumps resurgence and the need to replace the MR (Measles-Rubella) vaccine in the UIP with the MMR vaccine.
- Public health significance: Mumps is often considered a mild, self-limiting disease in children, with a low mortality rate.
- While complications can occur, such as orchitis, meningitis, or encephalitis, these are relatively rare compared to the complications associated with other vaccine-preventable diseases like measles or diphtheria.
- Resource allocation: Given the limited resources and the need to prioritize, the Indian government has focused the UIP on diseases with higher morbidity and mortality rates, such as tuberculosis, polio, and measles.
- Including the mumps vaccine in the UIP would require additional funding and logistics, which may divert resources from other pressing public health issues.
WHO recommendation to integrate mumps control:
- Measles-Mumps-Rubella (MMR) vaccine: The WHO recommends using the combined MMR vaccine to control mumps, measles, and rubella simultaneously.
- This vaccine is highly effective and has been widely used in many countries' immunization programs.
- Efficiency and cost-effectiveness: Integrating mumps control with measles and rubella programs is an efficient and cost-effective approach.
- It allows countries to target three diseases with a single vaccine, reducing the number of injections and simplifying the immunization schedule.
- Global goals: The WHO has set global goals for measles elimination and rubella control. By integrating mumps control with these programs, countries can work towards achieving these goals while also addressing mumps incidence.




