Measles and Mumps

Measles (rubeola) and mumps are members of the Paramyxoviridae family of viruses. They both cause illnesses in children throughout the world that are preventable through vaccination. Vaccination has drastically reduced the number of people affected by measles in the United States and in many parts of the world, but the World Health Organization (WHO) still lists measles as a leading cause of death in young children. According to their estimates, measles affects more than 20 million people a year and in 2007 was responsible for nearly 200,000 deaths, primarily in children under the age of five. These numbers take into account efforts that led to the vaccination of 576 million children in high risk countries from 2000 to 2007 and a corresponding decrease in the number of measles deaths by 74% during the same time period. Mumps, a milder illness, is not as widely vaccinated against and is still endemic in many parts of the world.

According to the Centers for Disease Control and Prevention (CDC), the number of cases of measles in the U.S. has dropped from about 900,000 in 1941 to fewer than 150 cases a year since 1997. The incidence of mumps infections has similarly decreased from several hundred thousand a year in the U.S. to several hundred. These changes are due to comprehensive measles and mumps vaccination programs. While vaccines are available for each virus, combination vaccines, such as MMR that protects simultaneously against measles, mumps, and rubella, are frequently utilized. In recent years, the majority of new cases in the U.S. have occurred in occasional epidemics, primarily in people who have not been vaccinated - especially those who have traveled to areas of the world where measles or mumps are more prevalent.

Measles, also called rubeola, is an extremely contagious viral infection that is transmitted through respiratory secretions. The virus infects cells in the lungs and at the back of the throat and causes symptoms such as a high fever, dry cough, red eyes, light sensitivity, a runny nose, sore throat, tiny white spots inside the mouth, and a characteristic rash that typically starts on the face and spreads down the body to the trunk and legs. Most people recover within a couple of weeks, but up to 20% develop complications that may include an ear infection, bronchitis, pneumonia, diarrhea, encephalitis, or blindness. People who are malnourished, have a vitamin A deficiency, or have compromised immune systems are frequently more severely affected. Women who are pregnant when they are infected with measles are at a greater risk of miscarriage or of premature labor.

Mumps is a viral infection that is transmitted through respiratory secretions or saliva. After a 2 to 3 week incubation period, an infected person typically develops flu-like symptoms such as a headache, muscle aches, and fever that are followed by characteristic parotitis – swelling of the salivary (parotid) glands below one or both ears. For most people, mumps is a mild, self-limited illness, but some may develop complications such as deafness, inflammation of the testicles (orchitis) or ovaries (oophoritis), pancreatitis, meningitis, or encephalitis.

Measles (rubeola) and mumps testing involves the measurement of antibodies in the blood or, less commonly, the detection of the mumps or measles virus in a culture. Rarely, testing may be performed to detect the genetic material of the measles or mumps virus.

The sample required depends on whether testing is being done to determine the presence of antibody or to detect the virus itself. Antibody testing requires a blood sample, obtained by inserting a needle into a vein in the arm. Viral culturing may be performed on a variety of samples, including blood, urine, nasopharyngeal aspirate/washing, throat swab, a swab of the inside of the cheek (buccal swab), cerebrospinal fluid, or other body tissue.

A nasopharyngeal swab is collected by having you tip your head back and then a Dacron swab (like a long Q-tip with a small head) is gently inserted into one of your nostrils until resistance is met. It is left in place for several seconds, then rotated several times to collect cells, and withdrawn. This is not painful, but it may tickle a bit and cause your eyes to tear. For a nasal aspirate, a syringe is used to push a small amount of sterile saline into your nose and then gentle suction is applied to collect the resulting fluid.

No test preparation is needed.