Mumps Emergence in New York and New York Orthodox Jewish Communities

The largest outbreak of mumps in the United States of the past three years has recently affected several orthodox Jewish communities in New Jersey and New York. Between August of 2009 and October of 2009 180 cases of mumps in the United States and 15 in Canada have been reported in predominantly orthodox Jewish communities.[1] Symptoms of this preventable viral infection, mumps, include fever, headache, swollen, and inflamed glands and may lead to complications. Some of the more serious complications include deafness (temporary or permenant), meningitis, and orchitis (inflammation of the testes, sometimes leading to fertility problems).

Lakewood, New Jersey, which also has a large orthodox Jewish population, has had multiple reports in mostly fully immunized young adults as well as in the Brooklyn community of Borough Park.[2] It is thought to have began at an all boy's summer camp in Sullivan County, New York and was possibly triggered by an 11 year old boy from England attending the camp. In the UK, the outbreak has been more prominent with 4,000 reported cases. There have been 1,586 reports of mumps across the East Midlands alone in the first nine months of 2009, compared to 504 in the UK during all of 2008.[3] Although there have been no deaths and only 3 hospitalizations due to complications due to mumps, it raises questions by all regarding how this disease is still surviving with wide spread vaccinations of the measles, mumps, and rubella (MMR) vaccine.

Initially the two theories on how mumps has reappeared in the western world are regarding opinions and stances against vaccination. For instance, there has recently been concern over the link between the MMR vaccine and autism with the theory that by receiving the vaccine it erodes the bodies' ability to defend itself by bombarding the immune system. Actress Jenny McCarthy has particularly been a key figure in this theory writing several books about her autistic son and appearing in the media to discuss it. The medical community is at odds with this theory. Another thought was related to the nature of the community that was affected. Historically, many orthodox Jewish communities refused vaccination connected to the traditional rejection of Zionism. The community viewed vaccination as government policy and boycotted it. They believed everything is in god's hands, including one's health. [4]This belief appears to not hold true in modern orthodox communities with studies showing most orthodox Jewish parents get their children vaccinated at the same rate the general population does. In 2006, there was a similar mumps epidemic and scientists predicated at that time that there would be another in 2009. This is likely due to the fact that 1 in 20 people vaccinated do not develop antibodies from the vaccine.[5]

Children should get their first MMR vaccine after their first birthday (between 12 and 15 months of age) and their second before the start of kindergarten. One issue remains that many people only receive the first vaccine and thus lack the proper level of immunity. The Mumps vaccine was released in 1967. Prior to that time, 200,000 cases were diagnosed in the US every year. After vaccinations in 1967 that number dropped to less than 1,000 per year. Since the two dose vaccine has been offered widespread, mumps has dropped by 99% in the U.S.[6] There is no treatment for mumps and the virus can last one month from incubation to recovery.

[1]http://www.google.com/hostednews/ap/article/ALeqM5hWyGhtbrhcNIZ1HGUatrSOqzmtiAD9BU9PE01

[2] http://www.jacksonnjonline.com/2009/10/23/mumps-outbreak-in-lakewood-nj/

[3] Nottingham Evening Post, Nottingham, UK. November 19, 2009, pg. 2.

[4] http://www.haaretz.com/hasen/spages/921836.html

[5] http://ny1.com/7-brooklyn-news-content/top_stories/108869/mumps-outbreak-hits-the-city

[6] http://scienceblogs.com/whitecoatunderground/2009/11/mumps_redux.php?utm_source=sbhomepage&utm_medium=link&utm_content=channellink