Why LA County mumps cases in recent outbreak first went misdiagnosed



Cases of mumps are so infrequent, that physicians may not even know how to spot the infectious disease, which is why patients in the recent Los Angeles County outbreak went misdiagnosed, health officials said Friday.

Many of the 41 patients who came down with mumps went to various health providers across Los Angeles County, said Michelle Parra, director for the immunization program for the Los Angeles County Public Health Department.

In a public health alert for physicians and health care providers Thursday, officials said many of the cases were initially misdiagnosed and there was a reliance on using false negative results.

“In terms of misdiagnoses, it’s not an uncommon thing to misdiagnose mumps,” Parra said. “There are other conditions that look similar to mumps. Nowadays physicians are not thinking about mumps. A lot of people are vaccinated.”

Of the 41 patients, five had documented proof they had been vaccinated, 23 said they thought they had been, while 12 patients had no idea. One person had never been vaccinated, Parra said.

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Also, a few of the patients were from Orange County, Parra added.

Health officials said most of the patients are men who have sex with men, and the majority of the cases were linked to patients attending large venues such as gyms, bars, theaters and nightclubs. Some of the patients are women and heterosexual men who have social connections to men who have sex with men, health officials noted.

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The outbreak can be linked to two clusters from March, when seven men in L.A. County were diagnosed with mumps.

RELATED STORY: Mumps outbreak prompts LA County public health alert

“A major factor contributing to outbreaks of mumps is being in a crowded environment,” according to the alert. “Also, certain behaviors that result in exchanging saliva, such as kissing or sharing utensils, cups, lipstick or cigarettes, may increase the spread of the virus.”

Parra said most of the cases were concentrated closer to the Westside of Los Angeles County.

“Historically, we’ve seen mumps on college campuses, in dorms, in the military, and sports teams,” Parra said, adding that the health department has alerted providers in the LGBTQ community to test for disease.


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Symptoms include fatigue, body aches, headache, loss of appetite, a low-grade fever and swelling of the salivary glands, according to health experts. In adult men, mumps can sometimes lead to sterility.

Nationwide, 2,570 people have been diagnosed with mumps from January to April of this year, according to the federal Centers for Disease Control and Prevention.

The agency reports that mumps is no longer common in the United States, but some outbreaks have been reported. Last year, there were 5,833 cases.

“Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year, but the actual number of cases was likely much higher due to underreporting,” according to the CDC. “Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases in the United States.”

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Mumps patients are contagious from two days before through five days after onset, according to the CDC.

Public health officials said routine vaccination is the most effective way to prevent the disease. California requires that all children entering kindergarten receive two doses of the MMR vaccine. As of July, 1 2016, only children with medical proof can be exempt. Adults who don’t know if they have received the vaccine should speak with their provider, Parra said.

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