In Marshall County, Kan., just south of the Nebraska border, public health officials are eagerly awaiting the last day of school on Thursday.
Over the past three months, the county has taken the lead in Kansas mumps cases, with 29 confirmed illnesses that have mostly occurred at the Marysville Junior Senior High School.
“We’re hoping with the close contact related with school, that kids may not be together as much in that close an environment (once school is out) and then we may see less risk of that transmission,” said Tami Stowell, a public health nurse in the Marshall County Health Department.
Johnson County officials aren’t expecting a similar reprieve. Their outbreak may get worse before it gets better, as students exposed to mumps at universities in the region return home.
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The Marshall County mumps outbreak is one of several across Kansas, which has had 144 cases since December, and Missouri, which has had more than 400.
Almost all of them can be traced to a single gathering place where people spread the virus. Missouri’s cases have mostly been from one large outbreak at the University of Missouri-Columbia and several smaller outbreaks at other colleges.
In Kansas, most of Riley County’s 17 cases have been at Kansas State University, most of Douglas County’s 17 cases have been at the University of Kansas and the Crawford County outbreak that sickened 15 started at Pittsburg State University.
Then there’s Johnson County, where health officials say there’s been no rhyme or reason to its 27 cases, 18 of which have occurred since early April.
“We’re seeing basically all ages,” said Nancy Tausz, the disease containment director for the Johnson County Health Department. “There’s no concentration on one age or the other.”
In an advisory posted online Monday, the department urged residents to make sure they’re up to date on their measles-mumps-rubella vaccine, try not to share germs and stay home if they feel sick.
In a letter to parents dated May 18, Shawnee Mission South reported one of its students had mumps. But a district spokeswoman said that’s the only case this year. The Shawnee Mission school year ended the next day.
When mumps first appeared in Johnson County in December, the Kansas Department of Health and Environment reported that it had been brought there by someone infected in the University of Missouri outbreak. Later cases were linked to the KU outbreak.
Douglas Dechairo, the director of Watkins Health Services at the University of Kansas, said Johnson County’s high population and the mobility of its residents make it hard for the county to stop mumps from being brought in.
“Some of those Johnson County ones are our cases,” Dechairo said.
Mumps is a contagious viral illness spread through close contact with a person who has it, sometimes even before that person is showing symptoms. Common symptoms are fever, muscle aches and swollen saliva glands. In rare cases, the disease can cause serious health problems.
Mass vaccination efforts that started in the 1960s nearly wiped out the disease, but a small resurgence over the past two years has raised questions about the vaccine, which is estimated to be 88 percent effective in the standard two-dose series. In Kansas, 86 percent of mumps cases have been in people who are vaccinated.
The University of Missouri-Columbia started recommending students get a third dose of vaccine after a large-scale mumps outbreak flared up on campus in November and December. Almost 400 students had been infected as of last week. The pace of the outbreak seems to have slowed since the third dose was deployed, but university health officials have said they can’t draw conclusions about whether that’s because of the vaccine or other factors.
A committee of health experts that makes recommendations to the Centers for Disease Control is currently studying the data from Missouri and other outbreaks to determine whether a third vaccine is effective.
With 29 cases in a county of about 10,000 people, the Marysville outbreak was the first in Kansas deemed intense enough to try a third dose. With help from KDHE and the CDC, the Marshall County Health Department hosted a free vaccine clinic in the high school library earlier this month. Stowell said the community has been cooperative and the department is doing what it can to keep other people from getting sick.
“We’ve managed as far as having enough staff,” Stowell said. “Hopefully we’re on the tail end of it.”