EPIDEMIC PAROTITIS IN ARKANSAS

Abstract

Epidemic parotitis or mumps is caused by a paramyxovirus well known for affecting the salivary glands and gonads. The signature feature of this disease is bilateral parotid enlargement. While subclinical infections occur, the classic presentation has become so rare that many experienced clinicians have never seen a case. The development of the MMR vaccine in 1971 along with a booster recommendation in the 1990s had essentially eliminated mumps in the U.S. More recently however, along with other communicable diseases, epidemic parotitis appears to be making a comeback; perhaps most publicized in the 2014 National Hockey League affair. Recent outbreaks in the nation’s heartland have affected schools in significant numbers, and Arkansas in particular has been hardest hit with 2802 reported cases as of February, 2017. Although all racial and socioeconomic groups have been impacted, Marshallese migrants living in Northwest Arkansas have been disproportionally affected, constituting 57% of all cases. While under vaccination initially was presumed to be the major reason behind the outbreak, it appears that the surge in cases is more driven by poverty and intense exposures afforded by crowded housing. We present a brief history of epidemic parotitis in Northwest Arkansas with emphasis on the unique Marshallese population.