Study: Orthodox Jewish males transmitted mumps in school

A mumps outbreak in New York and New Jersey in which 97 percent of the more than 3,500 cases were Orthodox Jews was a result of the way Orthodox boys are schooled, according to a new study.

study on the June 2009 to June 2010 outbreak in New York City, two upstate New York counties and one New Jersey county home to a high percentage of Orthodox Jews appears in the Nov. 1  2012 issue of the New England Journal of Medicine.

Adolescents 13 years to 17 years of age, representing 27 percent of all the patients, and males, representing 78 percent of patients in that age group, were disproportionately affected, according to the study abstract. Most of the boys had been vaccinated against the disease. 

Most of the boys that contracted the disease studied in Jewish yeshiva high schools, “where students spend many hours daily in intense, face-to-face interaction,” according to the study abstract, leading to the mumps' spread.

The study concluded that  “intense exposures, particularly among boys in schools, facilitated transmission and overcame vaccine-induced protection in these patients.”

Mumps Outbreak Hits Los Angeles

A mumps outbreak among observant Jews on the East Coast appears to be spreading to the Los Angeles Jewish community.

Eight cases of the mumps have been confirmed in Los Angeles this year, at least six of them in the observant Jewish community in the last two months, according to the Los Angeles County Department of Public Health. The cases are believed to have spread to Los Angeles following Passover travel, and many more reports are being investigated.

In 2009, only eight cases of mumps were reported countywide.

This year’s first case in the Los Angeles Jewish community was reported in Yeshiva Ohr Elchonon Chabad in the post-high school program, but the disease has since appeared outside the Chabad community. Chabad schools and other Jewish schools put parents on alert about the East Coast outbreak at the beginning of the school year.

Around 2,800 cases of mumps have been confirmed in New York and New Jersey in the last year, and 2,600 in Israel. Quebec is also seeing an outbreak among the Jewish community.

Mumps, transmitted through coughing and sneezing, manifests with fever, aches, fatigue and tell-tale swelling behind the jaw and under the ears. Symptoms are generally worse for adults, and in post-pubescent males symptoms include testicular swelling. Symptoms begin 12 to 25 days after exposure and can last around a week.

While mumps itself is not a dangerous disease, complications include deafness, meningitis, pancreatitis, encephalitis and male infertility.

The Department of Public Health sent out an alert to schools and pediatricians last week, urging people to get vaccinated and to make sure boosters are up to date.

The best protection from mumps is the MMR (measles, mumps, rubella) vaccine. But the vaccine is not a guarantee; one dose is 73 to 91 percent effective, and two doses are 79 to 95 percent effective. Some recent cases have been among vaccinated individuals, though anecdotal evidence suggests symptoms are not as severe in vaccinated individuals, according to Dr. David Keene, a pediatrician.

While no data exists specifically on the Jewish community’s vaccination rates, it is assumed Jews vaccinate at the same rate as the general population, according to Alvin Nelson El-Amin, medical director of the Department of Public Health’s immunization program. In Los Angeles, 92 percent of the population is immunized, El-Amin said.

While that is a good percentage, it is declining, El-Amin said. In 2000, only 0.43 percent of kindergarten parents would not vaccinate because of personal beliefs. In the fall of 2009, that number was up to 1.42 percent.

Much of the decline is attributed to fears among parents that ingredients in vaccines can cause autism. That theory has been widely discredited by scientists and doctors.

Rabbi Heshy Ten of Bikur Cholim Jewish Healthcare Foundation says that he is not aware of any pockets in the Jewish community that do not vaccinate for ideological reasons.

Ten says the disease in New York has spread to the entire observant community, and contrary to reports is not limited to the Chasidic population. He urges everyone to be on alert, especially as the summer camp season nears.

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