Vaccines in People Allergic to Eggs: What's Safe?

Why Japan Banned MMR Vaccine

by JENNY HOPE, Daily Mail

Japan stopped using the MMR vaccine seven years ago - virtually the only developed nation to turn its back on the jab.

Government health chiefs claim a four-year experiment with it has had serious financial and human costs.

Of the 3,969 medical compensation claims relating to vaccines in the last 30 years, a quarter had been made by those badly affected by the combined measles, mumps and rubella vaccine, they say.

The triple jab was banned in Japan in 1993 after 1.8 million children had been given two types of MMR and a record number developed non-viral meningitis and other adverse reactions.

Official figures show there were three deaths while eight children were left with permanent handicaps ranging from damaged hearing and blindness to loss of control of limbs.

The government reconsidered using MMR in 1999 but decided it was safer to keep the ban and continue using individual vaccines for measles, mumps and rubella.

The British Department of Health said Japan had used a type of MMR which included a strain of mumps vaccine that had particular problems and was discontinued in the UK because of safety concerns.

The Japanese government realised there was a problem with MMR soon after its introduction in April 1989 when vaccination was compulsory. Parents who refused had to pay a small fine.

An analysis of vaccinations over a three-month period showed one in every 900 children was experiencing problems. This was over 2,000 times higher than the expected rate of one child in every 100,000 to 200,000.

The ministry switched to another MMR vaccine in October 1991 but the incidence was still high with one in 1,755 children affected. No separate record has been kept of claims involving autism.

Tests on the spinal fluid of 125 children affected were carried out to see if the vaccine had got into the children's nervous systems. They found one confirmed case and two further suspected cases.

In 1993, after a public outcry fuelled by worries over the flu vaccine, the government dropped the requirement for children to be vaccinated against measles or rubella.

Dr Hiroki Nakatani, director of the Infectious Disease Division at Japan's Ministry of Health and Welfare said that giving individual vaccines cost twice as much as MMR 'but we believe it is worth it'.

In some areas parents have to pay, while in others health authorities foot the bill.

However, he admitted the MMR scare has left its mark. With vaccination rates low, there have been measles outbreaks which have claimed 94 lives in the last five years.

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Mumps Outbreak In Delhi, Other States? What Doctors Say

Dr Kiran Aggarwal speaks to NDTV on the mumps outbreak

New Delhi:

Cases of mumps appear to be spreading in Delhi as doctors report more and more children and young adults between 18 and 25 are visiting them with symptoms.

Though the viral infection appears to be spreading in Delhi and the National Capital Region (NCR), other states such as Andhra Pradesh, Kerala, Telangana, and Maharashtra have seen rising mumps cases in children in the past few months.

Dr Kiran Aggarwal, paediatrician and former president of the Delhi-based Indian Academy of Paediatrics, told NDTV thousands of cases are being reported from across the country.

"It can be called an outbreak. Why not? Earlier, we used to see mumps cases in certain seasons, one or two months, and would go away. But this time mumps has been around for seven-eight months," Dr Aggarwal said.

"It's not a disease that needs hospitalisation. General doctors can see it," she added.

Health Ministry data shows over 15,000 cases of mumps have been reported between the January to March period this year.

The symptoms include swelling in the neck, one side or both, she said. "It is also painful to eat when you have mumps," Dr Aggarwal said.

People with mumps usually get better in four-five days, she said, adding the swelling goes away in a few days. "But it is a highly infectious disease. Anyone can give infection fast to people around," she said.

There is a vaccine for mumps called 'measles, mumps, and rubella' (MMR) vaccine, but is not part of the national schedule of mandatory vaccines.

"Nobody thought about including it. One reason is the national infectious disease portal has no records. How would you know how many cases are there? When vaccines are brought into the national schedule, there is also a cost factor. It has to be administered to the entire population, and not selectively. So do we have enough in the Budget to set aside for this? Cost factor is always there," Dr Aggarwal said.

According to the US Centres for Disease Control and Prevention (CDC), mumps is caused by a paramyxovirus, a member of the Rubulavirus family. The average incubation period for mumps is 16 to 18 days, with a range of 12 to 25 days.

Mumps is known for the puffy cheeks and tender, swollen jaw that it causes, the CDC says. This is a result of swollen salivary glands under the ears on one or both sides, often referred to as parotitis.

Other symptoms include fever, headache, muscle aches, tiredness, and loss of appetite. The symptoms typically appear 16 to 18 days after infection, but this period can range from 12 to 25 days after infection. Some people who get mumps have very mild symptoms (like a cold), or no symptoms at all and may not know they have the disease, the CDC says.

Can You Get Mumps Twice? An Expert Shares Insights

Mumps is a highly contagious viral disease that leads to symptoms such as fever, headaches, muscle pain, and loss of appetite. However, one of the striking features of the condition is swelling in the front of the neck, also called salivary glands, or right in front of the ears, known as parotid glands.

When it comes to mumps, a common question people ask is whether you can get it twice, meaning if you have already had the condition when you were young, can you still get it as an adult or at any other point in time? We asked Dr Tharanath S, Consultant Physician and Infectious Diseases Specialist, SPARSH Hospital, Yelahanka, Bengaluru, to shed light on the same and to share whether the disease can be prevented.

Also Read: Swelling Of Salivary Glands? Expert Explains Mumps, Its Symptoms And How To Prevent It

How Does Mumps Spread And Who Is Most At Risk?

According to StatPearls Publishing, mumps is endemic worldwide, meaning the virus is constantly present around the world; however, epidemic outbreaks occur every few years (roughly every five years) in places where people don't get vaccinated.

Mumps usually spread from person to person through direct contact with respiratory droplets or saliva of an infected person.

According to the US Centers for Disease Control and Prevention (CDC), while there are vaccinations to prevent the disease, outbreaks still occur among groups of people who have prolonged, close contact, such as sharing water bottles or cups, kissing, practising sports together, or living in close quarters  with a person who has mumps.

Dr Tharanath says, "Mumps primarily affect children of school-going age groups (5–10), but even adults can get infected."

Can You Get Mumps Twice?

When it comes to reinfection with mumps, Dr Tharanath says it's very rare.

Generally, having mumps once confers lifelong immunity, according to the expert.

However, if a person has never been clinically diagnosed with mumps, they should definitely receive a vaccination, according to the doctor.

In fact, the introduction of the mumps vaccine in 1967 led to a 99.8% decrease in documented cases in the United States by 2001, according to research.

Also Read: Mumps Outbreak Grips Kerala: Here's Everything To Know About The Condition

There are currently two vaccines that can help prevent mumps: the MMR vaccine and the MMRV vaccine.

The MMR vaccine protects children and adults from mumps, measles, and rubella, whereas the MMRV vaccine protects children from mumps, measles, rubella, and chickenpox.

Mumps Management Tips

While the most effective way to prevent mumps is through vaccination, good hygiene practices, and avoiding social gatherings or school if infected, management of mumps focuses on symptomatic treatment for fever and pain, good hydration, watching out for complications, and universal immunisation, according to Dr Tharanath.

He says, "It's crucial to stay hydrated and avoid acidic foods that can irritate swollen salivary glands. Additionally, practising good hygiene, such as frequent handwashing, can prevent the spread of the virus."

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