Mumps outbreak in Mumbai’s poorer areas causes worry

The mumps virus spreads through direct contact with infected saliva or through respiratory droplets from an infected person’s nose, mouth or throat. While there is no definitive treatment, patients are given medicines to treat body ache and fever, asked to apply cold or warm compresses on their swollen salivary glands and drink plenty of water and fluids

Mumbai: At Janta Nagar, a slum in Mankhurd, residents are grappling with a surge in mumps cases, a viral infection caused by a paramyxovirus. Shalika Khatoon, 31, who caught the virus along with her daughter Zeenat, 9, and son Mohammed Kabir, 7, revealed that many children in their lane were infected. “My daughter was the first to be infected two weeks ago, followed by my son,” said Shakila. “Both got chills, fever and body ache. Concerned about the swelling in their necks, I took them to the mohalla clinic.”

Mumbai, India - Nov. 9, 2023: Dr Shilpa Varma, the doctor who treatment to Mumps patient 9 years old Zinath Fatima at Janta Nagar, Mankhurd in Mumbai, India, on Thursday, November 9, 2023. (Photo by Satish Bate/ Hindustan Times) (Hindustan Times)

The mumps virus spreads through direct contact with infected saliva or through respiratory droplets from an infected person’s nose, mouth or throat. While there is no definitive treatment, patients are given medicines to treat body ache and fever, asked to apply cold or warm compresses on their swollen salivary glands and drink plenty of water and fluids.

Rashida Ansari, 25, who lives in Mandala, Mankhurd, was at the mohalla clinic at Janta Nagar with her four-year-old daughter, Elma, on Saturday. “She had a fever, body ache and chills,” said Rashida. “Many children in our area have similar symptoms and swelling in the neck region.”

Dr Shilpa Varma, who heads the clinic, said that since its opening on October 11, she had been seeing at least two or three mumps cases a day. “There are adults too,” she said. “I have never seen so many mumps cases in my career though I have practised in Kurla and the Dharavi slums.” Dr Varma counsels the parents of mumps-positive children to keep them at home, as the disease is contagious.

Mankhurd—the M East ward that saw a measles eruption last year—is not the only area seeing a mumps outbreak. Mumbai paediatricians say they have been seeing a rise in mumps cases in lower socio-economic areas for the last six weeks. While vaccination is the best way to prevent mumps and its complications, the free national vaccination programme does not include this particular disease, which is why mumps cases from the socio-economically weaker sections are burgeoning.

Dr Amit Mhatre, a paediatrician who works in the Chembur-Mankhurd area, said that his group of three paediatricians had seen close to 1,000 cases in the last two months. “The problem is that the government gives only MR vaccines—measles and rubella,” he said. “Mumps needs to be included in the national immunisation programme.”

Dr Mhatre said that he alone saw six to seven cases every week, all of them from socio-economically weaker backgrounds who went to government hospitals for vaccination. He also pointed to another reason for the mumps epidemic: the Covid-19 pandemic. “The outbreak is not surprising,” he said. “Chicken pox and mumps eruptions are happening because of the lack of immunisation during the pandemic months.”

Dr Bakul Parekh, a paediatrician practising in Ghatkopar and a member of the Indian Academy of Paediatricians (IAP), said the winter months saw more outbreaks of viral infections like mumps and measles, as cold and dry air provided optimal conditions for the spread of viruses. Dr Parekh, who has seen quite a few cases in the last few weeks, said that to stop the spread, 90 percent of the population needed to be vaccinated. “Unfortunately, because mumps is not part of the national immunisation programme, the majority of the population is not covered, which is leading to the outbreak,” he said.

Dr Nehal Shah, president (elect) of the IAP’s Mumbai chapter, said that mumps could have long-term complications, especially in males. “Apart from causing a drop in immunity for a couple of weeks like other viral infections, mumps can cause male infertility,” she said. “Some patients also get mumps encephalitis, a neurological complication.” Dr Shah reiterated the point about the national vaccination programme needing to include mumps.

Dr Vijay Yewale, ex-president of the IAP’s Mumbai chapter, said that the mumps-measles-rubella (MMR) vaccine was given only in the private sector because of which mumps vaccination coverage was not high. “IAP recommends three doses of MMR—the first one at nine months, the second at 16 to 18 months and the third at the school entry point,” he said. “However, it has been observed that children get only the first dose. Mumps requires repeated vaccines for long-lasting immunity.”