Earthquake and Tsunami

Technical Reports

MoH Reports

Republic of Maldives

Department of Public Health

Mumps notifications from Hulhumale relief camp, Maldives to March 20^th 2005

16 cases of mumps were notified to the Department of Public Health from Hulhumale Relief camp from January 30^th 2005 until March 20^th 2005.

Background

Thirteen families from affected islands were relocated to Hulhumale on January 20^th 2005. Prior to this, from December 26^th 2004, they were being housed in Male.

There are currently 71 people in total in the camp, with eight children under 5 years and thirteen aged 5 to 14 years. These figures are not static. Families share sleeping accommodation. There are shared bathroom facilities and communal washing and ironing areas.

There are about 1600 people living on the rest of the island and the children from the camp attend the school on the island. There have been mumps notifications from the other part of the island and data are in the Appendix.

Mumps immunization is not part of the routine immunization schedule in The Maldives.

Mothers have confirmed that all required immunizations have been completed. The records kept on the islands of origin will have been destroyed.

A team (Ministry of Health, WHO) went out to visit the camp on Friday 18^th February 2005, accompanied by the Director of Hulhumale Hospital, the Health Worker and the paediatrician who made the diagnosis in the children.  Mumps testing kits were requested from SEARO and these arrived in Male at IndiraGandhiMemorialHospital where testing was undertaken last week.

Descriptive Epidemiology

Sixteen people were given a diagnosis of mumps based on a case definition of fever and parotid gland swelling. The date of onset of the index case was January 30^th 2005. The last three reported cases were on March 20^th.

Figure 1

Epidemic Curve for mumps cases reported from Hulhumale relief camp to March 20^th 2005 (n=16)

Table 1

Age and Sex of mumps cases notified

Location of cases

The cases were originally from Thaa Villifushi, Raa Kandholhudhoo, and Thaa Madifushi.

The cases are grouped by family/ addresses (Table 2).

Table 2

Islands and addresses of cases

Laboratory Diagnosis:

5 samples in total were submitted from four families for mumps specific IgM testing. Four of these were positive.

Control Measures:

All cases were advised to remain in isolation. A separate camp was set up for this purpose.

Outcome:

Communication with the Health Worker at Hulhumale Hospital/Relief Camp indicated that none of the present cases are seriously ill and the previous cases are now well.

Wider Control Measures

Healthcare professionals notifying cases from all are being advised to keep cases in isolation until 9 days after onset of parotitis.

Mumps IgM testing is also being carried out in samples of cases e.g. selected cases from family groups.

Findings

Almost all mumps samples tested were positive (See Appendix). The case definition therefore appears to be both sensitive and specific which supports the fact that clinical diagnosis is predictive when true infection is on the increase.

26^th March 2005.

Appendix 1

Summary of Mumps in the Maldives to March 23^rd 2005

Twenty-nine islands have reported cases of mumps to the Department of Public Health since January 2^nd 2005.

Epidemic curve for all cases reported is shown in Figure 1.

Figure 1

Epidemic curve for all mumps cases notified to DPH since January 2^nd 2005 N= 253

Table 1

Age – Sex distribution for Male and Atolls

Table 2: Reported mumps cases by Island by Month of reporting