ARCHIVED - Guidelines for the Prevention and Control of Mumps Outbreaks in Canada
Appendix 2: Key Recommendations for the Prevention and Control of Mumps Outbreaks
Section(s) | Key Recommendations |
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4.2 | Outbreak Definition Confirmed cases in excess of what is expected in the jurisdiction over a given period of time. |
4.3
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Case Definitions In the absence of recent immunization (i.e. in the previous 28 days): Confirmed Case (any one of the following):
Clinical Case / Probable Case
Refer to Section 5.0 and Appendix 4 for details on preferred clinical specimens and interpretation of laboratory results. |
4.3 |
Contact Definition Any of the following during the infectious period (i.e. approximately 7 days before to 5 days after symptom onset):
Refer to Section 6.3.3 if the contact is a health care worker. |
6.1 |
Case Management Clinical cases should be managed as confirmed cases until laboratory evidence suggests otherwise.
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6.2 |
Contact Management (community contacts; health care workers who are contacts are addressed separately in section 6.4.3) At the start of the outbreak, individual contacts can be managed either directly/individually or indirectly using the case to disseminate information to their contacts. Depending on the epidemiology of the outbreak, alternative follow-up mechanisms (e.g. letter, Internet, public service announcement, press release, toll-free telephone number) should be considered to reach contacts and other at-risk groups. Regardless of the mechanism, the dissemination of information to contacts should include
Offer immunization to susceptible groups as defined by the epidemiology of the outbreak; recognize that immunization may not prevent disease if the individual is already infected, and previous outbreak experiences have found uptake to be low |
6.3.1 |
Gatherings During an outbreak, events need not be cancelled. However, because of the slight but real risk of exposure, public exposure settings should be communicated to the public and gathering organizers should advise participants of the following:
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6.3.2 |
Schools/Educational Institutions Encourage schools/educational institutions to practise general good hygiene to prevent disease spread (e.g. use good hand hygiene, avoid sharing food/drink/utensils, cover coughs and sneezes with a tissue or forearm, and stay home when ill). If a case is identified, notify staff, students and families. Refer to Section 4.3 for defining contacts of cases. |
6.3.3 |
Health Care Settings (include acute care, long-term care and home care) |
7.3.3 |
Some health care settings may not have occupational health and infection prevention and control departments. When occupational health and infection prevention and control are referred to, they mean the individual(s) responsible for occupational health and infection prevention and control for that health care setting. Definitions: A health care worker (HCW) is an individual who may have the potential to acquire or transmit an infectious agent during the course of his or her work in the health care workplace (e.g. nurses, physicians, students, volunteers, home care workers, emergency responders and support staff). Pre-placement of HCWs
Existing HCWs Occupational Health should provide MMR to all HCWs unless the individual has
HCWs who are cases
HCWs who are contacts
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6.4 | Travellers Travellers should ensure that their routine immunizations are up to date. As mumps is transmitted through infected oral/nasal secretions, travellers should protect themselves and others by practicing good hand hygiene and coughing or sneezing into a tissue or forearm. They should avoid sharing food, drinks or utensils. In Canada, individuals can be refused permission to board an aircraft or cruise ship if they appear to have an infectious disease. Travellers with symptoms of mumps, including fever, should postpone travelling until they are better. When provincial/territorial borders are crossed, the province or territory where the case was diagnosed should alert other provinces/territories and the Public Health Agency of Canada (Centre for Immunization and Respiratory Infectious Diseases). When cases or contacts are from a different country, the identifying provincial/territorial health authority should notify PHAC, which will contact the appropriate authority of the affected country. When mumps cases or contacts are identified in international travellers by the Quarantine Service or Duty Officers at an international port of entry, PHAC will notify the appropriate provincial/territorial or international public health authority. Airplanes: Individual follow-up is not recommended, although notification of implicated public health authorities is suggested as other jurisdictions may have different protocols. Cruise Ships: The cruise ship's health services would have the responsibility for the traveller's health during the cruise and would follow up with contacts according to the conveyance operator's policy. |
7.0 |
Immunization (summarized from previous sections) |
7.3.2 |
Community contacts of cases |
6.2 |
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7.3.3 |
HCWs who are contacts of cases |
6.3.3 |
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8.0 | Strategic Risk Communications In outbreaks, strategic communications play a key role in successfully managing the risk. It is important that risk managers and communicators collaborate to identify the desired behavioural changes that will reduce the risk among stakeholders and to identify the barriers that may discourage change, in order to develop efficient strategies for risk mitigation. |
8.1 |
The goal of strategic risk communications is to establish trust with the affected stakeholders in order to encourage them to make behavioural changes to reduce their risk. The best way to do this is to involve stakeholders early on and to be transparent with all information. |
8.2 |
Communications activities include identifying spokespersons to speak to the media about the issue and developing media lines, backgrounders, and question and answer content. Sharing key messages, communication materials and best practices across all jurisdictions involved is essential for managing an outbreak. |
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