Health care worker exclusion

The Centers for Disease Control and Prevention (CDC) recommends furloughing health care workers who have active mumps or who are nonimmune and have had unprotected exposures — those who have been within 3 feet of a mumps patient without wearing a surgical mask. All exposed health care workers should report signs or symptoms of illness during the incubation period (12 to 25 days after exposure), the CDC says. The agency also provided this guidance:

Management of health care workers with illness due to mumps:

• A diagnosis of mumps should be considered in exposed health care workers who develop nonspecific respiratory infection symptoms during the incubation period after unprotected exposure to mumps, even in the absence of parotitis (swelling of the salivary glands).

• Health care workers with mumps illness should be excluded until nine days after the onset of parotitis.

Management of health care personnel who are exposed to persons with mumps:

Health care workers with any of the following are considered immune to mumps: history of physician-diagnosed mumps, past receipt of at least one dose of mumps vaccine or positive mumps IgG.

For health care personnel who are nonimmune:

• Nonimmune personnel should be excluded from the 12th day after the first unprotected exposure to mumps through the 26th day after the last exposure. The mumps vaccine cannot be used to prevent the development of mumps after exposure. Hence, previously unvaccinated health care personnel who receive a first dose of vaccine after an exposure are considered nonimmune and must be excluded from the 12th day after the first exposure to mumps through the 26th day after the last exposure.

For health care personnel who are immune:

• Those personnel who had been previously vaccinated for mumps, but received only one dose of mumps vaccine may continue working following an unprotected exposure to mumps. Such workers should receive a second dose as soon as possible, but no sooner than 28 days after the first.

• Health care personnel who are immune do not need to be excluded from work following an unprotected exposure. However, because one dose of MMR vaccine is about 80% effective in preventing mumps and two doses are about 90% effective, some vaccinated personnel remain at risk for infection. Therefore, health care workers should be educated about symptoms of mumps, including nonspecific presentations, and should notify employee health if they develop these symptoms.