A guide to vaccinology: from basic principles to new developments
Why Are University Students Catching Mumps?
Uptake of the measles, mumps, and rubella virus (MMR) vaccine has gone down in recent years
A total of 223 suspected cases were reported, with 40 confirmed, across Nottingham Trent University and the University of Nottingham.
That has now risen to 241 suspected cases with 51 confirmed by Public Health England (PHE).
BBC News has taken a look at why this is and whether university students are still at risk.
Where else is this happening?The numbers seem particularly high in Nottingham.
PHE said latest figures showed cases of mumps in England had decreased in 2018, with 1,024 confirmed cases compared with 1,796 in 2017.
There have also been a handful of reported cases at the universities of Bath, Hull and Liverpool and in the US - specifically Temple University, in Philadelphia, which has recorded about 100 people with signs of the infection.
There does not appear to be any reason as to why the Nottingham numbers are much higher, though experts have said it could be that there are more in the city who are not immune.
Students outside an emergency clinic at Temple University, in Philadelphia
Prof Jonathan Ball, from the University of Nottingham - an expert in viruses and viral vaccines and treatments - said it was affecting students because they gathered in "close proximity for fairly large periods of time".
This would include in halls of residence, lecture theatres or even at nightclubs, which hold specific nights aimed at students.
"The virus [could] spread fairly easy, especially if there are relatively large numbers of people who have not been vaccinated," he said.
A marine biology student at the University of Hull, who did not want to give his name, said he started feeling ill while on a field trip to the Isle of Cumbrae in Scotland.
The 19-year-old, who said he knew at least two others who had the symptoms, had to be isolated and driven home, avoiding public transport because of the risk of others being infected.
Can you catch it if you have been vaccinated?Yes. Dr Vanessa MacGregor, from PHE, said it had seen a rise in figures recently, with teenagers and young adults who have not had two doses of the MMR vaccine "particularly vulnerable".
The NHS says the vaccine is part of the routine childhood immunisation schedule, in which a child is given one dose when they are 12 to 13 months old, and a second at three years and four months.
Dr MacGregor urged those who have not had the MMR vaccine - or only received one dose - to ensure they took up the offer of MMR (measles, mumps and rubella) vaccination.
Students in Philadelphia have been taking the MMR jab
The University of Hull student also said it was "strange" he had contracted the infection because he had received both doses and this had been confirmed by his father.
According to Prof Ball, the mumps part of the vaccine is the "least effective".
He said: "For the mumps vaccine, we expect about 88% of people vaccinated to be protected, whereas for the measles vaccine this is as high as 98%.
"If you then add unvaccinated people into the mix, it is easy to see how a relatively contagious virus as mumps can spread so easily."
Mumps was once common in children before vaccinations began in the 1980s
He said this was further complicated, because some people who are infected show little or no symptoms at all.
However, if the majority were vaccinated, those susceptible to the infection would benefit from "herd immunity", the level considered by experts to protect a population from a disease.
But, as Prof Ball states: "If you start to reduce the numbers of people being vaccinated, then that herd protection just isn't there."
Why is uptake of the MMR vaccine declining?The "damaging" work of discredited scientist and struck-off medic Andrew Wakefield in the 1990s "helped fuel the fire of the anti-vaccine movement," according to Prof Ball.
In 1998, the doctor led a study that linked the MMR vaccine to autism, impacting on the coverage of the vaccine, with rates dropping to about 80% in the late 1990s and a low of 79% in 2003.
The GMC ruled that Andrew Wakefield acted "irresponsibly" in carrying out his research
Rates partially recovered after the research was disproved but the volume of anti-vaccine sentiment on social media has increased in recent years.
This led Health and Social Care Secretary Matt Hancock to call for new laws to force social media companies to remove content that promoted false information about vaccines.
Prof Ball said there were rarely "side effects" with vaccines and even if there were, the benefits outweighed these.
You may also like:"Because we have lived through a golden age of vaccination, we have forgotten just how harmful, and sometimes even fatal, these virus infections can be," he said.
Are students and others still at risk?Dr Natalie Riddell, a lecturer in immunology and ageing at the University of Surrey, said a reduced amount of people being vaccinated against any contagious disease was dangerous.
"Babies and immuno-compromised people [such as the elderly or those receiving chemotherapy] rely on the rest of us to be vaccinated to prevent the spread of disease," she said.
"It is totally unnecessary for people to risk their friends and family becoming ill, or even dying, from measles or mumps, as there is a safe and effective vaccine to protect against both."
Prof Ball said poor vaccine uptake worldwide had led to an increase in outbreaks of mumps and measles and we should "expect things to get worse" before they get better.
The University of Nottingham has been hit by the mumps virus
US county declares measles emergency Mumps outbreak at universities Minister targets anti-vaccination websites Vaccine deniers gaining ground - NHS bossMumps - Is It The Forgotten Disease?
Swollen glands below the ears are a classic sign of mumps
There has been a sharp increase in cases of mumps this year in England - but the viral illness which can cause swollen glands (and, more rarely, testes) has been around for a very long time.
Way back in the 5th Century BC, Hippocrates is thought to be the first person to have recorded the symptoms of the disease.
The Greek physician described "swellings... About the ears, in many on either side, and in the greatest number on both sides".
This is a result of the mumps virus causing the swelling and inflammation of one or both parotid glands, which sit in front of the ears.
It can lead to difficulty opening the mouth to talk, eat and drink.
And this recognisable symptom probably gave the illness its name.
'Hamster face'Mumps is a strange word for an illness, and it has no clear origin.
It could come from the old English word for grimace or sulk - mump - or it may be linked to the Icelandic word for a mouth being filled too full - mumpa - and the Dutch for mumble, "mompelen".
However, the overriding impression is that the distinctive "hamster face" appearance of the illness has influenced its name.
The mumps virus is very contagious and can be passed through saliva or droplets
But it is not the only part of the body that can swell up - in rare cases, the testes, the pancreas, the brain and the ovaries can too.
"It doesn't make boys sterile - that's a myth," says Prof Helen Bedford, from the Royal College of Paediatrics and Child Health.
Mumps is, however, more serious and more painful the older you are.
Headaches, fever and ear pain often accompany the swelling.
Outbreaks are commonMumps has not only reappeared this year, despite the rise in cases.
Before the MMR vaccine - the second M stands for mumps - was introduced in the UK in 1988, eight out of 10 people developed mumps and most of them were children of school age.
At that time, there were five deaths a year from mumps, mainly due to encephalitis or swelling of the brain.
Cases have never spiked like that again, but outbreaks are common and cases of mumps consistently outnumber measles and rubella cases each year.
Teenagers and young adults in colleges and universities are now the ones who tend to be affected - for several reasons.
They may be too old to have been immunised or offered the MMR, or may only have had one dose of the vaccine - or they had two doses, but the vaccine's protection against mumps has worn off.
"The mumps vaccine is not as effective as other bits of MMR, which is why it's important to have two doses," says Prof Bedford.
Close-mixing groups of young people in other countries are similarly affected by mumps outbreaks.
The virus is easily spread, through saliva or droplets in a cough or sneeze - a bit like colds and flu.
Prof Bedford says it is important to remember the impact of mumps (as well as measles and rubella) on children, and young people.
"Mumps can make children feel very unwell and stay in bed for days.
"It's not nothing. Perhaps we've lost sight of what these illnesses are really like," she says.
Thankfully, we have Hippocrates to remind us.
Rise in mumps cases prompts vaccine callMumps Case In Elizabeth City Draws Attention To Vaccination Numbers
ELIZABETH CITY, N.C. — Mumps is a disease you may have heard of in history books. We're hearing about it this week too. School leaders in the Elizabeth City-Pasquotank Public School District informed parents Sundayabout a positive diagnosis in a middle schooler.
They said the district is working closely with public health officials to monitor the situation.
Previous coverage: Student at River Road Middle School in Elizabeth City diagnosed with mumps
Student at River Road Middle School in Elizabeth City diagnosed with mumps
"The great concern will be unvaccinated classmates because it's highly contagious and the patient is shedding the virus (contagious) before they feel sick," explained Dr. Gary Moss, Sanford Health-affiliated allergist/immunologist.
Dr. Moss said mumps has been nearly eradicated nationwide since the MMR vaccine—a combination vaccine for measles, mumps, and rubella—was introduced decades ago.
"We don't see it that much since vaccination started," he said. "I've actually never seen a real case of mumps before."
Watch related coverage: What to know about mumps
Morning Rounds: Mumps
He's concerned that vaccination rates may continue to decline nationally. The Virginia Department of Health reports that the MMR vaccine is part of the required childhood series in Virginia for school attendance, although there are religious and medical exemptions. Still, the National Institutes of Health said vaccination rates have been declining across the country largely due to delayed childhood vaccines during the pandemic, barriers to access, and general vaccine hesitancy.
"[If rates continue to decline] I think within one to three years we're going to see outbreaks of mumps and measles, it has a lag time. There's something called 'herd immunity'. If 99 percent of people get vaccinated and someone gets sick it stops there. If enough people don't get vaccinated it starts spreading," explained Dr. Moss.
In 2024, there were 11 reported cases of mumps in Virginia and seven in North Carolina, according to the CDC.
Dr. Moss says that while there are some reasons why people may not get vaccinated, cases of mumps, measles, and rubella are preventable with the MMR vaccine.
Watch related coverage: Health officials see an uptick in COVID cases this summer, new vaccine in September: VDH
Health officials see an uptick in Covid cases this summer, here's when the new vaccine comes out
"These are long-lasting vaccines. So it's possible if herd immunity fails, some adults would get it, but if they had the vaccine, it wouldn't be as severe," said Moss. "We are immunologists, so we talk to people about vaccines very frequently, and we try to show them what the risks and benefits are. And while there's risk and benefits to everything, the risks here are very low. These are highly preventable diseases that we have vaccines for that have many decades of being safe and effective."
In the Elizabeth City case, the school district said that after a diagnosis is confirmed, "additional notices, control measures, and contact tracing are done."
A single case isn't reason to raise the alarm either, according to the CDC. The CDC reports it takes at least three cases that are linked by time and place to be considered an outbreak.
For more information on mumps symptoms and how it is spread, visit the CDC's website.
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A guide to vaccinology: from basic principles to new developments
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