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In the 21st century there is no way New Zealand should be experiencing an outbreak of mumps.
But this year an "epidemic", centred on Auckland, has spread across the country. More than 1000 people in Auckland contracted mumps, and about 70 were hospitalised Because of low immunisation New Zealand is also vulnerable to a large-scale outbreak of measles.
Measles is of special concern because any outbreak could be deadly.
The issue is the so-called "lost generation" of 11 to 29-year olds with low rates of the full MMR (measles, mumps, rubella) vaccinations. They often missed the second of the two vaccinations.
The mumps outbreak took on epidemic status because, as Auckland Regional Public Health Service director Julia Peters said, it was widespread and stopping its transmission was not possible.
Mumps is a virus which causes discomfort, fever, soreness and swelling of the face — the lumps and bumps which give it its names. In adults it can be mild, but it can cause meningitis or encephalitis, inflated testicles or ovaries, deafness and infertility.
All Black star Reiko Ioane was among those afflicted, although not badly, while on the end-of-year northern tour.
Squad member Jack Goodhue developed symptoms, too, and his departure was delayed.
Ardie Savea was a third member afflicted.
This gave the epidemic additional profile. Hopefully, that will help the missing vaccination generation to seek and receive free mumps boosters.
University of Otago students were not spared. About 12 cases were confirmed, and booster MMR injections offered.
While it seems the outbreak might have had its origins in the Pacific, Dunedin’s cases were caught in New Zealand. It is a disease not just prevalent in the poorer parts of South Auckland. It has been causing issues across university campuses in North America and Britain.
Nonetheless, the failure of New Zealand’s MMR vaccination programme is an embarrassment.
There was no proper national register, and it was found in the 1990s that less than 60% of infants had received all their vaccinations by age 2.
The Maori and Pasifika rates were under 50%. Little wonder a measles epidemic in the 1990s killed seven people.
The National Immunisation Register began in 2004, and every baby was included unless families opted out (only 1% did so).
By 2012, rates were close to the 95% target, and this country can be proud of what has now been achieved.
The MMR vaccinations are at 15 months and at age 4.
The outbreak again illustrates the importance of vaccinations for public health, something that 1% who opt out choose to ignore. Fortunately, for the life and health of all New Zealand children, that figure remains low.
Those children whose parents chose to disregard or reject the science of vaccination are lucky they can, mostly, rely on "herd immunity".
If almost all the population is vaccinated, it is hard for viruses like mumps to take hold and spread.
The earlier failures are both an indictment and a warning. Health programmes require proper systems and proper follow-ups.
They need to recognise human nature and work with their weaknesses. They need to be thorough and comprehensive and not leave compliance to chance.
In the meantime, about 570,000 under 30s might be undervaccinated.
They are susceptible to all three MMR diseases, and the mumps epidemic is a salutary reminder.
Measles could still easily flare again and rubella in pregnancy (most of the "lost generation" are in child-bearing ages) can cause severe birth defects.
Families need to check their Well Child books and with their GPs’ practices.
The mumps epidemic is likely to rumble through next year, and more vigorous promotion by authorities for catch-up vaccinations will be required.