Investigating Mumps Outbreak in Odisha, India: An Opportunity to Assess the Health System by Utilizing the Essential Public Health Services Framework.

AbstractMumps, a highly contagious, viral disease continues to spread in India, despite the availability of an effective vaccine. On November 24, 2014, we came across a suspected case of mumps in a 6-year-old boy in a village of Bhusandapur sector in Odisha. We initiated an outbreak investigation using standard techniques outlined by the Centers for Disease Control and Prevention, Atlanta, GA. This uncovered a silent epidemic of 94 case patients (10% of the population) over a period of 16 weeks between August and December 2014, in a single village, which had gone completely unnoticed by the existing health-care system. Since the index case was one of the last case patients of the outbreak, investigation for immediate control was not a priority. Hence, we have used this exercise to describe the outbreak and identify causes that led to its nondetection. Age range of the case patients was between 2 and 40 years; 85 (90.4%) case patients were </= 15 years of age and 54 (57.4%) were females. Average duration of illness was 9 days. No child had received the mumps vaccine. The outbreak had led to a community expenditure of 538 USD. The exercise uncovered a number of weak links in the essential public health services within the health-care delivery system in the area.