Esforço multidisciplinar para a evicção de um surto de parotidite epidémica numa maternidade

Abstract

Mumps is a disease caused by paramyxovirus, whose notification to health authorities is mandatory. Vaccination in Portugal was started in 1987. There have been several outbreaks worldwide, even in populations with high vaccination rates, but none were reported in maternity hospitals. We report the case of a 36 year-old primigravida, admitted in the 37th week of pregnancy, because of fever, painful uterine contractions and a non-reassuring cardiotocograph. A caesarean section was performed 28 hours after admission due to non-reassuring fetal status, and a newborn with normal Apgar score was delivered. The following day she developed headache, tender bilateral parotid swelling, effacement of the mandibular angle, and tender cervical limphadenopathies. The patient was isolated, and blood samples were collected for paramyxovirus’ serology. All her contacts (healthcare providers and puerperas) were clinically evaluated and non-immunized subjects were vaccinated. Relatives were contacted and counselled. Primary healthcare facilities were asked to facilitate access to the vaccination unit. The Neonatology Department was alerted and the newborn’s blood was sampled for serologic testing. Public authorities were notified through an appropriate declaration form. The patient progressively recovered. Disease was serologically confirmed in the newborn but was asymptomatic. Healthcare providers, contacted puerperas and their newborns were followed up for 4 weeks but none developed symptoms