updated 5/17/2006 8:51:43 PM ET 2006-05-18T00:51:43

A government vaccine panel is urging mumps shots for everyone in the region of an outbreak unless they are immune to the virus from childhood exposure or from being vaccinated.

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And health-care workers under age 50 should get two doses unless they still have immunity from childhood, the immunization advisory committee said.

Wednesday's more aggressive policy by the panel, which advises the federal Centers for Disease Control and Prevention, is an effort to thwart future outbreaks like the one that is plaguing Iowa and some other Midwestern states.

"Hopefully the current outbreak is waning," said CDC spokesman Curtis Allen. "This is for future outbreaks."

Health officials in Iowa say there are still more than 1,700 cases statewide, but the number is on the decline. Last week the state urged people ages 18 to 46 to get vaccinated. The CDC and a drug company have been providing extra vaccine.

Since 1989, the government has recommended two doses of measles-mumps-rubella vaccine for all children, a regimen considered effective at preventing mumps in about 90 percent of people.

Children are recommended to receive the first dose around their first birthday and the second between the ages of 4 and 6.

But not all adults have received two doses, health officials learned from the outbreak. So the committee made its recommendations Wednesday to ensure that health care workers and specific groups affected in the midst of an outbreak are properly protected. The panel's advice is usually adopted by the CDC.

The committee recommended that health care workers born in 1957 or later receive two doses of measles-mumps-rubella vaccine rather than a single dose, as the panel previously recommended in 1998. Two doses of vaccine provide protection about 90 percent of the time. In contrast, a single dose is about 80 percent effective.

Health officials generally believe that people born before 1957 tend to be immune to the disease because they likely were infected as children when the disease was more common in the United States. Mumps have been on the wane since a vaccine came along in the late 1960s.

In addition, the committee recommended that two groups that typically only have had a single dose of vaccine _ children ages 1 to 4 who may not have been vaccinated a second time and adults born in 1957 or later are fine with just the one dose even during an outbreak. But if those groups have high numbers of mumps cases in an outbreak, they should get a second dose, said Jane Seward of the CDC's National Center for Immunizations and Respiratory Diseases.

The Midwestern mumps outbreak has changed conventional wisdom. It hit colleges especially hard, and health officials believe it's partly because many of those students were born before 1989 and got only one dose of vaccine.

"The thing that surprised us was how fast it spread in college campuses," said Iowa state epidemiologist Patricia Quinlisk. "We knew that for college students, one dose (of mumps vaccine) was 80 percent effective. But 20 of every 100 college students were totally susceptible to it, living in dormitories, sharing beer glasses, having meals together every day. Now we know this is a very vulnerable population _ we need to give them better protection."

The panel also said when there is an outbreak, the committee recommended that everyone should be vaccinated, unless they can prove through lab tests or a doctor's diagnosis that they are immune to mumps. The panel considers an outbreak to be any area with five or more cases.

Quinlisk said the recommendations will "hopefully stop outbreaks in the future or have control measures already in place so outbreaks will not get as large."

The Midwestern epidemic has affected a dozen states, with more than 3,000 cases reported since November.

Mumps is a virus spread by coughing and sneezing. The most common symptoms are fever, headache and swollen salivary glands under the jaw. It can lead to more severe problems, such as hearing loss, meningitis and testicular damage that can result in sterility.

Copyright 2006 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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