Mumps Spread in School Cluster: Risk Factors Behind the Surge of Mumps Cases at Elementary School 4 Magelang
Abstract
Mumps is a viral infectious disease that primarily affects children and spreads easily among susceptible individuals and can be prevented through MMR vaccination, although it is not yet included in Indonesia’s national immunization program. Magelang City Health Office received a report of an increase in mumps cases on November 4, 2024, through the Early Warning and Response System (SKDR). Mumps transmission occurred within the Elementary School 4 Magelang cluster. An outbreak investigation was important to determine the magnitude of the problem and the factors that contributed to the occurrence of mumps. The research design employed a 1:4 case-control study involving all 12 identified mumps cases and 48 controls from a total population of 114. Cases were defined as students experiencing clinical symptoms of mumps, specifically posterior jaw pain and/or parotid gland swelling, or who were diagnosed by medical personnel. Data collection was conducted using interviews with the students and parents, observations, and case report data. The data were analyzed using bivariate analysis with the chi-square test. Twelve cases were reported in total, beginning with the first case on September 25, 2024, and peaking between November 5–11. The highest attack rate was observed among male students (14.06%), students aged 6–7 years (19.23%), and first-grade students (20%). The most common symptom was posterior jaw pain (100%), and the most common risk factors were a history of contact with patients (66.7%) and a history of travel (33.3%). Bivariate analysis revealed that sharing eating and drinking utensils (p-value 0.006) and travel history (OR = 11.5; 95% CI: 1.79–73.58) were significantly associated with mumps occurrence. However, other factors such as MMR vaccination status, history of contact with patients, and current illness status were not statistically significant. Schools should collaborate with healthcare facilities to strengthen infectious disease surveillance and prevent further cases.
Full Text:
PDFReferences
Ahmed, S., & Aziz, I. (2017). Mumps 2017: The role of educational institutes in preventing the spread of the disease. American Journal of Infection Control, 45(7), 817–818. https://doi.org/10.1016/j.ajic.2017.03.027
Ali, N., Strahler, J., & Nater, U. M. (2025). The effects of chronic fatigue and chronic stress on alterations in immune cell responses to acute psychosocial stress. Brain, Behavior, and Immunity, 123, 707–716. https://doi.org/10.1016/j.bbi.2024.10.013
Alotiby, A. (2024). Immunology of stress: A review article. Journal of Clinical Medicine, 13(21). https://doi.org/10.3390/jcm13216394
Balai Besar Laboratorium Kesehatan Masyarakat Makassar. (2024, December 2). Waspada! Kasus gondongan meningkat, kenali gejala dan cara penanganannya. BB Labkesmas Makassar
Bhat, U. M., Mir, N. Y., Farooq, W., Zaman, B. U., & Malik, M. I. (2023). Clinical profile of mumps in children in a tertiary care hospital in Kashmir. International Journal of Contemporary Pediatrics, 10(3), 290–294. https://doi.org/10.18203/2349-3291.ijcp20230421
Bureau of Communication and Public Services. (2017). Imunisasi measles rubella lindungi anak kita. Kementerian Kesehatan Republik Indonesia. https://sehatnegeriku.kemkes.go.id/baca/umum/20170719/0621730/imunisasi-measles-rubella-lindungi-anak-kita/
Bockelman, C., Frawley, T. C., Long, B., & Koyfman, A. (2018). Mumps: An emergency medicine-focused update. Journal of Emergency Medicine, 54(2), 207–214. https://doi.org/10.1016/j.jemermed.2017.08.037
Brauer, M., Wolfaardt, M., Webber, L. M., & Taylor, M. B. (2016). Molecular detection and characterisation of mumps virus in cerebrospinal fluid in a Gauteng laboratory. Southern African Journal of Infectious Diseases, 31(1), 29–31. https://doi.org/10.1080/23120053.2016.1118843
Cardemil, C. V., Dahl, R. M., James, L., Wannemuehler, K., Gary, H. E., Shah, M., Marin, M., Riley, J., Feikin, D. R., Patel, M., & Quinlisk, P. (2017). Effectiveness of a third dose of MMR vaccine for mumps outbreak control. New England Journal of Medicine, 377(10), 947–956. https://doi.org/10.1056/nejmoa1703309
Centers for Disease Control and Prevention (CDC). (n.d.). Mumps symptoms and complications. https://www.cdc.gov/mumps/signs-symptoms/index.html
Centers for Disease Control and Prevention (CDC). (2022). A child’s health is the public’s health. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/childrenindisasters/features/children-public-health.html
Chatterjee, S., Murallidharan, J. S., Agrawal, A., & Bhardwaj, R. (2022). A review on coronavirus survival on impermeable and porous surfaces. Sadhana – Academy Proceedings in Engineering Sciences, 47(1), Article 5.
Directorate General of Health Services (2024). Kenali gejala dan penyebab gondongan. Kementerian Kesehatan Republik Indonesia. https://ayosehat.kemkes.go.id/kenali-gejala-dan-penyebab-gondongan
Diversity, G., Lam, E., Rosen, J. B., & Zucker, R. (2020). Mumps: An update on outbreaks, vaccine efficacy, and prevention strategies. Journal of Clinical Microbiology, 33(2), 1–16.
Franjić, S. (2024). Mumps is transmitted by droplets. Med Discoveries, 3(2), 2–5. https://doi.org/10.52768/2993-1142/1119
Huang, A. S., Cortese, M. M., Curns, A. T., Bitsko, R. H., Jordan, H. T., Soud, F., Villalon-Gomez, J., Denning, P. M., Ens, K. A., Hanson, G. R., & Dayan, G. H. (2009). Risk factors for mumps at a university with a large mumps outbreak. Public Health Reports, 124(3), 419–426. https://doi.org/10.1177/003335490912400311
Jemail, L., Miyao, M., Hamayasu, H., Minami, H., Abiru, H., Baba, S., Osamura, T., Tamaki, K., & Kotani, H. (2020). Fatal mumps myocarditis associated with left ventricular non-compaction. American Journal of Case Reports, 21, e921177. https://doi.org/10.12659/AJCR.921177
Klein, S. L., Marriott, I., & Fish, E. N. (2014). Sex-based differences in immune function and responses to vaccination. Transactions of the Royal Society of Tropical Medicine and Hygiene, 109(1), 9–15. https://doi.org/10.1093/trstmh/tru167
Kwon, T., Gaudreault, N. N., & Richt, J. A. (2021). Environmental stability of SARS-CoV-2 on different types of surfaces under indoor and seasonal climate conditions. Pathogens, 10(2), Article 227
Liu, H., Xie, Y., Zhu, Z., Liu, Y., Yu, Y., Wang, J., Shen, L., Qian, Y., & Tang, W. (2025). Risk factors for mumps in children under 15 years of age during the transition from single-dose to two-dose MMR vaccination strategy: A matched case-control study. Frontiers in Public Health, 13, 1–13. https://doi.org/10.3389/fpubh.2025.1592602
Mirambo, M. M., Michael, F., Nyawale, H., Mbugano, F., Walwa, M. B., Mahamba, D., Msanga, D. R., Okamo, B., Damiano, P., & Mshana, S. E. (2024). The high seropositivity of mumps virus IgG antibodies among school-aged children in rural areas of the Mbarali District in the Mbeya Region, Tanzania: It is high time for consideration in the national immunization program. Children, 11(1), 1–10. https://doi.org/10.3390/children11010073
Moncla, L. H., Black, A., Debolt, C., Lang, M., Graff, N. R., Pérez-Osorio, A. C., Müller, N. F., Haselow, D., Lindquist, S., & Bedford, T. (2021). Repeated introductions and intensive community transmission fueled a mumps virus outbreak in Washington state. eLife, 10. https://doi.org/10.7554/eLife.66448
Rausch Phung, Elizabeth. A., Davison, P., & Morris, J. (2024). Mumps. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534785/
Saadat, S., Rao, P. K., Khatri, N., & Rawtani, D. (2023). Viability of COVID-19 in different environmental surfaces. In The Environmental Impact of COVID-19 (pp. 19–33).
Tiwari, A., Patnayak, D. P., Chander, Y., Parsad, M., & Goyal, S. M. (2006). Survival of two avian respiratory viruses on porous and nonporous surfaces. Avian Diseases, 50(2), 284–287.
Joyse, T. J., Kumar, G. V., Kumar, A. G., & Kannan, K. R. (2024).
Mumps: Understanding the virus and staying safe—Case series. International Journal of Scientific Research, 13(11), 84–85. https://doi.org/10.36106/ijsr
Morrone, A., Hay, R., & Naafs, B. (2020). Skin disorders in migrants. Springer. https://doi.org/10.1007/978-3-030-37476-1
Ngaovithunvong, V., Wanlapakorn, N., Tesapirat, L., Suratannon, N., & Poovorawan, Y. (2016). Mumps antibody in the Thai population 17 years after the universal measles mumps rubella vaccination program. Journal of Infection in Developing Countries, 10(7), 735–740. https://doi.org/10.3855/jidc.7560
Nurpuspita Sari, P., Mandalika Laisatu Rahman, R., & Rahman, I. (2025). Penyuluhan fisioterapi mengenai edukasi pemberian senam pencegahan osteoartritis dalam mengantisipasi nyeri lutut pada pasien penderita osteoartritis di RSUD dr. H. Soemarno Sosroatmodjo Tanjung Selor. Padma, 5(1), 31–38. https://doi.org/10.56689/padma.v5i1.1766
Ogbuanu IU, Kutty PK, Hudson JM, Blog D, Abedi GR, Goodell S, Lawler J, McLean HQ, Pollock L, Rausch-Phung E, Schulte C, Valure B, Armstrong GL, Gallagher K. Dampak dosis ketiga vaksin campak-gondok-rubella pada wabah gondok. Pediatrics. 2012 Des; 130 (6):e1567-74.
Riggenbach, M. M., Haralambieva, I. H., Ovsyannikova, I. G., Schaid, D. J., Poland, G. A., & Kennedy, R. B. (2022). Mumps virus-specific immune response outcomes and sex-based differences in a cohort of healthy adolescents. Clinical Immunology, 234, 108912. https://doi.org/10.1016/j.clim.2021.108912
Sridhar, M., Khan, I. D., Jain, R., Pandey, R., Srivastava, S., Makkar, A., Pathania, S., Tandel, K., Parihar, M., Brijwal, M., Kumar, R., & Bhalla, S. (2021). Common-source outbreak of hepatitis A in an Indian Himalayan mountain camp. Journal of Archives in Military Medicine, 9(3). https://doi.org/10.5812/jamm.116257
Palyama, S., Wisanti, R., Peospitaningtyas, E., & Ningsih, R. N. (2025). Bilateral mumps with orchitis: A case report. International Journal of Medical Science and Health Research, 10(3), 21–30. https://doi.org/10.70070/3aeqvz04
Qin, W., Wang, Y., Yang, T., Xu, X. K., Meng, X. M., Zhao, C. J., Li, S. Y., Xie, S. Y., Li, K. C., & Su, H. (2019). Outbreak of mumps in a student population with high vaccination coverage in China: Time for two-dose vaccination. Human Vaccines & Immunotherapeutics,15(9),2106–2111. https://doi.org/10.1080/21645515.2019.1581526
Suparman, D. D., Mas’ud, I. A., & Karismananda, K. (2024). Parotitis mumps: Diagnosis, tata laksana, dan edukasi pencegahan penularan pada fasilitas pelayanan primer. UMI Medical Journal, 9(2), 116–124. https://doi.org/10.33096/umj.v9i2.326
Teferi, M. G., Gulma, A. K., Akalu, M. T., Hassen, G. W., Gashaw, E. M., & Gerer, N. D. (2025). Mumps-associated hepatitis: A rare clinical presentation. IDCases, 40, e02207. https://doi.org/10.1016/j.idcr.2025.e02207
Steven, T., Kerndt, C. C., & Hossain, R. M. (2023). Case-control studies. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/28846237/
Tian, H., Dang, R., & Chen, J. (2024). Associations between health promotion behaviors and multidimensional health among Chinese middle-school students: A study focusing on gender differences. Journal of Men’s Health, 20(9), 71–78. https://doi.org/10.22514/jomh.2024.151
Health Promotion Team, Dr. Soeradji Tirtonegoro General Hospital, Klaten. (2024). Gondongan (parotis). Dinas Kesehatan Provinsi Kalimantan Barat. https://dinkes.kalbarprov.go.id/artikel/gondongan-parotis/
Iwagami, M., & Shinozaki, T. (2022). Introduction to matching in case-control and cohort studies. Annals of Clinical Epidemiology, 4(2), 33–40. https://doi.org/10.37737/ace.22005
Twanabasu, S., Homagain, S., Tuladhar, S., Maskey, S., Mahaseth, A., Subedi, B. K., & Regmi, D. (2024). Vaccination against mumps: Aren’t we late already? Journal of the Nepal Medical Association, 62(276), 555–557. https://doi.org/10.31729/jnma.8731
Wohl, S., Metsky, H. C., Schaffner, S. F., Piantadosi, A., Burns, M., Lewnard, J. A., Chak, B., Krasilnikova, L. A., Siddle, K. J., Matranga, C. B., Bankamp, B., Hennigan, S., Sabina, B., Byrne, E. H., McNall, R. J., Shah, R. R., Qu, J., Park, D. J., Gharib, S., … Grad, Y. H. (2020). Combining genomics and epidemiology to track mumps virus transmission in the United States. PLoS Biology, 18(2), 1–28. https://doi.org/10.1371/journal.pbio.3000611
World Health Organization. (2020). Health risks when travelling. https://www.who.int/news-room/questions-and-answers/item/health-risks-when-traveling
Wu, H., Wang, F., Tang, D., & Han, D. (2021). Mumps orchitis: Clinical aspects and mechanisms. Frontiers in Immunology, 12, 1–9. https://doi.org/10.3389/fimmu.2021.582946
Yang, T., Wang, Y., Zhao, Q., Guo, X., Yu, S., Zhao, Z., Deng, B., Huang, J., Liu, W., Su, Y., & Chen, T. (2022). Age-specific transmission dynamic of mumps: A long-term large-scale modeling study in Jilin Province, China. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.968702
Zerbo, O., Modaressi, S., Glanternik, J. R., Goddard, K., Ross, P., Lewis, N., & Klein, N. P. (2020). Identification and description of mumps cases in a non-outbreak setting and evaluation of the effectiveness of mumps-containing vaccines over time. Human Vaccines & Immunotherapeutics, 16(12), 3098–3102.
DOI: http://dx.doi.org/10.30829/contagion.v8i3.29314
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 Arlyn Manggar, Muh Fauzi, Yudhy Dharmawan, Bhekti Noor Fitriani

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.





