Article by Keith Brown, keith.brown@patch.com



The probable outbreak of mumps has increased to 22 cases, and the majority of those affected are tied to D'Jais bar in Belmar, county health officials said Thursday.



The Monmouth County Health Department said that 15 additional cases of probable mumps have been reported, bringing the number to 22 cases that the department is investigating.



Of those cases, the overwhelming majority -- 20 cases -- either work or attended the popular beachfront bar in recent weeks. One of those afflicted is a pre-schooler, according to a county health department release.



Of those exhibiting signs of mumps about are from Monmouth County, with the other half living outside the county, including one from Florida, the department said.



"Since yesterday, an additional 15 individuals with mumps-like symptoms have come forward," Michael Meddis, county public health coordinator, said in a release. "The medical professionals advised these individuals to be on bed rest, increase their fluid intake and take steps to reduce their fever."



People reporting mumps-like symptoms living in the county are from Asbury Park, Belmar, Farmingdale, four people from Howell, Keyport, three from Long Branch, Neptune City, Tinton Falls and Wall Township, the department said.



Mumps symptoms have been reported in people living in Woodbridge, Saddle Brooke, Ogdensburg, Emerson, Lawrenceville, Point Pleasant and Port Saint Lucie, Florida.



Meddis said in the release that the investigation is continuing as new cases are presented and to determine the source of transmission and identify close personal contacts.



People who were vaccinated with the MMR -- measles, mumps and rubella -- vaccine, as an infant and again between the ages of 4 and 6, are 90 percent less likely to contract mumps, according to the Centers for Disease Control.



Symptoms of the infection include swelling of salivary glands, fever, headache, muscle aches, tiredness and loss of appetite. Mumps is spread through saliva or mucus from the mouth, nose, or throat of an infected person, according to the release.



The measles, mumps and rubella vaccine given at infancy and again between 4 and 6 years old renders a person 90 percent less likely to contract mumps, according to the Centers for Disease Control.



Most mumps transmission likely occurs before the salivary glands begin to swell and within the 5 days after the swelling begins. Therefore, CDC recommends isolating mumps patients for 5 days after their glands begin to swell, the release says.



Anyone with such symptoms should contact their health care professional immediately.



More information about mumps is available from the Center for Disease Control and Prevention website at http://www.cdc.gov/mumps/index.html.