If you want to avoid getting the mumps during this outbreak in Hawaii, you're going to have to roll up your sleeve.
      Even if you had a mumps vaccination, you are being urged to get a booster shot.

As a pediatrician Dr. Gail Nakaichi wants to protect her patients from mumps, a virus that causes fevers, headaches, muscle aches, and swollen and tender salivary glands.

"This can be very contagious, and affect children and adults," said Nakaichi, a Kailua pediatrician.

Hawaii has reached a record number of mumps cases. 
More have contracted cases during the 2017 outbreak, then over the past 20 years combined. 

"When we look at our case numbers over the last 20,30 years, we've not seen numbers like this in a long time," said Hawaii Epidemiologist Dr. Sarah Park.

Usually cases of mumps are imported when people come from other places, but this year many of the cases have locally generated.
While many may think of mumps as a childhood disease, that is another difference during this outbreak.

"The average patient was in their 20s, or they might be in their late teens. But we have seen adults in their 20s, 30s, and 40s and that is becoming the norm," said Park.

Some who came down with mumps may have even been vaccinated before. 
Because the mumps vaccine isn't 100% effective.

"With 2 doses, what you need to be fully vaccinated, the mumps vaccine is 88% effective. So 88 out of 100 people will have decent immune response, but 12 will remain unimmune," stated Park.

Even that initial immunity can wear off, leaving some susceptible to mumps.

"As children we get immunizations, but over time their effectiveness can decrease. So in situations of outbreaks, we recommend children and adults get re-immunized to contain that outbreak," said Nakaichi.

The state recommends all adults under 60 get at least one dose of the mumps vaccine...including a booster shot.

The majority of those who contracted mumps have not had severe cases, but nearly two dozen people had complications, like painful inflammation or hearing loss.

The outbreak is also NOT showing any sign of slowing down. 
If Hawaii's clusters of cases are like others around the country, the outbreak will go on for many more months.  

"This is a big deal, a very deal. Not just to Hawaii, but across the US," said Park. 
But there are steps people can take to protect themselves.
Including take a step back from others, to limit their exposure or spread of the mumps virus.

"This is a preventable disease, vaccine preventable disease. There are other measures we could take like social distancing measures, that we could take and should take for our community," added Park.

Those steps could also limit the spread of the flu, during the expected busy part of flu season.