The state of Washington has reported 278 confirmed and likely cases of mumps — a contagious condition caused by a virus spreading among humans through saliva and mucus — in five counties since October.

The counties are King, Pierce, Snohomish, Spokane, and Yakima.

A Case Of Mumps

From Jan. 1 to 27 alone, the U.S. Centers for Disease Control and Prevention (CDC) has received reports of 228 mumps cases, with nearly half of the cases coming from Arkansas.

“Arkansas is also having a large outbreak that is continuing into 2017,” said CDC medical officer Dr. Manisha Patel in a CNN report.

Mumps cases fluctuate from hundreds to thousands, and in 2016 the CDC received 5,311 cases in 46 states and DC.

The disease usually starts with headache, fever, fatigue, muscle pain, appetite loss, and even swelling salivary glands that cause puffy cheeks for a couple of days. These symptoms can last from two to 10 days or more.

Occasionally, adult patients can develop complications such as deafness and inflammation of the ovaries, brain, testicles, or breast tissue. Quite rarely mumps can lead to encephalitis, which could also result in death.

Antibiotics will not be able to address mumps since it is caused by a virus. Doctors would usually recommend simple bed rest and taking over-the-counter pain medications.

Get A Shot, Officials Urge

Health officials recommend vaccination to curb the spread of the disease. According to the Washington health department spokesperson Dave Johnson, the MMR vaccine remains the best protection against mumps.

If already sick or suspect he or she has mumps, it’s best to stay home especially kids and workers in schools and universities, Johnson added. While there is no exact “trigger point,” a mumps outbreak can sometimes occur in one county and spread. Those attending schools, churches, and other institution can transmit it to those in close contact.

Children are recommended to get two doses of the MMR vaccine, which is protective against measles, mumps, and rubella (albeit not 100 percent effective). The first dose is usually given at 12 to 15 months, while the second is administered at ages 4 to 6. There is an alternative shot in the form of the MMVR vaccine (with the addition of varicella or chickenpox), and it is licensed to be provided to kids from 12 months to age 12.

Effectiveness can vary if one gets one or two shots. Two doses offer about 88 percent effectiveness, meaning 12 out of 100 vaccinated individuals still fall ill when exposed to the virus.

The CDC noted that in December, most of the state outbreaks had been happening among the vaccinated, with recent outbreaks — including a 2014 one that involved NHL players — raising a debate on the need for a third vaccine dose.

Patel said, however, that no side effects beyond the typical ones — such as fever and mild rash — have been seen in studies involving a third dose.

Seattle and King County public health officer Dr. Jeff Duchin said that outbreaks can still take place in vaccinated groups since some do not get lasting protection from the shot.

“But, if unvaccinated, many, many, more people would become ill,” he warned.

Prior to the immunization program in the United States starting 1967, the health agency received 186,000 case reports every year.