Two doses of MMR vaccine do not provide 100% protection against mumps; one dose is about 78% effective and two doses are about 88% effective.

1. The preferred specimen is a parotid gland duct swab collected within 9 days (ideally 1-3 days) from parotitis onset.
2. Massage the parotid (salivary) glands for 30 seconds.
3. The swab specimen needs to be collected from the buccal cavity near Stensen’s duct, typically near the upper rear molars, between the cheek and teeth, though anatomy can be distorted with parotid gland swelling. Sweep the swab between the cheek and gum near the upper molar to the lower molar area. Synthetic swabs are preferred, such as a commercial product designed for the collection of throat specimens or a flocked polyester fiber swab.
4. For sending to commercial lab: Call lab to confirm specimen criteria. Local labs that accept specimens for RT-PCR are below. In general, swabs should be placed in 3 ml of standard viral transport medium (VTM) or viral culture medium (VCM) and remain for at least 1 hour at 4°C. The swab can be broken off and left in the tube or discarded.

Infection control and patient counseling:

• Consider masking patients in the waiting room if they endorse or screen positive for cheek/jaw swelling.
• If mumps is suspected, provide surgical masks to the patient while awaiting laboratory results and counsel patients to wear the mask around others (including around family members) and avoid congregate settings for 5 days from the onset of parotitis.