It's hard to get anywhere (from Iowa) without connecting.
Fortunately, for most people, mumps is a fairly mild illness and they get over it quickly. Some people may have it without even any symptoms and not even be aware that they're spreading it.
When it comes to infectious disease, college campuses are sort of a perfect storm - close quarters, where people are coughing and sneezing, where they are not thinking much about hygiene and think nothing of sharing a beer glass or sharing saliva via kissing. All those kinds of things that would easily spread disease happen on college campuses and probably contributed to what we saw all these cases in Iowa.
College graduation, high school proms, we're not recommending any be canceled. We just want to ensure that people are aware of the risk.
On one hand, given the 800-plus cases we have, this is a serious situation. On the same token, we have 2.8 million people in Iowa, so the relative risk of any single visitor getting mumps is extremely low.
We used to see about five cases a month. At the tail-end of December we realized we had a situation on our hands.
The college environment is a perfect situation for infectious disease, especially mumps. It's shared through saliva, so students can get it by living so close together, coughing, sneezing, sharing drinks and kissing. It tends to spread fairly easily.
We'd hate to say we're out of the woods.