While fewer reported cases signify South Carolina's first mumps outbreak in more than a decade could be coming to a close, health officials don't want to let their guard down until they see more weeks of lower incidents.
This week marks the third in a row of zero mumps cases at the College of Charleston, where the outbreak started in September.
Since the beginning of the spring semester, the college has reported only one case of the virus on campus.
In total, 76 cases of the mumps have been reported at the school.
The S.C. Department of Health and Environmental Control said that while there have been zero reported cases on campus, the department is still seeing a few mumps cases in the surrounding community.
A DHEC spokesman said the agency will continue to work with area health partners to diagnose and isolate cases to prevent further spread of disease.
Dr. Scott Curry, a board certified infectious disease specialist with the Medical University of South Carolina, said that when it comes to schools like C of C experiencing a mumps outbreak, it's not uncommon for the virus to spill out into surrounding communities.
The same was seen with Indiana University Bloomington, he said, where at least 20 students were infected during a mumps outbreak at the school last year.
In 2015, a mumps outbreak at the University of Iowa also spread to the surrounding community. More than 100 student cases were confirmed.
Since MUSC has tested for cases of the mumps in surrounding communities, he's not surprised that the outbreak hasn't been declared at an end.
With the mumps, there is a 12- to 25-day period where an infected person is contagious and likely showing symptoms.
“It’s not over until a full incubation period has been passed through,” Curry said.
There's also the chance that rising reported cases could emerge again, he said. If that happens, it's likely the college will see a second wave of the outbreak. They would then likely have to wait until the summer for cases decline again.
The initial hope was that after winter break the outbreak would ebb. So until there is a full 25-day period without any cases at the school or surrounding communities, the outbreak will continue to be present.
“Time will tell," Curry said.
The mumps is a viral infection with the symptoms that range from fever and fatigue to swelling of the salivary glands. A person can contract the infection through the sharing of utensils or inhaling the saliva droplets from an infected person's cough or sneeze.
To help with prevention, health officials recommend people get two doses of the Measles, Mumps and Rubella (MMR) vaccine. According to the Centers for Disease Control and Prevention, the vaccine is 88 percent effective in lowering the risk of getting the infection when a person completes the vaccine series.
Getting the two doses of the MMR vaccine is still the best protection from getting the mumps, according to DHEC.
Curry agrees. His fear is that the message that the MMR is useless has taken hold because of the outbreak.
Without the existence of a vaccine, he said the outbreak and symptoms people had would've definitely been worse. The difference would've likely been thousands of mumps cases versus the 76 the college saw if a vaccine didn't exist.
So he wants to make sure that people understand the vaccine is still vital even though there were people who still got the mumps.
"It just isn’t perfect," he said.
The outbreak at C of C took off in September when three cases of the mumps were confirmed by the state health department. Those first three individuals were a combination of vaccinated and unvaccinated people.
In response to the outbreak, the college began providing weekly updates of mumps cases while also encouraging students to get the recommended doses of the vaccine if they had not gotten it.
In a letter to students in November, C of C's President Andrew Hsu listed getting the MMR vaccine as the top thing students could do to help during the outbreak.
In applying to the College of Charleston, interested students must either provide records showing they got the MMR vaccine or supply a waiver stating they had not been vaccinated.
At the start of the outbreak, nearly 200 had supplied that waiver. But since the outbreak began, the college has hosted targeted vaccine clinics on campus to address vaccine concerns.
Even when the outbreak is over, it doesn't mean there will never be a mumps case in the Charleston area, Curry said.
“There’s always a little bit dribbling in the background," he said.