Multistate Mumps Outbreak Originating from Asymptomatic Transmission at a Nebraska Wedding — Six States, August–October 2019

In August 2019, 30 attendees at a Nebraska wedding developed mumps after being exposed to one asymptomatic index patient who was fully vaccinated according to Advisory Committee on Immunization Practices (ACIP) recommendations (1), resulting in a multistate outbreak. A public health investigation and response revealed epidemiologic links that extended from the index patient through secondary, tertiary, and quaternary patients and culminated in a measles-mumpsrubella (MMR) booster vaccination campaign in the local community where approximately half of the patients resided