Four people in Anchorage have been diagnosed with the mumps since May, according to the Alaska Department of Health and Social Services' epidemiology section.
One case was diagnosed in May. Three more confirmed cases were reported to the state in August, according to an advisory published Thursday.
None of the people reported any recent travel, which suggests "mumps may be circulating more widely in the community," the advisory notes.
Two of the patients diagnosed in August are relatives and a third has no known link to the others, according to the advisory. Of the four total cases, two people had a partial vaccination against the mumps and another two, who were not relatives, didn't have evidence of ever being vaccinated.
In the case from May, the person had come into contact with a relative who had been visiting from abroad the month before, according to a mumps advisory issued that month.
State epidemiologist Joe McLaughlin said in a phone interview Thursday that the May case and two of the patients diagnosed in August were all Pacific Islanders living in the same area of Anchorage. Despite that, McLaughlin said it was not clear if the relatives who were diagnosed had any connection to the third person.
The third case in August is a Caucasian person who does not live near the others.
McLaughlin said the state and Anchorage Department of Health and Human Services are trying to identify connections that the patients have in common.
If there's no established link, McLaughlin said it would suggest mumps could be circulating in Anchorage.
"These four cases could represent the tip of the iceberg," McLaughlin said. "In other words, there could be many additional cases of mumps that have not been identified."
The virus is spread through respiratory droplets or sharing saliva. Symptoms include puffy cheeks, swollen jaw, fever, headache, fatigue and loss of appetite.
Some people who get the mumps have mild symptoms or none at all. Most recover from the virus in a few weeks, although some can develop serious complications including meningitis and hearing loss.
According to the advisory, a vaccine is the best protection against the virus. Generally, children receive the vaccine in two doses, the first between 12 and 15 months of age and again between 4 and 6 years old. Adults who have not been vaccinated should do so promptly, according to the advisory.
McLaughlin said the mumps can be contagious two days before the onset of swollen jaw and cheeks and for five days after. Those who believe they have contracted the virus should call their health care provider to set up a time for testing, he advised.
People should not attempt to go into a clinic, McLaughlin said, since the disease could spread to others.
He added that if people suspect they have the mumps, but don't have a health care provider, they can contact a local public health nurse for assistance.