An additional four mumps cases on the Big Island were confirmed in the past week, bringing the total islandwide to 46 in 2017.
There have been 500 cases confirmed this year statewide, including two on Maui, 43 on Kauai and 409 on Oahu.
At least 12 of those cases include reports of complications from mumps infection such as hearing loss and orchitis.
The state Department of Health on Friday said in a news release it recommends people consider receiving an additional dose of the MMR vaccine as a preventive measure.
At least two of the documented Hawaii Island cases are in public schools: Chiefess Kapiolani Elementary School confirmed a case this week and Naalehu Elementary School said in a letter in August that one of its students was confirmed to have had mumps.
It’s unclear how many additional cases have been reported in Hawaii Island schools. The DOH said this week that because of privacy laws it could not release the name of schools with documented cases unless schools or the state Department of Education provides the authority to do so.
The DOE also does not have a complete list of schools that sent letters home to parents regarding mumps, according to a spokesman this week. He said schools can work directly with the DOH and send notifications on their own when a confirmed case occurs.
Schools are not required by law to notify parents.