Update 2 -- The Mumps

Betsy alerted us to this story two weeks before vacation, and now everyone's catching on.

When Iowa college students early this year began turning up in doctors' offices with puffy necks, headaches, fevers and, among some young men, swollen testicles, many physicians missed a diagnosis most doctors could have made in their sleep 25 years ago.

These patients had the mumps — as do at least 1,100 in eight Midwestern states as of Friday. The outbreak is still unfolding, spreading east and west, and beyond the 18- to 25-year-old set.

Of course we want to know what's going on. Why now? Why after all this time?

Experts suspect two factors: spotty vaccination coverage among college-aged kids and the unique bacterial and viral mixing bowl that is dorm life.

The virus that causes mumps appears to have found its perfect home in the college scene — with multiple kids lolling on beds in great heaving groups, swigging drinks in common, kissing and cruising the bars even when they're sick, and — oh, yes — attending classes en masse.

"They eat after each other, drink after each other, share other personal items — we know that living under those settings, people run higher risks of infection," says Dr. Georges Benjamin, executive director of the American Public Health Assn.

But is that so difereent from when your parents and I went to college? It's posssible that more people are missing out on their vaccinations. And colleges, unlike the military, are not alwasy requiring that incoming students have these shots.

Roughly half of the states, including Iowa, do not have precollege vaccination requirements in place, according to Dr. Jane Seward, acting deputy director of the CDC's viral diseases division.

Such rules are typically left to colleges to enforce, and where state rules are absent, colleges and universities are left to adopt regulations on their own.

And while we're at it, why not blame the victims (they're always a cheap and easy target) -- in this case, teenagers.

Unlike preschoolers, whose parents drive them to yearly check-ups, adolescents are less likely to see a physician for routine physicals, more likely to reject a shot when they feel fine and often not covered for preventive healthcare.

Adding to the problem, parents of teens often think childhood vaccinations should have been enough and have less power to persuade their older children to get immunized.

"Teens are pretty unresponsive in general — they tend to believe that they'll live forever and don't need these things," says Lawrence, who led a study by the Institute of Medicine of future U.S. vaccine priorities.

Stay tuned for more!