A very unpleasant disease has reared its ugly head in the United States, and authorities have been trying to understand why it’s happening and how to stop it. Health department officials in Texas have announced that cases of mumps have surged to a 20-year high, and there may have been a bunch of exposures on South Padre Island where spring-breakers are celebrating.

State health officials have reported 221 cases of mumps so far this year, the most since 1994 whn there were 234 cases. Mumps results in swollen salivary grands, swollen testicles, low fever, tiredness, and muscle aches, with symptoms emerging about 16 to 18 days after exposure.

Infections of mumps dived 99 percent since a vaccine was developed and released in 1967. The mumps vaccine protects 88 percent of people who are fully vaccinated, although some vaccinated people can still get sick if exposed.

“The Texas Department of State Health Services is advising health care providers to be on alert for mumps in their patients as the state experiences a 20-year high in mumps cases,” states the THHS website “State, regional and local health departments are currently investigating multiple outbreaks throughout the state, including one involving possible exposures on South Padre Island, a popular spring break destination for students from Texas and elsewhere in the United States. Texas has had 221 mumps cases this year, the largest total since there were 234 cases in 1994.”