About 90,000 new university students will be warned to have the MMR jab before starting their courses, in an unprecedented attempt to stem the mumps epidemic sweeping across campuses.
Nearly a third of 270,000 young people starting courses this autumn have probably not been immunised against the illness, which has affected more than 42,700 people in England and Wales during the first six months of the year.
All prospective students will be warned that they should arrive at university fully vaccinated against other serious diseases too when institutions confirm their places in August.
Over the last 12 months there have been 55,093 suspected cases of mumps, against 5,877 in the similar period in 2003-04. Nearly nine in 10 of these may be among 15- to 24-year-olds and health watchdogs have given up confirming cases for this age group in the laboratory.
During the whole of 1996 there were just 94 confirmed cases among people of all ages and even in 2004 there were only 8,104 confirmed among 16,650 reported cases.
The warning comes after health officials encouraged the fiercely independent universities to step up measures against what can prove a painful experience for those in their late teens and early 20s.
Nearly a third of those infected may show no symptoms, but for others there can be swollen neck glands, testes or ovaries, deafness and, more rarely, meningitis and other conditions. There could be long-term fertility problems, too.
The incubation period is two to three weeks and those infected may pass on the illness several days before telltale symptoms are obvious.
Some students are still worried about having the MMR jab, despite the discrediting of claims that it might be linked to autism when taken by infants.
Some universities have offered special immunisation sessions to students after arrival and this may have played a part in ensuring that weekly reports of cases have dropped below the 2,000 mark.
But a new cohort of unvaccinated young people will arrive in September and October. Universities UK, the umbrella body, has told members to ensure first-years are already fully inoculated not only against mumps and the meningitis C strain but also tetanus, polio, diphtheria, measles and rubella.
Prospective students will be expected to check with their GPs, although not all doctors have been prepared to give them jabs on the NHS because these are sometimes not catered for in budgets from local health trusts.
The combined measles, mumps and rubella vaccine, which is usually given to infants, with a booster before school, costs £12 a time through the private health organisation Bupa, while private clinics are charging as much as £130 for the single mumps vaccine, which is not licensed in this country but can be offered by approved doctors.
Many young adults are not protected against mumps because many were too old to have been routinely scheduled for the triple measles, mumps and rubella vaccine introduced in 1988. They have not been exposed to mumps before because of the fall in cases among younger people due to the MMR jab.
Students are more likely to catch mumps than their peers because they are in such close contact with so many other young people.
Universities will not make the offer of a place conditional on proper immunisation. Clare Taylor, head of welfare at Leicester University, said it was discussing with the local health trust funding urgent sessions for students who arrive not properly protected.
Between late last year and early this year, about 40 Leicester students fell ill with mumps but the incidence dropped quickly after the university and neighbouring De Montfort inoculated more than 4,000 students in February.
"We had a couple of students hospitalised so we decided to put some pressure on the trust to fund a vaccination programme. If we did not do this, the illness would hit the exam period," Ms Taylor said.
