Infectious disease experts are considering some creative and unusual vaccination strategies as they try to prevent more cases of the mumps in Nova Scotia.

Halifax's five-month-old mumps outbreak has made nearly 450 people sick, most of them young adults. More cases are expected this summer.

"Everybody can go out and dance and sing, but I might spew a bit of saliva on you while I'm doing that and that's how these things are spread," said Dr. Noni MacDonald, a pediatric infectious disease specialist and former dean of medicine at Dalhousie University in Halifax.

MacDonald said young people are at higher risk of spreading and contracting infectious diseases because they have many close contacts. But they are also the toughest to reach with vaccine programs, which means health planners have to think creatively.

For example, she said, it might help if young people at bars are offered a vaccine with their beer.

"Maybe what you could do is say if you go to the bar between 5 and 7, you could get your beer half price if you get your measles, mumps, rubella immunization updated," MacDonald said.

Many people spanning an age range from mid-teens to 40 received only a single dose of vaccine, not a second dose that's critical in preventing more mumps cases.

Dr. Robert Strang, Nova Scotia's acting deputy medical officer of health, said it may be necessary to expand a vaccination program.

"We've started already with university students because we know they're at increased risk of mumps, but we may have to do something with what we call the whole age cohort," he said.

In the latest Canadian Medical Association Journal, MacDonald said the mumps outbreak is the canary in the coal mine and warns of the system's inadequacies in controlling infection.

MacDonald and Strang agree the mumps outbreak has shown that reaching young people is an important way of stemming infectious disease, which could be critical if the next outbreak is a pandemic influenza.