Mumps

What is it?

Mumps disease is caused by the mumps virus. Many children have mild or no symptoms but they are still contagious to others. Adults are more likely to experience complications than children.

Signs and Symptoms

• Fever
• Headache
• Swollen and painful salivary glands (found in front of and below the ear or under the jaw).

The disease is generally self-limiting, running its course before receding.

Complications of Mumps Disease

• Meningitis (inflammation of the lining of the brain) in 20% of people infected.
• Orchitis (inflammation of the testicle) in 20-30% of post-pubertal males.
• Oophoritis (inflammation of the ovary) in 5% of post-pubertal females.
• Deafness and infertility occur occasionally.
• Spontaneous abortion in about 27% of cases during the first trimester of pregnancy.

How is it spread?

• Through direct or indirect contact with nose and throat secretions of an infected person.
• Touching the nose and throat secretions of an infected person.
• Kissing.
• Sharing anything that is put in the mouth (e.g., cups, toys).

Incubation Period

Usually 16 – 18 days from contact with an infected person but can range from 14 – 25 days.

When is the person contagious?

From 7 days before to 9 days after the onset of swelling. Child is most contagious 2 days before to 4 days after the onset of illness.

How to prevent spread of the illness to other children?

Exclude child from school or child care facility for 9 days after the onset of swelling if there are any unimmunized children.

Carefully dispose of (or clean, if applicable) articles soiled with nose and throat secretions of an infected child.

Mumps vaccine is part of the routine childhood immunizationschedule starting at 12 month of age

The vaccine, MMR, also provides proteciton againstm easles and rubella

Diagnosis

• A physical examination confirms the presence of the swollen glands.
• Usually, the disease is diagnosed on clinical grounds, and no confirmatory laboratory testing is needed.
• If there is uncertainty about the diagnosis, a test of saliva or blood may be carried out; diagnostic confirmation, using real-time, polymerase chain reaction (PCR) technology, has also been used.
• An estimated 20%-30% of cases are asymptomatic.
• As with any inflammation of the salivary glands, serum amylase is often elevated.

Treatment

• There is no specific treatment for mumps.

• Symptoms may be relieved by the application of intermittent ice or heat to the affected neck/testicular area and by paracetamol (Tylenol) for pain relief.

• Aspirin is not used due to a hypothetical link with Reye’s syndrome.

Prognosis

• Death is very unusual. The disease is self-limiting, and general outcome is good, even if other organs are involved.

• Mumps viral infections in adolescent and adult males carry an up to 30% risk that the testes may become infected (orchitis or epididymitis), which can be quite painful; about half of these infections result in testicular atrophy, and in rare cases sterility can follow.

• Mild forms of meningitis in up to 10% of cases (40% of cases occur without parotid swelling).

• Oophoritis (inflammation of ovaries) in about 5% of adolescent and adult females but fertility is rarely affected.

• Pancreatitis in about 4% of cases, manifesting as abdominal pain and vomiting.

• Encephalitis (very rare, and fatal in about 1% of the cases when it occurs).

• Acute unilateral deafness (sensorineural hearing loss) occurs in about 0.005%.

After the illness, lifelong immunity to mumps generally occurs; reinfection is possible but tends to be mild and atypical.