7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 1/8

Mumps facts

  Mumps is a highly contagious viral infection with an incubation period of 14-18 days

from exposure to onset of symptoms. The duration of the disease is approximately 10days.

  The initial symptoms of mumps infection are nonspecific (low-grade fever , malaise,headache, muscle aches, and loss of appetite). The classic finding of parotid glandtenderness and swelling generally develops the third day of illness. The diagnosis is

generally made without the need for laboratory tests.

  Serious complications of mumps include meningitis, encephalitis, deafness, and orchitis. 

  The MMR vaccine  provides 80% effective immunity against mumps following a two-

dosage schedule (12-15 months with booster at 4-6 years of age).

   No specific therapy exists for mumps. Warm or cold packs for the parotid gland

tenderness and swelling is helpful. Pain relievers (acetaminophen [Tylenol] andibuprofen [Advil]) are also helpfu

  What is mumps?

  Comment on this Read 13 Comments Share Your Story   Mumps is a viral infection transmitted by and affecting only humans. While the salivary

glands (especially the parotid gland) are well known to be involved during a mumpsinfection, many other organ systems may also experience effects of the virus infection.

There is no cure for mumps, but the illness is of short duration (seven to 10 days) and

resolves spontaneously. Prior to the introduction of mumps vaccination, the highest rateof new cases of mumps was reported in the late winter to early spring.

  What is the history of mumps?  Medical historians believe that documentation of a clinical illness consistent with mumps

dates back to Greco-Roman times. The first effective vaccine against mumps was

introduced in 1948 and used from 1950-1978. Unfortunately, this vaccine strain had

limited long-term immune memory effectiveness. The current strain used in the UnitedStates and worldwide provides over 80% long-term immunity. The current childhood

mumps immunization schedule recommends vaccination at 1 and 4 years of age. Themumps vaccine is commonly administered as part of a combination vaccine (MMR) also providing protection against measles and rubella (German measles).

  What causes mumps? How is mumps transmitted?  Mumps virus is a single strand of RNA housed inside a two-layered envelope that

 provides the virus its characteristic immune signature. Only one type of mumps virus has been demonstrated to exist (in contrast to the many virus types that can cause the

common cold).

  Mumps is highly contagious and has a rapid spread among members living in close

quarters. The virus most commonly is spread directly from one person to another viarespiratory droplets. Less frequently, the respiratory droplets may land on fomites (sheets,

 pillows, clothing) and then be transmitted via hand-to-mouth contact after touching such

items. The incubation period from exposure to the virus and onset of symptoms isapproximately 14-18 days. Viral shedding is short lived and a patient should be isolated

from other susceptible individuals for the first five days following the onset of swelling

of the salivary (parotid) glands.

7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 2/8

What are risk factors for contracting mumps?

1.  Failure to be immunized completely (two separate doses) with exposure to those with

mumps2.  Age: The highest risk of contracting mumps is to children between 2-12 years of age

3.  Season: epidemics of mumps were most likely during the winter/spring seasons4.  Travel to high-risk regions of the world: Africa, general Indian subcontinent region, and

Southeast Asia. These areas have a very low rate of vaccination.

5.  Weakening immune system: either due to diseases (for example, HIV/AIDS, cancer ) or 

medication (oral steroid use for more than two weeks, chemotherapy) 6.  Born before 1956: Generally, these individuals are believed to have experienced mumps

infection in childhood. However, if they did not, they are at risk for adult mumps disease.

A blood test may be obtained to determine immunity and is worthwhile if any doubt

exists regarding prior mumps infection.

What are the signs and symptoms of mumps in children and adults?

Comment on this Share Your Story 

 Nonspecific symptoms of low-grade fever, headache, muscle aches (myalgia), reduced appetite, and malaise occur during the first 48 hours of mumps infection. Parotid gland swelling

characteristically is present on day three of illness. (The parotid gland is a salivary gland located

anterior to the ear and above the angle of the jaw -- imagine a large set of sideburns.) The parotid

gland is swollen and tender to touch, and referred pain to the ear may also occur. Parotid glandswelling may last up to 10 days, and adults generally experience worse symptoms than children.

Approximately 95% of individuals who develop symptoms of mumps will experience tender 

inflammation of their parotid glands.

Interestingly about 15%-20% of mumps cases have no clinical evidence of infection, and 50% of 

 patients will have only nonspecific respiratory symptoms and not the characteristic descriptionabove. Adults are more likely to experience such a subclinical or respiratory-only constellation

of symptoms while children between 2-9 years of age are more likely to experience the classic

 presentation of mumps with parotid gland swelling.

How is mumps diagnosed?

The diagnosis of mumps is primarily one of clinical acumen. Supportive laboratory studies aregenerally done to support the clinical impression. The purpose of these laboratory studies is to

exclude other viruses that may give a similar clinical presentation as well as exclude veryinfrequent similarly presenting parotid gland enlargement (for examples, salivary gland cancer , 

Sjögren's syndrome, IgG-4 related disease, sarcoidosis, side effects of thiazide diuretics, etc.).

What is the treatment for mumps in adults and in children?

Comment on this Share Your Story 

7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 3/8

The mainstay of therapy (regardless of age range) is to provide comfort for this self-limited

disease. Taking analgesics (acetaminophen, ibuprofen) and applying warm or cold packs to the

swollen and inflamed salivary gland region may be helpful.

What are complications of mumps?

There are four serious complications of mumps: meningitis (infection of the spinal fluid which

surrounds the brain and spinal cord), encephalitis (infection of the brain substance), deafness,

and orchitis (infection of the testicle/testicles). All four complications may occur without the

 patient experiencing the classic involvement of the parotid gland.

1.  Meningitis: More than 50% of patients with mumps will have meningitis, which may

occur during any period of the disease. Generally patients make a full recovery without permanent side effects.

2.  Encephalitis: Until the 1960s, mumps was the primary cause of confirmed viral

encephalitis in the United States. Since the successful introduction of a vaccination

 program, the incidence of mumps encephalitis has fallen to 0.5%. Fortunately, most patients recover completely without permanent side effects.

3.  Deafness: Preceding the mumps vaccination program, permanent nerve damage resulting

in deafness was not unusual. While occasionally bilateral, more commonly only one ear was affected.

4.  Orchitis: This complication was the most common side effect (40%) to postpubertal

males who contracted mumps. Severe pain (often requiring hospitalization for   painmanagement) was one-sided in 90% of cases. Between 30%-50% of affected testes

atrophied (decreased in size), and 13% demonstrated impaired fertility. The "common

knowledge" of sterility was actually rare. Previous concerns regarding mumps orchitis

and later  testicular cancer  have not been proven. (Ovarian involvement occurred in

approximately 7% of postpubertal girls.)

Less frequent complications of mumps infection include arthritis, infection of the pancreas,infection of the myocardium (heart muscle), and neurological conditions (for example, facial

 palsy, Guillain-Barré syndrome, etc.).

What is the prognosis of a mumps infection?

Mumps is generally a benign self-limited disease that produces lifelong immunity. Severe sideeffects are extremely rare; more common complications (though still relatively rare) are listed

above. Nonimmune women who contract mumps during the first trimester of their   pregnancy 

have an increased rate of  miscarriage, but infants carried to term have no higher risk for congenital malformations.

Where can people find more information on mumps?

The CDC web site (http://www.cdc.gov) provides an excellent resource for the disease and

vaccination program for mumps and many other common infectious diseases. In addition, the

7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 4/8

American Academy of Pediatrics (http://www.aap.org) also provides valuable information for 

the medically trained and nonmedically trained individual.

Mumps

From Wikipedia, the free encyclopedia

Jump to: navigation, search 

For other uses of the word Mumps or MUMPS, see Mumps (disambiguation). 

Mumps

Classification and external resources 

Child with mumps 

ICD-10  B26

ICD-9  072

DiseasesDB 8449

MedlinePlus 001557

eMedicine emerg/324 emerg/391 ped/1503 

MeSH D009107

Mumps (epidemic parotitis) is a viral disease of the human species, caused by the mumpsvirus. Before the development of  vaccination and the introduction of a vaccine, it was a common

childhood disease worldwide. It is still a significant threat to health in developing countries, and

outbreaks still occur sporadically in developed countries.[1]

 

7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 5/8

Painful swelling of the salivary glands  – classically the  parotid gland  – is the most typical

 presentation.[2]

 Painful testicular swelling (orchitis) and rash may also occur. The symptoms are

generally not severe in children. In teenage males and men, complications such as infertility or subfertility are more common, although still rare in absolute terms.

[3][4][5] The disease is generally

self-limiting, running its course before receding, with no specific treatment apart from

controlling the symptoms with  pain medication. 

Fever and headache are  prodromal symptoms of mumps, together with malaise and anorexia. 

Other symptoms of mumps can include dry mouth, sore face and/or ears and occasionally inmore serious cases, loss of voice. In addition, up to 20% of persons infected with the mumps

virus do not show symptoms, so it is possible to be infected and spread the virus without

knowing it.[6]

 

Males past puberty who develop mumps have a 15 – 20 percent risk of  orchitis,[7]

  painful

inflammation of the testicles.[8]

 

Contents

  1 Cause 

  2 Diagnosis 

  3 Prevention 

  4 Treatment 

  5 Prognosis 

  6 Epidemiology 

  7 References 

  8 External links 

Cause

Mumps is a contagious disease that is spread from person to person through contact withrespiratory secretions, such as saliva from an infected person. When an infected person coughs or sneezes, the droplets aerosolize and can enter the eyes, nose, or mouth of another person. Mumps

can also be spread by sharing food and drinks. The virus can also survive on surfaces and then be

spread after contact in a similar manner.

A person infected with mumps is contagious from approximately 6 days before the onset of 

symptoms until about 9 days after symptoms start.

[9][10]

 The incubation period (time untilsymptoms begin) can be from 14 – 25 days, but is typically 16 – 18 days.[11]

 

Diagnosis

A physical examination confirms the presence of the swollen glands. Usually, the disease isdiagnosed 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; a newer diagnostic

7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 6/8

confirmation, using real-time nested polymerase chain reaction (PCR) technology, has also been

developed.[12]

 An estimated 20%-30% of cases are asymptomatic.[13]

 As with any inflammation

of the salivary glands, serum amylase is often elevated.[14][15]

 

Prevention

The most common preventative measure against mumps is a vaccination with a mumps vaccine, invented by American microbiologist Maurice Hilleman at Merck .

[16] The vaccine may be given

separately or as part of the MMR immunization vaccine which also protects against measles and

rubella. In the US, MMR is now being supplanted by MMRV, which adds protection againstchickenpox. The WHO (World Health Organization) recommends the use of mumps vaccines in

all countries with well-functioning childhood vaccination programmes. In the United Kingdom it

is routinely given to children at age 13 months with a booster at 3 – 5 years(preschool) This

confers lifelong immunity. The American Academy of Pediatrics recommends the routineadministration of MMR vaccine at ages 12 – 15 months and at 4 – 6 years.

[17] In some locations, the

vaccine is given again between 4 to 6 years of age, or between 11 and 12 years of age if not

 previously given. The efficacy of the vaccine depends on the strain of the vaccine, but is usuallyaround 80%.

[18][19] The Jeryl Lynn strain is most commonly used in developed countries but has

 been shown to have reduced efficacy in epidemic situations. The Leningrad-Zagreb strain

commonly used in developing countries appears to have superior efficacy in epidemic

situations.[20]

 

Because of the outbreaks within college and university settings, many governments haveestablished vaccination programs to prevent large-scale outbreaks. In Canada, provincial

governments and the Public Health Agency of Canada have all participated in awareness

campaigns to encourage students ranging from grade 1 to college and university to get

vaccinated.[21]

 

Some anti-vaccine activists  protest against the administration of a vaccine against mumps,

claiming that the attenuated vaccine strain is harmful, and/or that the wild disease is beneficial.There is no evidence whatsoever to support the claim that the wild disease is beneficial, or that

the MMR vaccine is harmful. Claims have been made that the MMR vaccine is linked to autism

and inflammatory bowel disease, including one study by Andrew Wakefield[22][23]

 (the paper wasdiscredited and retracted in 2010 and Wakefield was later stripped of his license after his work 

was found to be an "elaborate fraud" [24]

) that indicated a link between gastrointestinal disease, 

autism, and the MMR vaccine. Also, subsequent studies indicate no link between vaccination

with the MMR and autism.[25]

 Since the dangers of the disease are well known, while the dangersof the vaccine are quite minimal, most doctors recommend vaccination.

The WHO, the American Academy of Pediatrics, the Advisory Committee on ImmunizationPractices of the Centers for Disease Control and Prevention, the American Academy of Family

Physicians, the British Medical Association and the Royal Pharmaceutical Society of Great

Britain currently recommend routine vaccination of children against mumps. The British MedicalAssociation and Royal Pharmaceutical Society of Great Britain had previously recommended

against general mumps vaccination, changing that recommendation in 1987. In 1988 it became

7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 7/8

United Kingdom government policy to introduce mass child mumps vaccination programmes

with the MMR vaccine, and MMR vaccine is now routinely administered in the UK.[citation needed ]

 

Before the introduction of the mumps vaccine, the mumps virus was the leading cause of viral

meningoencephalitis in the United States. However, encephalitis occurs rarely (less than 2 per 

100,000).

[26]

 In one of the largest studies in the literature, the most common symptoms of mumpsmeningoencephalitis were found to be fever (97%), vomiting (94%) and headache (88.8%).[27]

 

The mumps vaccine was introduced into the United States in December 1967: since its

introduction there has been a steady decrease in the incidence of mumps and mumps virusinfection. There were 151,209 cases of mumps reported in 1968. Since 2001, the case average

was only 265 per year, excluding an outbreak of >6000 cases in 2006 attributed largely to

university contagion in young adults.[28][29]

 

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 acetaminophen/ paracetamol for  pain relief. Acetylsalicylic acid (Aspirin) is not used because there is a hypothetical link with

Reye's syndrome. Warm saltwater  gargles, soft foods, and extra fluids may also help relieve

symptoms.

According to the Department of Health of Minnesota there is no effective post-exposure

recommendation to prevent secondary transmission, nor is the post-exposure use of vaccine or immunoglobulin effective.

[30] 

Patients are advised to avoid acidic foods and beverages, since these stimulate the salivaryglands, which can be painful.

[31] 

Prognosis

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

organs are involved. Known complications of mumps include:

  Infection of other organ systems

  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.[32]

 

  Spontaneous abortion in about 27% of cases during the first trimester of pregnancy.[32]

 

  Mild forms of  meningitis in up to 10% of cases[32]

 (40% of cases occur without parotid swelling)  Oophoritis (inflammation of ovaries) in about 5% of adolescent and adult females,

[32] 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)[32] 

  Profound (91 dB or more) but rare sensorineural hearing loss, uni- or bilateral. Acute unilateral

deafness occurs in about 0.005% of cases.[32] 

7/30/2019 Mumps Facts

http://slidepdf.com/reader/full/mumps-facts 8/8

After the illness, lifelong immunity to mumps generally occurs; reinfection is possible but tends

to be mild and atypical.[32]