Mumps

Mumps

Mumps is an infection caused by a type of virus called a paramyxovirus. It typically causes inflammation and swelling of the glands around the face, neck and jaw.  It is very contagious and spread in saliva, the same way as a cold or flu. This means it can be caught from an infected person coughing, sneezing, etc. It can also be caught from touching infected objects – for example, door handles.

Mumps infection is less common since the introduction of the measles, mumps and rubella (MMR) vaccine. Mumps infection is now most common in children who have not received the vaccine.

It is very unusual for children under one year to have mumps.

Symptoms of mumps

  • Swelling and pain of one or both salivary glands (parotid glands) are the usual main symptoms. They are just below the ears and cannot normally be seen or felt them. The salivary glands make saliva which drains into the mouth. Swelling causes distortion of the face and neck with skin over the gland hot and flushed but there is no rash
  • With severe swelling, the mouth cannot be opened and is dry because the salivary ducts are blocked.
  • Chewing and swallowing may be sore.
  • High temperature (fever), headache, feeling tired and being off food may develop for a few days. These symptoms may occur before swelling of the parotid glands develops.
  • Mild abdominal pain may occur.

The swelling of the parotid glands usually lasts for 4-8 days.  Mumps is normally a mild illness, but complications sometimes occur. This is why immunisation is important.

There may be no symptoms, or only very minor ones. It is thought that about 3 in 10 people who contract the mumps virus have no symptoms. The immune system makes antibodies during the infection. These clear the virus and then provide lifelong immunity. It is therefore very rare to have more than one episode of mumps.

What are the possible complications of mumps?

The outlook for young children with mumps is very good. Teenagers and adults with mumps are more likely to develop complications, which may include one (or more) of the following:

  • The testicles (testes) are sometimes affected. One testicle (testis) may become inflamed, swollen, and painful for about a week. This is uncommon in young children. However, about 1 in 4 males who get mumps over the age of 12 years will develop a painful swollen testis. Occasionally, both testes are affected. In very rare cases this may cause infertility.
  • Brain inflammation (encephalitis or meningitis) is an uncommon complication. It typically causes drowsiness, headache, stiff neck, wanting to keep out of the light and being sick (vomiting). Although alarming, meningitis caused by the mumps virus usually clears without any treatment after a few days, without any long-term problems. Meningism occurs in around 15% of patients.
  • Hearing loss can sometimes occur in people with mumps. This is usually only transient and usually improves with time. Very rarely, mumps can cause permanent deafness.
  • If a woman develops mumps in the first 12 weeks of a pregnancy, it may increase the risk of miscarriage. (However, the mumps virus is not thought to cause malformations or defects in an unborn baby.)

Diagnosis of mumps

Mumps is most commonly diagnosed by the symptoms and the type of glands that are enlarged in the body. However, since the introduction of the MMR vaccine, all cases are confirmed by a sample (swab) taken from the mouth to obtain some saliva.(does this apply to pakistan??)

Treatment for mumps

There is no medicine that kills the mumps virus. For most people, mumps improves over a week with no long-term problems.

Treatment aims to ease symptoms until the body’s immune system clears the virus:

Treatment is not required if symptoms are mild.

Paracetamol or ibuprofen can be taken ease fever and pain.

Children should have lots to drink, particularly if they have a high temperature (fever). Fruit juice may stimulate the parotid gland to make more saliva, and cause more pain. Water is best if this occurs.

A warm flannel held against a painful parotid gland can be soothing.

Most children are back to normal within 7-10 days.  Medical help should be sought if it is suspected that a complication is developing (described above).

Precautions

Mumps is very infectious. It takes 14-25 days to develop symptoms after being infected. Affected people are infectious from about six days before, until about five days after, a parotid gland begins to swell.

Children immunised against mumps are unlikely to catch mumps. However, immunisation is not 100% effective. Also, some adults may not be immune and some children may have a poor immune system. So, patients with mumps should stay off school, nursery, college or work and avoid other people as much as possible. This is as soon as mumps is suspected and for five days from the onset of parotid gland swelling.

Mumps immunisation

An effective vaccine to prevent mumps is available. It is part of the MMR vaccine. This is routinely offered to all children aged 12-13 months.

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