Mumps
Basic Information
Mumps has declined radically since a live virus vaccination was put to extensive use in 1967, though mumps has had a slight increase in the U.S. recently, most likely due to a drop in vaccination participation. There are currently approximately 1600 cases per year in the U.S., compared to 150,000 cases per year prior to 1967. The virus primarily infects children and adolescents between the ages of ten and fourteen and is seen most prevalently in late winter and early spring, as is the case with chickenpox, rubella and measles.
Mumps is a contagious viral infection, though less communicable than measles and chickenpox. It can become endemic in densely populated areas.
It is spread by:
- infected airborne droplets
- direct contact with materials contaminated by infected saliva
Mumps is responsible for the swelling (enlarging) of the salivary gland (the parotids) on either or both sides of the jaw. The swelling can be quite painful.
The virus is found in saliva from one day to one week before the salivary glands begin to swell and the virus remains in the saliva for the entire time the glands are enlarged which is from six to nine days.
The incubation period for mumps is two to three weeks.
Symptoms
Symptoms begin with:
- chills
- fever (low to moderate)
- headache
- malaise
- loss of appetite
- sore throat
Then swelling of the salivary glands occurs, making chewing and swallowing difficult. Usually the first palpable sign of swollen salivary glands is discomfort or pain when drinking or swallowing sour or acidic liquids such as lemon juice or vinegar. At this stage, the patient can spike a high fever which usually comes down in three or four days as swelling begins to lessen. The second day of salivary gland involvement is usually the most acute. Generally within ten days full recovery occurs.
Diagnosis/Treatment
Diagnosis is sometimes difficult, except in cases of epidemic, because other viruses that cause salivary gland swelling must be ruled out. These include:
- flu
- cytomegalovirus
- Staphylococcus
Also conditions that cause swelling of salivary glands include:
- leukemia
- sickle cell anemia
- diabetes mellitus
- malnutrition
- cirrhosis
Diagnosis is made on physical examination and can be confirmed by serologic tests.
Since mumps is caused by a virus, there is no treatment or cure for the disease as such. Symptoms are treated, as well as certain complications of the disease.
Patients are contagious from two days before salivary gland swelling to nine days afterward. Most patients recover without problems and enjoy lifetime immunity after their initial infection.
If you have mumps get plenty of rest and avoid acidic liquids and spicy food that creates saliva or foods that are difficult to chew. Since you have an infection, do not use aspirin if you are under sixteen years of age because of the risk of Reye's syndrome. Use nonaspirins to bring down the fever and wet compresses on the jaw for relief.
Initially the mumps patient should be isolated until swelling has stopped.
A child should be kept home from school for eight or nine days after swelling occurs.
Complications can occur but are most often associated with the postpubertal patient. Extra salivary gland involvement most often manifests itself as:
- pancreatitis
- meningitis
- testicular inflammation in twenty percent of males (rarely causing sterility)
- mastitis in thirty percent of women over fifteen years of age
The MMR (measles, mumps, rubella) vaccine is most effective and is recommended for children (See Childhood Immunizations for vaccination schedule.) and for adolescents and adults (See Adult Immunizations for vaccination schedule.). But pregnant women and immunocompromised patients should not have this vaccination.
If you or your child has the mumps or would like to be immunized for mumps, please see your health care provider promptly.