Mumps

Definition

Mumps is a relatively mild short-term viral infection of the salivary glands that usually occurs during childhood. Typically, mumps is characterized by a painful swelling of both cheek areas, although the person could have swelling on one side or no perceivable swelling at all. The salivary glands are also called the parotid glands; therefore, mumps is sometimes referred to as an inflammation of the parotid glands (epidemic parotitis). The word mumps comes from an old English dialect word that means lumps or bumps within the cheeks.

Description

Mumps is a very contagious infection that spreads easily in such highly populated areas as day care centers and schools. Although not as contagious as measles or chickenpox , mumps was once quite common. Prior to the release of a mumps vaccine in the United States in 1967, approximately 92% of all children had been exposed to mumps by the age of 15. In these pre-vaccine years, most children contracted mumps between the ages of four and seven. Mumps epidemics came in two to five year cycles. The greatest mumps epidemic was in 1941 when approximately 250 cases were reported for every 100,000 people. In 1968, the year after the live mumps vaccine was released, only 76 cases were reported for every 100,000 people. By 1985, less than 3,000 cases of mumps were reported throughout the entire United States, which works out to about 1 case per 100,000 people. The reason for the decline in mumps was the increased usage of the mumps vaccine. However, 1987 noted a five-fold increase in the incidence of the disease because of the reluctance of some states to adopt comprehensive school immunization laws. Since then, state-enforced school entry requirements have achieved student immunization rates of nearly 100% in kindergarten and first grade. In 1996, the Centers for disease Control and Prevention (CDC) reported only 751 cases of mumps nationwide, or, in other words, about one case for every five million people.

Causes & symptoms

The paramyxovirus that causes mumps is harbored in the saliva and is spread through sneezing , coughing, and other direct contact with another person's infected saliva. Once the person is exposed to the virus, symptoms generally become noticeable in 14–24 days. Initial symptoms include chills, headache , loss of appetite, and a lack of energy. However, an infected person may not experience these initial symptoms. Swelling of the salivary glands in the face (parotitis) generally occurs within 12–24 hours of the above symptoms. Accompanying the swollen glands is pain on chewing or swallowing, especially with acidic beverages, such as lemonade. A fever as high as 104°F (40°C) is also common. Swelling of the glands reaches a maximum on about the second day and usually disappears by the seventh day. Once a person has contracted mumps, he or she becomes immune to the disease, despite how mild or severe symptoms may have been.

While the majority of cases of mumps are uncomplicated and pass without incident, some complications can occur. Complications are, however, more noticeable in adults who get the infection. In 15% of cases, the covering of the brain and spinal cord becomes inflamed (meningitis ). Symptoms of meningitis usually develop within four or five days after the first signs of mumps. These symptoms include a stiff neck, headache, vomiting , pain with bending or flexing the head, and a lack of energy. Mumps meningitis is usually resolved within seven days, and damage to the brain is exceedingly rare.

Mumps infection can spread into the brain causing inflammation of the brain (encephalitis). Symptoms of mumps encephalitis include the inability to feel pain, seizures, and high fever. Encephalitis can occur during the parotitis stage or one to two weeks later. Recovery from mumps encephalitis is usually complete, although complications, such as seizure disorders, have been noted. Only about 1 in 100 patients with mumps encephalitis dies from the complication.

About one-quarter of all post-pubertal males who contract mumps can develop a swelling of the scrotum (orchitis) about seven days after the parotitis stage. Symptoms include marked swelling of one or both testicles, severe pain, fever, nausea , and headache. Pain and swelling usually subside after 5–7 days, although the testicles can remain tender for weeks.

Girls occasionally suffer an inflammation of the ovaries, or oophoritis, as a complication of mumps, but this condition is far less painful than orchitis in boys.

As of late 2002, some researchers in Europe are studying the possibility that mumps increases a person's risk of developing inflammatory bowel disease (IBD) in later life. This hypothesis will require further research, as present findings are inconclusive.

Diagnosis

When mumps reaches epidemic proportions, diagnosis is relatively easy on the basis of the physical symptoms. The doctor will take the child's temperature, gently palpate (touch) the skin over the parotid glands, and look inside the child's mouth. If the child has mumps, the openings to the ducts inside the mouth will be slightly inflamed and have a "pouty" appearance. With so many people vaccinated today, a case of mumps must be properly diagnosed in the event the salivary glands are swollen for reasons other than viral infection. For example, in persons with poor oral hygiene, the salivary glands can be infected with bacteria. In these cases, antibiotics are necessary. Also in rare cases, the salivary glands can become blocked, develop tumors, or swell due to the use of certain drugs, such as iodine . A test can be performed to determine whether the person with swelling of the salivary glands actually has the mumps virus.

As of late 2002, researchers in London have reported the development of a bioassay for measuring mumps-specific IgG. This test would allow a doctor to check whether an individual patient is immune to mumps, and allow researchers to measure the susceptibility of a local population to mumps in areas with low rates of vaccination.

Treatment

Nutritional therapy

Nutritional therapy may alleviate pain and aid healing. A nutritionist or naturopath may recommend the following:

• drinking lots of fluids to replace fluid loss
• eating only such easy-to-digest foods as soups, broth or bland foods
• taking multivitamin/mineral supplement to help boost the immune function

Homeopathy

A number of homeopathic remedies can be used in the treatment of mumps. For example, belladonna may be useful for flushing, redness, and swelling. Bryonia (wild hops ) may be useful for irritability, lack of energy, or thirst. Phytolacca (poke root) may be prescribed for extremely swollen glands. A homeopathic physician should always be consulted for appropriate doses for children, and remedies that do not work within one day should be stopped. A homeopathic preparation of the mumps virus can also be used prophylactically or as a treatment for the disease.

Herbal therapy

Several herbal remedies may be useful in helping the body recover from the infection or may help alleviate the discomfort associated with the disease. Echinacea (Echinacea spp.) can be used to boost the immune system and help the body fight the infection. Other herbs taken internally, such as cleavers (Galium aparine ), calendula (Calendula officinalis ), and phytolacca (poke root), target the lymphatic system and may help to enhance the activity of the body's internal filtration system. Since phytolacca can be toxic, it should only be used by patients under the care of a skilled practitioner. Topical applications are also useful in relieving the discomfort of mumps. A cloth dipped in a heated mixture of vinegar and cayenne (Capsicum frutescens ) can be wrapped around the neck several times a day. Cleavers or calendula can also be combined with vinegar, heated, and applied in a similar manner.

Acupressure

Acupressure can be used effectively to relieve pain caused by swollen glands. The patient can, by using the middle fingers, gently press the area between the jawbone and the ear for two minutes while breathing deeply.

Allopathic treatment

When mumps occurs, the illness is usually allowed to run its course. The symptoms, however, are treatable. Because of difficulty swallowing, the most important challenge is to keep the patient fed and hydrated. The individual should be provided a soft diet, consisting of cooked cereals, mashed potatoes, broth-based soups, prepared baby foods, or foods put through a home food processor. Aspirin, acetaminophen, or ibuprofen can relieve some of the pain due to swelling, headache, and fever. Avoiding fruit juices and other acidic foods or beverages that can irritate the salivary glands is recommended, as is avoiding dairy products that can be hard to digest. In the event of complications, a physician should be contacted at once. For example, if orchitis occurs, a physician should be called. Also, supporting the scrotum in a cotton bed on an adhesive-tape bridge between the thighs can minimize tension. Ice packs are also helpful.

Expected results

When mumps is uncomplicated, the prognosis for full recovery is excellent. In rare cases, however, a relapse occurs after about two weeks. Complications can also delay complete recovery.

Prevention

A vaccine exists to protect against mumps. The vaccine preparation (MMR) is usually given as part of a combination injection that helps protect against measles, mumps, and rubella . MMR is a live vaccine administered in one dose between the ages of 12-15 months, 4-6 years, or 11-12 years. Persons who are unsure of their mumps history and/or mumps vaccination history should be vaccinated. Susceptible health care workers, especially those who work in hospitals, should be vaccinated. Because mumps is still prevalent throughout the world, susceptible persons over age one who are traveling abroad would benefit from receiving the mumps vaccine.

The mumps vaccine is extremely effective, and virtually everyone should be vaccinated against this disease. There are, however, a few reasons why people should not be vaccinated against mumps:

• Pregnant women who contract mumps during pregnancy have an increased rate of miscarriage, but not birth defects. As a result, pregnant women should not receive the mumps vaccine because of the possibility of damage to the fetus. Women who have had the vaccine should postpone becoming pregnant for three months following vaccination.
• Unvaccinated persons who have been exposed to mumps should not get the vaccine, as it may not provide protection. The person should, however, be vaccinated if no symptoms result from exposure to mumps.
• Persons with minor fever-producing illnesses, such as an upper respiratory infection, should not get the vaccine until the illness has subsided.
• Because mumps vaccine is produced using eggs, individuals who develop hives , swelling of the mouth or throat, dizziness , or breathing difficulties after eating eggs should not receive the mumps vaccine.
• Persons with immune deficiency diseases and/or those whose immunity has been suppressed with anti-cancer drugs, corticosteroids, or radiation should not receive the vaccine. Family members of immunocompromised people, however, should get vaccinated to reduce the risk of mumps.
• The CDC recommends that all children infected with human immunodeficiency disease (HIV) who are asymptomatic should receive an MMR vaccine at 15 months of age.

The mumps vaccine has been controversial in recent years because of concern that its use was linked to a rise in the rate of childhood autism . The negative publicity given to the vaccine in the mass media led some parents to refuse to immunize their children with the MMR vaccine. One result has been an increase in the number of mumps outbreaks in several European countries, including Italy and the United Kingdom.

In the fall of 2002, the New England Journal of Medicine published a major Danish study disproving the hypothesis of a connection between the MMR vaccine and autism. A second study in Finland showed that the vaccine is not associated with aseptic meningitis or encephalitis as well as autism. Since these studies were published, American primary care physicians have once again reminded parents of the importance of immunizing their children against mumps and other childhood diseases.

Resources

BOOKS

"Viral Infections: Mumps." Section 19, Chapter 265 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

Zand, Janet, Allan N. Spreen, and James B. LaValle. "Mumps." Smart Medicine for Healthier Living. Garden City Park, NY: Avery Publishing Group, 1998.

PERIODICALS

Gabutti, G., M. C. Rota, S. Salmaso, et al. "Epidemiology of Measles, Mumps and Rubella in Italy." Epidemiology and Infection 129 (December 2002): 543–550.

Kimmel, S. R. "Vaccine Adverse Events: Separating Myth From Reality." American Family Physician 66 (December 1, 2002): 2113–2120.

Madsen, K. M., A. Hviid, M. Vestergaard, et al. "A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism." New England Journal of Medicine 347 (November 7, 2002): 1477–1482.

Makela, A., J. P. Nuorti, and H. Peltola. "Neurologic Disorders After Measles-Mumps-Rubella Vaccination." Pediatrics 110 (November 2002): 957–963.

McKie, A., D. Samuel, B. Cohen, and N. A. Saunders. "A Quantitative Immuno-PCR Assay for the Detection of Mumps-Specific IgG." Journal of Immunological Methods 270 (December 1, 2002): 135–141.

Nielsen, S. E., O. H. Nielsen, B. Vainer, and M. H. Claesson. "Inflammatory Bowel Disease—Do Microorganisms Play a Role?" [in Danish] Ugeskrift for laeger 164 (December 9, 2002): 5947–5950.

Pugh, R. N., B. Akinosi, S. Pooransingh, et al. "An Outbreak of Mumps in the Metropolitan Area of Walsall, UK." International Journal of Infectious Diseases 6 (December 2002): 283–287.

ORGANIZATIONS

American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007. (847) 434-4000. <www.aap.org>.

Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. <http://www.cdc.gov>.

OTHER

Recommended Childhood Immunization Schedules, United States, 1995. June 16, 1995, Volume 44, RR-5. Can be purchased from Superintendent of Documents, U. S. Government Printing Office, Washington, DC 20402-9325. (202) 783-3238.

Update: Vaccine Side Effects, Adverse Reactions, Contraindications, and Precautions September 6, 1996, Volume 45, RR-12. Can be purchased from Superintendent of Documents, U. S. Government Printing Office, Washington, DC 20402-9325. (202) 783-3238.

Mai Tran

Rebecca J. Frey, PhD

Mumps

Definition

Mumps is a relatively mild short-term viral infection of the salivary glands that usually occurs during childhood. Typically, mumps is characterized by a painful swelling of both cheek areas, although the person could have swelling on one side or no perceivable swelling at all. The salivary glands are also called the parotid glands, therefore, mumps is sometimes referred to as an inflammation of the parotid glands (epidemic parotitis). The word mumps comes from an old English dialect, meaning lumps or bumps within the cheeks.

Description

Mumps is a very contagious infection that spreads easily in such highly populated areas as day care centers and schools. Although not as contagious as measles or chickenpox, mumps was once quite common. Prior to the release of a mumps vaccine in the United States in 1967, approximately 92% of all children had been exposed to mumps by the age of 15. In these pre-vaccine years, most children contracted mumps between the ages of four and seven. Mumps epidemics came in two to five year cycles. The greatest mumps epidemic was in 1941 when approximately 250 cases were reported for every 100,000 people. In 1968, the year after the live mumps vaccine was released, only 76 cases were reported for every 100,000 people. By 1985, less than 3,000 cases of mumps were reported throughout the entire United States, which works out to about 1 case per 100,000 people. The reason for the decline in mumps was the increased usage of the mumps vaccine. However, 1987 noted a five-fold increase in the incidence of the disease because of the reluctance of some states to adopt comprehensive school immunization laws. Since then, state-enforced school entry requirements have achieved student immunization rates of nearly 100% in kindergarten and first grade. In 1996, the Centers for Disease Control and Prevention (CDC) reported only 751 cases of mumps nationwide, or, in other words, about one case for every five million people.

Causes and symptoms

The paramyxovirus that causes mumps is harbored in the saliva and is spread by sneezing, coughing, and other direct contact with another person's infected saliva. Once the person is exposed to the virus, symptoms generally occur in 14-24 days. Initial symptoms include chills, headache, loss of appetite, and a lack of energy. However, an infected person may not experience these initial symptoms. Swelling of the salivary glands in the face (parotitis) generally occurs within 12-24 hours of the above symptoms. Accompanying the swollen glands is pain on chewing or swallowing, especially with acidic beverages, such as lemonade. A fever as high as 1048F (40°C) is also common. Swelling of the glands reaches a maximum on about the second day and usually disappears by the seventh day. Once a person has contracted mumps, they become immune to the disease, despite how mild or severe their symptoms may have been.

While the majority of cases of mumps are uncomplicated and pass without incident, some complications can occur. Complications are, however, more noticeable in adults who get the infection. In 15% of cases, the covering of the brain and spinal cord becomes inflamed (meningitis ). Symptoms of meningitis usually develop within four or five days after the first signs of mumps. These symptoms include a stiff neck, headache, vomiting, and a lack of energy. Mumps meningitis is usually resolved within seven days, and damage to the brain is exceedingly rare.

The mumps infection can spread into the brain causing inflammation of the brain (encephalitis ). Symptoms of mumps encephalitis include the inability to feel pain, seizures, and high fever. Encephalitis can occur during the parotitis stage or one to two weeks later. Recovery from mumps encephalitis is usually complete, although complications, such as seizure disorders, have been noted. Only about 1 in 100 with mumps encephalitis dies from the complication.

About one-quarter of all post-pubertal males who contract mumps can develop a swelling of the scrotum (orchitis ) about seven days after the parotitis stage. Symptoms include marked swelling of one or both testicles, severe pain, fever, nausea, and headache. Pain and swelling usually subside after five to seven days, although the testicles can remain tender for weeks.

Girls occasionally suffer an inflammation of the ovaries, or oophoritis, as a complication of mumps, but this condition is far less painful than orchitis in boys.

As of late 2002, some researchers in Europe are studying the possibility that mumps increases a person's risk of developing inflammatory bowel disease (IBD) in later life. This hypothesis will require further research, as present findings are inconclusive.

Diagnosis

When mumps reaches epidemic proportions, diagnosis is relatively easy on the basis of the physical symptoms. The doctor will take the child's temperature, gently palpate (touch) the skin over the parotid glands, and look inside the child's mouth. If the child has mumps, the openings to the ducts inside the mouth will be slightly inflamed and have a "pouty" appearance. With so many people vaccinated today, a case of mumps must be properly diagnosed in the event the salivary glands are swollen for reasons other than viral infection. For example, in persons with poor oral hygiene, the salivary glands can be infected with bacteria. In these cases, antibiotics are necessary. Also in rare cases, the salivary glands can become blocked, develop tumors, or swell due to the use of certain drugs, such as iodine. A test can be performed to determine whether the person with swelling of the salivary glands actually has the mumps virus.

As of late 2002, researchers in London have reported the development of a bioassay for measuring mumps-specific IgG. This test would allow a doctor to check whether an individual patient is immune to mumps, and allow researchers to measure the susceptibility of a local population to mumps in areas with low rates of vaccination.

Treatment

When mumps does occurs, the illness is usually allowed to run its course. The symptoms, however, are treatable. Because of difficulty swallowing, the most important challenge is to keep the patient fed and hydrated. The individual should be provided a soft diet, consisting of cooked cereals, mashed potatoes, broth-based soups, prepared baby foods, or foods put through a home food processor. Aspirin, acetaminophen, or ibuprofen can relieve some of the pain due to swelling, headache, and fever. Avoid fruit juices and other acidic foods or beverages that can irritate the salivary glands. Avoid dairy products that can be hard to digest. In the event of complications, a physician should be contacted at once. For example, if orchitis occurs, a physician should be called. Also, supporting the scrotum in a cotton bed on an adhesive-tape bridge between the thighs can minimize tension. Ice packs are also helpful.

Alternative treatment

Acupressure can be used effectively to relieve pain caused by swollen glands. The patient can, by using the middle fingers, gently press the area between the jawbone and the ear for two minutes while breathing deeply.

A number of homeopathic remedies can be used for the treatment of mumps. For example, belladonna may be useful for flushing, redness, and swelling. Bryonia (wild hops) may be useful for irritability, lack of energy, or thirst. Phytolacca (poke root) may be prescribed for extremely swollen glands. A homeopathic physician should always be consulted for appropriate doses for children, and remedies that do not work within one day should be stopped. A homeopathic preparation of the mumps virus can also be used prophylactically or as a treatment for the disease.

Several herbal remedies may be useful in helping the body recover from the infection or may help alleviate the discomfort associated with the disease. Echinacea (Echinacea spp.) can be used to boost the immune system and help the body fight the infection. Other herbs taken internally, such as cleavers (Galium aparine ), calendula (Calendula officinalis ), and phytolacca (poke root), target the lymphatic system and may help to enhance the activity of the body's internal filtration system. Since phytolacca can be toxic, it should only be used by patients under the care of a skilled practitioner. Topical applications are also useful in relieving the discomfort of mumps. A cloth dipped in a heated mixture of vinegar and cayenne (Capsicum frutescens ) can be wrapped around the neck several times a day. Cleavers or calendula can also be combined with vinegar, heated, and applied in a similar manner.

Prognosis

When mumps is uncomplicated, prognosis is excellent. However, in rare cases, a relapse occurs after about two weeks. Complications can also delay complete recovery.

Prevention

A vaccine exists to protect against mumps. The vaccine preparation (MMR) is usually given as part of a combination injection that helps protect against measles, mumps, and rubella. MMR is a live vaccine administered in one dose between the ages of 12-15 months, 4-6 years, or 11-12 years. Persons who are unsure of their mumps history and/or mumps vaccination history should be vaccinated. Susceptible health care workers, especially those who work in hospitals, should be vaccinated. Because mumps is still prevalent throughout the world, susceptible persons over age one who are traveling abroad would benefit from receiving the mumps vaccine.

The mumps vaccine is extremely effective, and virtually everyone should be vaccinated against this disease. There are, however, a few reasons why people should not be vaccinated against mumps:

• Pregnant women who contract mumps during pregnancy have an increased rate of miscarriage, but not birth defects. As a result, pregnant women should not receive the mumps vaccine because of the possibility of damage to the fetus. Women who have had the vaccine should postpone pregnancy for three months after vaccination.
• Unvaccinated persons who have been exposed to mumps should not get the vaccine, as it may not provide protection. The person should, however, be vaccinated if no symptoms result from the exposure to mumps.
• Persons with minor fever-producing illnesses, such as an upper respiratory infection, should not get the vaccine until the illness has subsided.
• Because mumps vaccine is produced using eggs, individuals who develop hives, swelling of the mouth or throat, dizziness, or breathing difficulties after eating eggs should not receive the mumps vaccine.

• Persons with immune deficiency diseases and/or those whose immunity has been suppressed with anti-cancer drugs, corticosteroids, or radiation should not receive the vaccine. Family members of immunocompromised people, however, should get vaccinated to reduce the risk of mumps.
• The CDC recommends that all children infected with human immunodeficiency disease (HIV) who are asymptomatic should receive an the MMR vaccine at 15 months of age.

The mumps vaccine has been controversial in recent years because of concern that its use was linked to a rise in the rate of childhood autism. The negative publicity given to the vaccine in the mass media led some parents to refuse to immunize their children with the MMR vaccine. One result has been an increase in the number of mumps outbreaks in several European countries, including Italy and the United Kingdom.

In the fall of 2002, the New England Journal of Medicine published a major Danish study disproving the hypothesis of a connection between the MMR vaccine and autism. A second study in Finland showed that the vaccine is not associated with aseptic meningitis or encephalitis as well as autism. Since these studies were published, American primary care physicians have once again reminded parents of the importance of immunizing their children against mumps and other childhood diseases.

KEY TERMS

Asymptomatic— Persons who carry a disease and may be capable of transmitting the disease but who do not exhibit symptoms of the disease are said to be asymptomatic.

Autism— A severe developmental disorder that usually begins before three years of age and affects a child's social as well as intellectual development. Some researchers theorized that immunization with the MMR vaccine was a risk factor for autism.

Encephalitis— Inflammation of the brain.

Epidemic parotitis— The medical name for mumps.

Immunoglobulin G (IgG)— A group of antibodies against certain viral infections that circulate in the bloodstream. One type of IgG is specific against the mumps paramyxovirus.

Meningitis— Inflammation of the membranes covering the brain and spinal cord.

Orchitis— Inflammation or swelling of the scrotal sac containing the testicles.

Paramyxovirus— A genus of viruses that includes the causative agent of mumps.

Parotitis— Inflammation and swelling of the salivary glands.

Resources

BOOKS

Beers, Mark H., MD, and Robert Berkow, MD, editors. "Viral Infections: Mumps." Section 19, Chapter 265. In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

PERIODICALS

Gabutti, G., M. C. Rota, S. Salmaso, et al. "Epidemiology of Measles, Mumps and Rubella in Italy." Epidemiology and Infection 129 (December 2002): 543-550.

Kimmel, S. R. "Vaccine Adverse Events: Separating Myth From Reality." American Family Physician 66 (December 1, 2002): 2113-2120.

Madsen, K. M., A. Hviid, M. Vestergaard, et al. "A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism." New England Journal of Medicine 347 (November 7, 2002): 1477-1482.

Makela, A., J. P. Nuorti, and H. Peltola. "Neurologic Disorders After Measles-Mumps-Rubella Vaccination." Pediatrics 110 (November 2002): 957-963.

McKie, A., D. Samuel, B. Cohen, and N. A. Saunders. "A Quantitative Immuno-PCR Assay for the Detection of Mumps-Specific IgG." Journal of Immunological Methods 270 (December 1, 2002): 135-141.

Nielsen, S. E., O. H. Nielsen, B. Vainer, and M. H. Claesson. "Inflammatory Bowel Disease—Do Microorganisms Play a Role?" [in Danish] Ugeskrift for laeger 164 (December 9, 2002): 5947-5950.

Pugh, R. N., B. Akinosi, S. Pooransingh, et al. "An Outbreak of Mumps in the Metropolitan Area of Walsall, UK." International Journal of Infectious Diseases 6 (December 2002): 283-287.

ORGANIZATIONS

American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007. (847) 434-4000. 〈www.aap.org〉.

Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. 〈http://www.cdc.gov〉.

Mumps

Introduction

Disease History, Characteristics, and Transmission

Scope and Distribution

Treatment and Prevention

Impacts and Issues

BIBLIOGRAPHY

Introduction

Mumps is an acute viral illness whose main symptom is parotitis, an inflammation of the salivary glands in the neck. It was first described by the great Greek physician, Hippocrates, in the fifth century BC. Before an effective vaccination program was introduced in 1968, mumps was one of the most significant childhood diseases.

Mumps is as infectious as influenza and rubella (German measles), but somewhat less so than measles and chickenpox. Many of those infected with the virus have no symptoms at all. Mumps usually clears up within a week or so, and those infected then have lifelong immunity. However, the virus can spread through the lymph glands to cause a number of complications, including permanent deafness, so protecting children from mumps through vaccination is important. The introduction of vaccination for mumps has cut the rate of infections in the United States by 98%. However, local epidemics still sometimes occur.

Disease History, Characteristics, and Transmission

Mumps, also known as infectious parotitis, is caused by a paramyxovirus, which consists of single-stranded RNA (its genetic material [ribonucleic acid], as opposed to DNA [deoxyribonucleic acid]) surrounded by a protein envelope. The incubation period of the virus is 12–25 days, during which time it infects the upper respiratory tract and may pass to the glandular tissue of the ovaries, testes, or pancreas through the lymphatic system.

The most common symptom of mumps is parotitis, an inflammation of the salivary glands. The patient will experience pain, tenderness, and swelling in the jaw area, which may be accompanied by an earache. Approximately half of mumps infections are accompanied by parotitis. However, bacterial infection by Staphylococcus species can also cause parotitis, and that may be confused with mumps on diagnosis. Headache is another common symptom of mumps, and malaise, fever, and loss of appetite may also occur, especially in the early stages. Parotitis peaks about two days after its onset and the infection begins to clear within a week, with the vast majority of patients making a full recovery. One attack of mumps confers lifelong immunity, therefore it does not recur.

WORDS TO KNOW

MALAISE: Malaise is a general or nonspecific feeling of unease or discomfort, often the first sign of disease infection.

OOPHORITIS: Oophoritis is an inflammation of the ovary, which happens in certain sexually transmitted diseases.

ORCHITIS: Orchitis is inflammation of one or both testicles. Swelling and pain are typical symptoms. Orchitis may be caused by various sexually transmitted diseases or escape of sperm cells into the tissues of the testicle.

PANCREATITIS: Pancreatitis is an inflammation of the pancreas, an organ that is important in digestion. Pancreatitis can be acute (beginning suddenly, usually with the patient recovering fully) or chronic (progressing slowly with continued, permanent injury to the pancreas).

PARAMYXOVIRUS: Paramyxovirus is a type of virus that contains ribonucleic acid as the genetic material and has proteins on its surface that clump red blood cells and assist in the release of newly made viruses from the infected cells. Measles virus and mumps virus are two types of paramyxoviruses.

PAROTITIS: Parotitis is inflammation of the parotid gland. There are two parotid glands, one on each side of the jaw, at the back. Their function is to secret saliva into the mouth.

REPORTABLE DISEASE: By law, occurrences of some diseases must be reported to government authorities when observed by health-care professionals. Such diseases are called reportable diseases or notifiable diseases Cholera and yellow fever are examples of reportable diseases.

RIBONUCLEIC ACID (RNA): Any of a group of nucleic acids that carry out several important tasks in the synthesis of proteins. Unlike DNA (deoxyribonucleic acid), it has only a single strand. Nucleic acids are complex molecules that contain a cell's genetic information and the instructions for carrying out cellular processes. In eukaryotic cells, the two nucleic acids, ribonucleic acid (RNA) and deoxyribonucleic acid (DNA), work together to direct protein synthesis. Although it is DNA (deoxyribonucleic acid) that contains the instructions for directing the synthesis of specific structural and enzymatic proteins, several types of RNA actually carry out the processes required to produce these proteins. These include messenger RNA (mRNA), ribosomal RNA (rRNA), and transfer RNA (tRNA). Further processing of the various RNAs is carried out by another type of RNA called small nuclear RNA (snRNA). The structure of RNA is very similar to that of DNA, however, instead of the base thymine, RNA co

However, mumps does sometimes cause complications and, indeed, is responsible for one death a year, on average, in the United States. When the virus spreads to the glands, it can cause orchitis (inflammation of the testicles), oophoritis (inflammation of the ovaries), pancreatitis, arthritis, and encephalitis. Central nervous system involvement in the form of asymptomatic meningitis is common, while symptomatic meningitis with headache and stiff neck occurs in up to 15% of patients, although this usually resolves itself within several days. Around one in 10,000–20,000 cases of mumps will lead to permanent deafness, with sudden onset. In 80% of these cases, the deafness is confined to one ear.

The mumps virus is spread by airborne transmission and through the droplets created by coughs and sneezes. Those infected will spread the virus about a week before they develop symptoms—if any occur—and will remain infectious for up to ten days after the symptoms begin. People without symptoms may still be infectious.

Scope and Distribution

The mumps virus affects both children and adults around the world, with the peak of infection occurring in late winter and early spring, although cases occur throughout the year as well. However, mass vaccination has had a dramatic impact on the number of cases of mumps where it is used. In World War I (1939-1945), only gonorrhea and influenza caused more hospitalizations than mumps among the military.

When it comes to the complications of mumps, adults appear to be more susceptible than children. Men in the 15–29 age group are the most susceptible to orchitis, which affects 20–50% of those developing mumps. In 30% of these cases, both testicles are affected, which raises the threat of infertility. However, although shrinkage of the testicles does occur in some cases of orchitis, infertility rarely results. Around 5% of young women with mumps will develop oophoritis, which may cause severe pelvic pain, but this complication is not linked to infertility. Pregnant women who develop mumps run an increased risk of spontaneous abortion. Mumps has been a reportable disease in the United States for several years.

IN CONTEXT: SCIENTIFIC, POLITICAL, AND ETHICAL ISSUES

With regard to a potential connection between the measles, mumps, and rubella vaccine (MMR vaccine) and autism, scientists at the National Immunization Program (NIP) at Centers for Disease Control and Prevention (CDC) state that “the weight of currently available scientific evidence does not support the hypothesis that MMR vaccine causes autism. CDC recognizes there is considerable public interest in this issue, and therefore supports additional research regarding this hypothesis. CDC is committed to maintaining the safest, most effective vaccine supply in history.”

As of May 2007 the CDC further states that, “there is no convincing evidence that vaccines such as MMR cause long term health effects. On the other hand, we do know that people will become ill and some will die from the diseases this vaccine prevents. Measles outbreaks have recently occurred in the UK and Germany following an increase in the number of parents who chose not to have their children vaccinated with the MMR vaccine. Discontinuing a vaccine program based on unproven theories would not be in anyone's best interest. Isolated reports about these vaccines causing long term health problems may sound alarming at first. However, careful review of the science reveals that these reports are isolated and not confirmed by scientifically sound research. Detailed medical reviews of health effects reported after receipt of vaccines have often proven to be unrelated to vaccines, but rather have been related to other health factors. Because these vaccines are recommended widely to protect the health of the public, research on any serious hypotheses about their safety are important to pursue. Several studies are underway to investigate still unproven theories about vaccinations and severe side effects.”

SOURCE: Centers for Disease Control and Prevention, National Immunization Program

Treatment and Prevention

Treatment of mumps infection includes hydration and painkillers. If headache is severe, then lumbar puncture may bring relief. Strong painkillers may be needed in cases of orchitis, because the pain can be quite severe. Children and adults with mumps should be excluded from school or work during the infectious period.

Mumps can be prevented by immunization with a live mumps vaccine. This is part of the measles, mumps and rubella (MMR) vaccine, which is given as childhood immunization—once at 12–15 months and again between four and six years of age. Although the mumps vaccine is generally safe, it should not be given to pregnant women, those with a fever, or patients with weakened immunity. There have been occasional side effects of mumps vaccine on the central nervous system, some of which have led to deafness. As with all airborne diseases, good personal hygiene helps prevent transmission. Therefore, people should always cover their nose and mouth when they cough or sneeze, and wash their hands regularly.

Impacts and Issues

Mumps was once a major childhood disease with occasional serious complications, such as deafness and infertility. Vaccination has changed that. Mumps became a reportable disease in the United States in 1968, when vaccination was introduced. Before that, there were an estimated 212,000 cases per year. However, between 1983 and 1985, there were only around 3,000 cases reported annually, demonstrating the value of mass vaccination.

In 1986 and 1987, there was a relative resurgence of mumps, with around 13,000 cases being reported in the United States. Most occurred in the 10–19 age group, who were born before vaccination was introduced. Since mumps can affect adults too, this was not unexpected. There were several outbreaks among highly vaccinated school populations, which suggested that a single dose might not be sufficient to protect children.

Since 1989, there has been a marked decline in the number of reported cases of mumps, from 5,712 cases to a total of 258 cases in 2004. But childhood infections like mumps can still come back unexpectedly. In 2006, there were outbreaks in several states, mostly among young adults, which led to a total of more than 6,000 reported cases. Most of these cases had received either one or two shots of MMR, but possibly had not developed a full immune response for some reason.

Introduction of mumps vaccine has been associated with a shift in the age at which people get the disease. Previously, 90% of cases occurred among children aged 15 or younger. But since 1990, those aged 15 or older have accounted for 30–40% of cases each year, with males and females being affected equally. These trends may reflect the effect of vaccine coverage in the population, and also the tendency of mumps to affect both children and young adults. Mumps is a disease that should not be taken lightly. Any lapse in vaccination coverage could lead to more outbreaks, with the attendant—albeit rare—complications.

See AlsoChildhood Infectious Diseases, Immunization Impacts; Measles (Rubeola); Rubella.

IN CONTEXT: SOCIAL AND PERSONAL RESPONSIBILITY

Social issues can still arise out of even the most effective and seemingly well-intended of medical advances. For example, although childhood diseases such as measles, mumps, whooping cough, and diphtheria have been effectively controlled by childhood vaccinations, some parents resist or reject vaccinating their own children because they feel that the small personal risk is not mitigated by the larger social benefit of disease control. By opting out of the system (by relying on the immunizations of others to reduce the risk of disease) they rely upon the acts their social group to offer their open children personal protection.

BIBLIOGRAPHY

Books

Wilks, David, Mark Farrington, and David Rubenstein. The Infectious Disease. 2nd ed. Malden: Blackwell, 2003.

Wilson, Walter R., and Merle A. Current Diagnosis & Treatment in Infectious Diseases. New York: McGraw Hill, 2001.

Web Sites

Centers for Disease Control and Prevention. “Pink Book—Mumps.” <http://www.cdc.gov/nip/publications/pink/mumps.pdf> (accessed March 25, 2007).

Susan Aldridge

Mumps

Definition

Mumps is a relatively mild short-term viral infection of the salivary glands that usually occurs during childhood.

Description

Typically, mumps is characterized by a painful swelling of both cheek areas, although the person could have swelling on one side or no perceivable swelling at all. The salivary glands are also called the parotid glands; therefore, mumps is sometimes referred to as an inflammation of the parotid glands (epidemic parotitis). The word mumps comes from an old English dialect, meaning lumps or bumps within the cheeks.

Demographics

Mumps is a very contagious infection that spreads easily in such highly populated environments as daycare centers and schools. Although not as contagious as measles or chickenpox , mumps was once quite common. Prior to the release of a mumps vaccine in the United States in 1967, approximately 92 percent of all children had been exposed to mumps by the age of 15. In the pre-vaccine years, most children contracted mumps between the ages of four and seven. Mumps epidemics came in two to five year cycles. The greatest mumps epidemic was in 1941 when approximately 250 cases were reported for every 100,000 people. In 1968, the year after the live mumps vaccine was released, only 76 cases were reported for every 100,000 people. By 1985, fewer than 3,000 cases of mumps were reported throughout the entire United States, the equivalent of about one case per 100,000 people. The reason for the decline in mumps was the increased usage of the mumps vaccine. However, 1987 noted a five-fold increase in the incidence of the disease because of the reluctance of some states to adopt comprehensive school immunization laws. After that, state-enforced school entry requirements achieved student immunization rates of nearly 100 percent in kindergarten and first grade. In 1996, the Centers for Disease Control and Prevention (CDC) reported only 751 cases of mumps nationwide, that is, about one case for every 5 million people.

Causes and symptoms

The paramyxovirus that causes mumps is harbored in the saliva and is spread by sneezing, coughing, and other direct contact with another person's infected saliva. Once the person is exposed to the virus, symptoms generally occur in 14 to 24 days. Initial symptoms include chills, headache , loss of appetite, and a lack of energy. However, an infected person may not experience these initial symptoms. Swelling of the salivary glands in the face (parotitis) generally occurs within 12 to 24 hours of the above symptoms. Accompanying the swollen glands is pain on chewing or swallowing, especially with acidic beverages, such as lemonade. A fever as high as 104°F (40°C) is also common. Swelling of the glands reaches a maximum on about the second day and usually disappears by the seventh day. Once individuals have contracted mumps, they become immune to the disease, despite how mild or severe their symptoms may have been.

While the majority of cases of mumps are uncomplicated and pass without incident, some complications can occur. Complications are, however, more noticeable in adults who get the infection. In 15 percent of cases, the covering of the brain and spinal cord becomes inflamed (meningitis ). Symptoms of meningitis usually develop within four or five days after the first signs of mumps. These symptoms include a stiff neck, headache, vomiting , and a lack of energy. Mumps meningitis is usually resolved within seven days, and damage to the brain is exceedingly rare.

The mumps infection can spread into the brain causing inflammation of the brain (encephalitis ). Symptoms of mumps encephalitis include the inability to feel pain, seizures, and high fever. Encephalitis can occur during the parotitis stage or one to two weeks later. Recovery from mumps encephalitis is usually complete, although complications, such as seizure disorders, have been noted. Only about one person in 100 with mumps encephalitis dies from the complication.

About one-fourth of all post-pubertal males who contract mumps can develop a swelling of the scrotum (orchitis) about seven days after the parotitis stage. Symptoms include marked swelling of one or both testicles, severe pain, fever, nausea , and headache. Pain and swelling usually subside after five to seven days, although the testicles can remain tender for weeks.

Girls occasionally suffer an inflammation of the ovaries (oophoritis) as a complication of mumps, but this condition is far less painful than orchitis in boys.

Diagnosis

When mumps reaches epidemic proportions, diagnosis is relatively easy on the basis of the physical symptoms. The doctor will take the child's temperature, gently palpate (touch) the skin over the parotid glands, and look inside the child's mouth. If the child has mumps, the openings to the ducts inside the mouth will be slightly inflamed and have a "pouty" appearance. With so many people vaccinated as of the early 2000s, a case of mumps must be properly diagnosed in the event the salivary glands are swollen for reasons other than viral infection. For example, in persons with poor oral hygiene , the salivary glands can be infected with bacteria. In these cases, antibiotics are necessary. Also in rare cases, the salivary glands can become blocked, develop tumors, or swell due to the use of certain drugs, such as iodine. A test can be performed to determine whether the person with swelling of the salivary glands actually has the mumps virus.

In late 2002, researchers in London reported the development of a bioassay for measuring mumps-specific IgG. This test would allow a doctor to check whether an individual patient is immune to mumps and allow researchers to measure the susceptibility of a local population to mumps in areas with low rates of vaccination .

Treatment

When mumps does occurs, the illness is usually allowed to run its course. The symptoms, however, are treatable. Because of difficulty swallowing, the most important challenge is to keep the patient fed and hydrated. The individual should be provided a soft diet, consisting of cooked cereals, mashed potatoes, broth-based soups, prepared baby foods, or foods put through a home food processor. Aspirin (only for individuals over the age of 20), acetaminophen , or ibuprofen can relieve some of the pain due to swelling, headache, and fever. Patients should void fruit juices and other acidic foods or beverages that can irritate the salivary glands. They should also avoid dairy products that can be hard to digest. In the event of complications, a physician should be contacted at once. For example, if orchitis occurs, a physician should be called. Also, supporting the scrotum in a cotton bed on an adhesive-tape bridge between the thighs can minimize tension. Ice packs are also helpful.

Prognosis

When mumps is uncomplicated, prognosis is excellent. However, in rare cases, a relapse occurs after about two weeks. Complications can also delay complete recovery.

Prevention

A vaccine exists to protect against mumps. The vaccine preparation (MMR) is usually given as part of a combination injection that helps protect against measles, mumps, and rubella . MMR is a live vaccine administered in one dose between the ages of 12 and 15 months, between four and six years of age, or 11 and 12 years of age. Persons who are unsure of their mumps history and/or mumps vaccination history should be vaccinated. Susceptible healthcare workers, especially those who work in hospitals, should be vaccinated. Because mumps is still prevalent throughout the world, susceptible persons over the age of one year who are traveling abroad would benefit from receiving the mumps vaccine.

The mumps vaccine is extremely effective, and virtually everyone should be vaccinated against this disease. There are, however, a few reasons why people should not be vaccinated against mumps:

• Pregnant women who contract mumps during pregnancy have an increased rate of miscarriage but not birth defects. As a result, pregnant women should not receive the mumps vaccine because of the possibility of damage to the fetus. Women who have had the vaccine should postpone pregnancy for three months after being vaccinated.
• Unvaccinated persons who have been exposed to mumps should not get the vaccine, as it may not provide protection. The persons should, however, be vaccinated if no symptoms result from the exposure to mumps.
• Persons with minor fever-producing illnesses, such as an upper respiratory infection, should not get the vaccine until the illness has subsided.
• Because mumps vaccine is produced using eggs, individuals who develop hives , swelling of the mouth or throat, dizziness , or breathing difficulties after eating eggs should not receive the mumps vaccine.
• Persons with immune deficiency diseases and/or those whose immunity has been suppressed with anti-cancer drugs, corticosteroids, or radiation should not receive the vaccine. Family members of immunocompromised people, however, should get vaccinated to reduce the risk of mumps.
• The CDC recommends that all children infected with human immunodeficiency disease (HIV) who are asymptomatic should receive an the MMR vaccine at 15 months of age.

Parental concerns

The mumps vaccine has been controversial in the early 2000s because of concern that its use was linked to an increased rate of childhood autism . The negative publicity given to the vaccine in the mass media led some parents to refuse to immunize their children with the MMR vaccine. One result has been an increase in the number of mumps outbreaks in several European countries, including Italy and the United Kingdom.

KEY TERMS

Asymptomatic —Persons who carry a disease and are usually capable of transmitting the disease but who do not exhibit symptoms of the disease are said to be asymptomatic.

Autism —A developmental disability that appears early in life, in which normal brain development is disrupted and social and communication skills are retarded, sometimes severely.

Encephalitis —Inflammation of the brain, usually caused by a virus. The inflammation may interfere with normal brain function and may cause seizures, sleepiness, confusion, personality changes, weakness in one or more parts of the body, and even coma.

Epidemic parotitis —The medical name for mumps.

Immunoglobulin G (IgG) —Immunoglobulin type gamma, the most common type found in the blood and tissue fluids.

Meningitis —An infection or inflammation of the membranes that cover the brain and spinal cord. It is usually caused by bacteria or a virus.

Orchitis —Inflammation of one or both testes, accompanied by swelling, pain, fever, and a sensation of heaviness in the affected area.

Paramyxovirus —A genus of viruses that includes the causative agent of mumps.

Parotitis —Inflammation and swelling of one or both of the parotid salivary glands.

In the fall of 2002, the New England Journal of Medicine published a major Danish study disproving the hypothesis of a connection between the MMR vaccine and autism. A second study in Finland showed that the vaccine is also not associated with aseptic meningitis or encephalitis. Since these studies were published, U.S. primary care physicians have once again reminded parents of the importance of immunizing their children against mumps and other childhood diseases.

Resources

BOOKS

Gutierrez, Kathleen A. "Mumps Virus." In Principles and Practice of Pediatric Infectious Diseases, 2nd ed. Edited by Sarah S. Long et al. St. Louis, MO: Elsevier, 2003.

Maldonado, Yvonne A. "Mumps." In Nelson Textbook of Pediatrics. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2004.

Ron Gasbarro, PharmD Rebecca J. Frey, PhD Rosalyn Carson DeWitt, MD

Mumps

What Is Mumps?

Is Mumps Common?

How Do People Contract Mumps?

What Happens When People Have Mumps?

Can Mumps Be Prevented?

Resources

Mumps is a contagious viral infection that causes inflammation and swelling in the glands of the mouth that produce saliva.

KEYWORDS

for searching the Internet and other reference sources

MMR vaccination

Orchitis

Parotitis

Salivary glands

What Is Mumps?

Mumps is an infection caused by a virus. The mumps virus can infect various parts of the human body but typically attacks the salivary glands. The mouth has three pairs of salivary glands: one pair under the mouth and lower jaw; a second pair under the tongue; and a third pair in the back of both cheeks between the ear and the jaw. In most cases, mumps affects the third pair, called the parotid glands*, causing them to swell painfully.

*parotid

(puh-RAH-tid) gland is the salivary gland located in the jaw just beneath and in front of each ear.

In some patients, the virus spreads to the central nervous system* and causes a condition called aseptic meningitis*. Up to 15 percent of patients who have mumps, most commonly adults, will develop cases of meningitis with symptoms (such as headache and stiff neck).

*central nervous

(SEN-trul NER-vus) system is the part of the nervous system that includes the brain and spinal cord.

*aseptic meningitis

(a-SEP-tik meh-nin-JY-tis) is a milder, non-bacterial form of meningitis that is usually caused by a virus. Meningitis is an inflammation of the meninges, or the membranes that surround the brain and the spinal cord.

Before the introduction of the mumps vaccine in 1967, the infection was also a major cause of acquired (not present at birth) deafness in childhood. Deafness occurs in about 1 out of 20,000 cases of mumps, often in only one ear.

Is Mumps Common?

Mumps was a common childhood illness in the United States until 1967, when a vaccine was made available to the public. Before the vaccine, most mumps infections occurred in children under the age of 15, and 5- to 9-year-olds were the most frequently affected age group. In the twenty-first century, many cases are diagnosed in young adults who have not been immunized.

Since 1967, cases of mumps have declined steadily. Statistics indicate the dramatic impact that the vaccine has had. In 1964, approximately 212,000 cases of mumps were diagnosed in the United States. By 2001, that number had dropped to 231 cases, according to the U.S. Centers for Disease Control and Prevention.

Epidemics* of mumps are rare and usually break out among people who have not been vaccinated and who live in close quarters, such as

*epidemics

(eh-pih-DEH-miks) are outbreaks of diseases, especially infectious diseases, in which the number of cases suddenly becomes far greater than usual. Usually, epidemics that involve worldwide outbreaks are called pandemics.

army camps and college dormitories. For example, a small outbreak of the disease occurred between 1986 and 1987, mostly in older children and college-age students, because of insufficient immunization during a period from 1967 to 1977.

Although swollen salivary glands are typically associated with mumps, approximately one-fifth of people infected with the virus show no symptoms. Photo Researchers, Inc.

How Do People Contract Mumps?

Mumps is highly contagious. People infected with the mumps virus can spread it when they laugh, cough, or sneeze. Direct contact with saliva or fluid from an infected person’s nose also can spread mumps. Patients are contagious from about 1 day before their glands become swollen to up to 3 days after the swelling has improved.

What Happens When People Have Mumps?

Signs and symptoms

About 1 in 5 people who develop mumps have no symptoms. Many patients who do show signs of infection have only general symptoms such as a low fever, extreme tiredness, loss of appetite, muscle pain, and headache. Symptoms usually appear within 14 to 25 days after exposure to the virus.

Only 30 to 40 percent of people who become infected with the mumps virus have the swelling in the jaw area that most people associate with mumps. Earache and tenderness in the jaw are often the first signs of inflamed parotid glands. In 2 out of 3 cases of mumps, both parotid glands become swollen and painful, with one side swelling a few days before the other. Some patients also experience swelling in the other salivary glands. Talking, chewing, and swallowing can be painful, especially if the person eats or drinks acidic or sour food and beverages (such as lemonade and orange juice), which make the salivary glands squeeze out more saliva and increase discomfort.

Diagnosis and treatment

A doctor typically diagnoses mumps by examining a person who has symptoms of the infection. Other infections can cause swelling in the salivary glands, too, so a doctor may take a sample of blood to look for antibodies* to the virus. Other tests that can be used to diagnose mumps include culturing* samples of saliva or urine to find the mumps virus.

*antibodies

(AN-tih-bah-deez) are protein molecules produced by the body’s immune system to help fight specific infections caused by microorganisms, such as bacteria and viruses.

*culturing

(KUL-chur-ing) means being subjected to a test in which a sample of fluid or tissue from the body is placed in a dish containing material that supports the growth of certain organisms. Typically, within days the organisms will grow and can be identified.

Most cases of mumps can be treated at home. Over-the-counter pain medication, such as acetaminophen (uh-see-teh-MIH-noh-fen), can ease pain and fever, and warm or cold packs can soothe the pain of swollen, inflamed parotid glands. Resting and drinking plenty of non-acidic fluids help the body recover. The symptoms of mumps begin to clear up after 1 week and are usually gone within 10 days.

Complications

Complications of mumps are rare but can be serious and may require additional treatment under a doctor’s care or even hospitalization. The infection can lead to inflammation and swelling of the brain (encephalitis, en-seh-fuh-LYE-tis), as well as inflammation of the pancreas* (pancreatitis, pan-kree-uh-TIE-tis), other organs, or the membranes covering the brain and the spinal cord (meningitis). If symptoms of encephalitis or meningitis occur, it usually is within 3 to 7 days after the swelling of the parotid glands begins. These symptoms include high fever, stiff neck, and headache. In some patients with mumps, an electrocardiogram* (EKG) will show signs of myocarditis*, but the condition rarely is severe enough to produce symptoms with mumps.

*pancreas

(PAN-kree-us) is a gland located behind the stomach that produces hormones and enzymes necessary for metabolism and digestion.

*electrocardiogram

(e-lek-tro-KAR-dee-o-gram), also known as an EKG, is a test that records and displays the electrical activity of the heart.

*myocarditis

(my-oh-kar-DYE-tis) is an inflammation of the muscular walls of the heart.

Up to half of all males who become infected with the mumps virus after puberty experience painful swelling of the testicles* as a complication of the disease. Usually one testicle becomes swollen, but in some cases both do. High fever, chills, headache, nausea (NAW-zee-uh), and vomiting accompany the swelling, which generally goes away within a week after it appears, along with the fever and other symptoms. In rare cases, this swelling can permanently damage the testicle leading to infertility* because of reduced ability to produce sperm cells. Only 5 percent of females who contract mumps after puberty will develop inflammation of the ovaries*, which causes abdominal* pain and other symptoms similar to those of appendicitis*.

*testicles

(TES-tih-kulz) are the paired male reproductive glands that produce sperm.

*infertility

(in-fer-TIH-lih-tee) is the inability of females to become pregnant or of males to cause pregnancy.

*ovaries

(O-vuh-reez) are the sexual glands from which ova, or eggs, are released in women.

*abdominal

(ab-DAH-mih-nul) refers to the area of the body below the ribs and above the hips that contains the stomach, intestines, and other organs.

*appendicitis

(ah-pen-dih-SY-tis) is an inflammation of the appendix, the narrow, finger-shaped organ that branches off the part of the large intestine in the lower right side of the abdomen.

Can Mumps Be Prevented?

Immunization is the best way to prevent mumps, and the vaccine usually is administered during early childhood. The vaccine requires two doses and generally is given in the same shot with the vaccines for measles and rubella. It is known as the MMR (measles-mumps-rubella) vaccine. The first dose typically is given when an infant is between 12 and 15 months old and the second when the child is between 4 and 5 years old. Avoiding close contact with someone who has been diagnosed with mumps also reduces the risk of contracting the virus, particularly if the uninfected person has not been vaccinated.

See also

Encephalitis

Measles (Rubeola)

Meningitis

Rubella (German Measles)

Vaccination (Immunization)

Resources

Organizations

U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333. The CDC posts information about mumps at its website.

Telephone 800-311-3435 http://www.cdc.gov

U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894. The National Library of Medicine has a website packed with information on diseases such as mumps, consumer resources, dictionaries and encyclopedias of medical terms, and directories of doctors and helpful organizations.

Telephone 888-346-3656

http://www.nlm.nih.gov

World Health Organization (WHO), Avenue Appia 20, 1211 Geneva 27, Switzerland. WHO provides information about mumps at its website.

Telephone 011-41-22-791-2111 http://www.who.int

Website

KidsHealth.org. KidsHealth is a website created by the medical experts of the Nemours Foundation and is devoted to issues of children’s health. It contains articles on a variety of health topics, including mumps.

http://www.KidsHealth.org