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Dr. Sachin Shelke
Internal Medicine

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Mumps is no longer a disease that only affects children. It has been reported in more adults than usual. The primary reason for an increased number of cases of mumps is attributed to small outbreaks in specific parts of the world. Thankfully, India is not among these affected regions. However, to ensure that we continue to stay away from the outbreak of mumps, we need to learn what the disease is all about and how we can prevent it.

Mumps is a contagious viral infection that used to be common in children. Before vaccination, it was a common childhood disease worldwide. It is most recognizable by the painful swellings of the salivary glands at the side of the face under the ears (parotid glands).

Generally, mumps is considered a disease that affects children between the age of 5–9 years. Moreover, mumps can affect adults, and their complications are generally reported to be considered serious. Vaccines against mumps have been developed since the 1960s and are incorporated into the immunisation schedules. It is known as the MMR vaccine, i.e. Measles–Mumps–the Rubella vaccine. The incidence of the disease is low in countries that have a high immunisation rate. Mumps can last between 10 and 14 days. Once you develop mumps, there are rare chances that you can get infected with it.

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Types

Mumps has not been classified into different types.

Symptoms

Typically, mumps starts with a few days of fever; headache, muscle aches, tiredness, and loss of appetite, and is followed by the swelling of salivary glands. Moreover, up to 20% of persons infected with the mumps virus do not show symptoms. Males past puberty who develop mumps have a 15–20 per cent risk of infection of the testicles.

Once the body is affected by the virus, it spreads into the bloodstream and affects different body parts:


  1. Salivary gland - Pain and swelling are present in the salivary gland located under the jaw.

  2. Testes - Mumps causes tenderness, pain, swelling and shrinkage of the testicles.

  3. Ovaries - Mumps may cause pain in the lower abdomen in females.

  4. Pancreas - Mumps may cause infection and inflammation in the pancreas and lower abdomen.

  5. Brain - If the virus reaches the brain, it can cause infection and inflammation of the brain, which may lead to long-term complications such as paralysis and seizures.

Causes And Risk Factors

Causes


The cause of mumps is the mumps virus, which easily spreads from person to person via infected saliva.

A person infected with mumps can spread the infection:

  1. Sneezing, coughing or talking

  2. Using or sharing items that have been in contact with the infected person’s saliva, e.g. cups and bottles.

  3. Participating in activities, e.g. dancing or kissing, which brings you in close contact with the infected individual.


The spread of mumps can occur because of the swelling of salivary glands and can last for more than five days after the swelling begins.

Risk Factors


The risk factors for developing mumps are listed below:

  1. Travel to a place where the incidence of mumps is high.

  2. Being in contact with someone who has mumps.

  3. Going or staying in crowded settings such as hotels and hostels.

  4. History of not getting vaccinated for mumps.

  5. Having a weak immune system.

Prevention

In general, you are considered immune to mumps if you have previously had the infection or if you have been immunized against mumps. Usually, the mumps vaccine is given as a combined measles–mumps–rubella (MMR) vaccine, which contains the safest and most effective form of each vaccine.

Two doses of MMR vaccine are recommended before a child enters school:


  • The first is between ages 12 and 15 months

  • The second is between ages 4 and 6 years or between 11 and 12 years if not previously given


Once both doses are given, the vaccine provides 95% protection against mumps.

Safety of the MMR Vaccine:

MMR vaccination has been confirmed to be very safe and effective for preventing mumps. A single dose of the MMR vaccine provides long-lasting immunity. rash, fever, rash or swollen cheeks or neck are the most common side effects after vaccination.

It is uncommon that your child will develop any type of allergic reaction to the vaccination. Contact your physician immediately if you notice events such as loss of colour, wheezing or fatigue.

You can immunise children with a cold or minor fever; however, if your child has certain serious illnesses such as seizures and blood disorders, you must mention that to your physician.

You can stop the spread of mumps by following simple techniques such as

  1. Washing your hands regularly with soap.

  2. Use tissues and dispose of them correctly after you have sneezed in them.

  3. Trying to stay home and avoid work or school for at least five days since the symptoms are looking prominent.

Diagnosis

Your physician will ask you about your history of exposure to any person having mumps or swelling of the face. If you have been in contact with such a person, the doctor will verify how you have contracted the infection.

The physician will verify if you have taken the immunisation for mumps. This vaccination is a three-in-one vaccination providing protection against measles/mumps/rubella.

Mumps is caused by a virus called paramyxovirus, which can be detected through a test.

If your doctor suspects that you or your child has mumps, a virus culture (PCR) or a blood test may be required. Your immune system normally makes antibodies to help you fight an infection. Therefore, if you have mumps, the blood test can detect the antibodies in your system that is fighting the mumps virus.

Treatment

There are no treatment protocols for mumps; the disease completes its course. The treatment is focused on relieving the symptoms of the infection. No antibiotics work on viral infections; therefore, supportive therapy is the best remedy.

Non-aspirin medication such as acetaminophen or ibuprofen can be given to relieve pain.

Aspirin should be avoided as children are at risk of developing Reye’s syndrome which is disease-causing liver damage or swelling in the brain.

Lifestyle/management

Because mumps is caused by a virus, antibiotics are not effective. Similar to most viral illnesses, a mumps infection must simply run its course. Fortunately, most children and adults recover from an uncomplicated case of mumps within about two weeks. If you or your child has mumps, time and rest are the best treatments. You can take certain steps to ease pain and discomfort and keep others from becoming infected.


  • Rest in bed until the fever goes away.

  • Isolate yourself or your child to prevent spreading the disease to others.

  • Use a warm or cold compress to ease the pain of swollen glands, testicular swelling and pain.

  • Avoid foods that require chewing. Instead, try broth-based soups or soft foods, such as mashed potatoes or cooked oatmeal, for nourishment.

  • Avoid citrus fruits or juices, which stimulate saliva production.

  • Drink plenty of fluids

Prognosis And Complications

Prognosis

Recovery from mumps is quick; children usually recover within a few weeks. Children can resume going to school after the swelling subsides and when symptoms improve.

Mumps in adults is more severe than in children. Women who are pregnant might have a risk of abortion.

Once mumps has been diagnosed in your child, it is unlikely to have it again. Please ensure your child’s immunisations are up to date.

Complications

Mumps will usually pass without causing considerable damage to a person’s health. Serious complications are rare. Most mumps complications involve inflammation and swelling in certain parts of the body such as the testicles, pancreas, ovaries, breasts and brain membranes and fluid around the brain and spinal cord. In rare cases, mumps can cause hearing loss and pregnancy loss.

References.


  1. World Health Organisation. Immunisation - Mumps. [Internet] [Updated November 03, 2016 ] Available at: https://www.who.int/immunization/diseases/mumps/en/  (https://www.who.int/immunization/diseases/mumps/en/)

  2. Harvard Health. Mumps. [Internet] [Updated April 01, 2019] Available at: https://www.health.harvard.edu/a_to_z/mumps-a-to-z (https://www.health.harvard.edu/a_to_z/mumps-a-to-z)

  3. Center for Disease Control and Prevention. Mumps - Transmission. [ Internet ] https://www.cdc.gov/mumps/about/transmission.html (https://www.cdc.gov/mumps/about/transmission.html)

  4. Winchester Hospitals. Mumps. [Internet ] https://www.winchesterhospital.org/health-library/article?id=11658 (https://www.winchesterhospital.org/health-library/article?id=11658)

  5. Cleveland Clinic. Mumps. [Internet] [Updated on 8 June 2018] Available at: https://my.clevelandclinic.org/health/diseases/15007-mumps (https://my.clevelandclinic.org/health/diseases/15007-mumps)

  6. National Health System United Kingdom. Condition- Mumps. [Internet] [Updated on: 13 July, 2018] Available at: https://www.nhs.uk/conditions/mumps/(https://www.nhs.uk/conditions/mumps/)

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