Mumps

Symptoms of Mumps

The symptoms of mumps usually appear 14–18 days after exposure to the virus. The disease typically starts with mild flu-like symptoms, followed by more specific signs.

1. Swelling of the Parotid Glands:

   • Parotid gland swelling is the hallmark symptom of mumps. The parotid glands, which are located near the ears and along the jawline, become swollen and tender, causing the characteristic “chipmunk cheeks” appearance.
   • The swelling can be on one or both sides of the face. In some cases, the swelling may also affect other salivary glands.

2. Other Symptoms:

   • Fever: A moderate to high fever is common and may last for a few days.
   • Headache: Often a dull, throbbing headache.
   • Muscle aches.
   • Fatigue and malaise.
   • Loss of appetite.
   • Sore throat: Sometimes a mild sore throat accompanies the illness.
   • Pain while chewing or swallowing: This occurs due to inflammation of the salivary glands.

3. Incubation Period:

   • After exposure, the incubation period for mumps is typically 16-18 days, though symptoms may appear anywhere between 12 to 25 days after exposure.

Transmission of Mumps

Mumps is highly contagious and is spread through respiratory droplets when an infected person coughs, sneezes, or talks. The virus can also be transmitted by:

• Direct contact: Through sharing eating utensils, drinks, or kissing.
• Touching contaminated surfaces: The virus can live on surfaces for a short period, so touching items contaminated with respiratory secretions may lead to infection.
• Airborne transmission: The mumps virus can remain in the air for up to 2 hours after an infected person coughs or sneezes.

An individual is contagious from about 1-2 days before to 5 days after the onset of swelling in the salivary glands. This makes it difficult to prevent transmission, as people may spread the virus before they are aware they are infected.

Complications of Mumps

While mumps is often mild, especially in children, it can lead to serious complications, particularly in adults and individuals with weakened immune systems. Some potential complications include:

1. Orchitis (Testicular Inflammation):

   • Orchitis is one of the most common complications of mumps in post-pubertal males. It involves swelling and pain in one or both testicles and can lead to infertility in rare cases.
   • Orchitis usually occurs about 4-6 days after the onset of parotid swelling.

2. Meningitis:

   • Mumps can cause viral meningitis, an infection of the lining of the brain and spinal cord. This is a serious complication that can cause headaches, stiff neck, fever, and neurological symptoms, such as confusion or seizures.

3. Encephalitis:

   • Mumps can cause encephalitis, which is inflammation of the brain. It is less common but can lead to long-term neurological damage, such as seizures, cognitive impairment, and motor dysfunction.

4. Deafness:

   • Mumps can lead to permanent hearing loss in one or both ears, usually caused by viral infection of the inner ear. Deafness occurs in a small percentage of cases but is a serious complication.

5. Pancreatitis:

   • Inflammation of the pancreas (pancreatitis) can occur, causing abdominal pain, nausea, and vomiting. This is a less common complication.

6. Oophoritis (Ovarian Inflammation):

   • Mumps can also cause oophoritis, an inflammation of the ovaries, particularly in post-pubertal females. Although it is rare, it can cause pelvic pain and, in severe cases, fertility problems.

7. Pregnancy Complications:

   • There is some evidence that mumps infection during pregnancy, especially in the first trimester, may increase the risk of miscarriage or preterm labor, though this is considered rare.

Diagnosis of Mumps

Mumps is usually diagnosed based on clinical symptoms, especially the characteristic swelling of the parotid glands. However, laboratory tests can be used to confirm the diagnosis:

1. Polymerase Chain Reaction (PCR):

   • PCR testing can detect mumps virus RNA in throat, urine, or cerebrospinal fluid (if meningitis or encephalitis is suspected).

2. Serology (Antibody Testing):

   • Blood tests can detect IgM antibodies (indicating a recent infection) or IgG antibodies (indicating past infection or immunity) to the mumps virus.

3. Viral Culture:

   • A throat swab or urine sample can be cultured to isolate the mumps virus, though this is less commonly used today.

Treatment of Mumps

There is no specific antiviral treatment for mumps. Treatment is supportive and focuses on managing symptoms and preventing complications:

1. Rest and Hydration:

   • Rest is important for recovery, and staying well-hydrated is crucial, especially if fever or nausea is present.

2. Pain and Fever Relief:

   • Acetaminophen (Tylenol) or ibuprofen (Advil) can be used to manage pain and reduce fever. Aspirin should be avoided in children due to the risk of Reye’s syndrome, a serious condition that affects the liver and brain.

3. Cold or Warm Compresses:

   • Applying cold or warm compresses to the swollen glands may provide relief from pain and discomfort.

4. Avoidance of Acidic Foods:

   • People with mumps may find it painful to eat due to difficulty chewing or swallowing, so avoiding acidic foods (which can irritate the mouth) and sticking to soft foods can help.

5. Treatment for Complications:

   • If complications like orchitis, meningitis, or encephalitis develop, more intensive medical treatment may be required. For example, antiviral medications may be used to manage encephalitis, and supportive care such as fluids and pain management is essential for these complications.

Prevention of Mumps

The best way to prevent mumps is through vaccination with the MMR vaccine, which protects against measles, mumps, and rubella.

1. MMR Vaccine:

   • The MMR vaccine is highly effective in preventing mumps and is typically administered in two doses:
     • The first dose at age 12–15 months.
     • The second dose at age 4–6 years.
   • The MMR vaccine is about 88% effective at preventing mumps after two doses, although its effectiveness may be lower in some populations.

2. Herd Immunity:

   • High vaccination rates in the population help protect those who cannot be vaccinated, such as infants and people with certain medical conditions, through herd immunity. Maintaining a high vaccination rate is crucial to prevent outbreaks of mumps.

3. Isolation:

   • People with mumps should be isolated to prevent transmission. They should stay home from school or work until at least five days after the onset of gland swelling to reduce the risk of spreading the virus.

4. Post-exposure Prophylaxis:

   • There is no effective post-exposure prophylaxis for mumps. However, individuals who are exposed to mumps should be monitored for symptoms, especially if they have not been vaccinated or previously infected.

Conclusion

Mumps is a contagious viral infection that primarily affects the salivary glands, especially the parotid glands, causing swelling and pain. While the disease is often mild, it can lead to serious complications, including orchitis (inflammation of the testicles), meningitis, encephalitis, and permanent hearing loss. The MMR vaccine is the most effective way to prevent mumps and has dramatically reduced its incidence. Supportive care is the main treatment for mumps, and the disease is generally self-limiting, but complications may require medical intervention. Vaccination, isolation of infected individuals, and maintaining high vaccination rates are key to preventing the spread of mumps.