MUMPS

Figure 1

Mumps is an acute infectious disease caused by a paramyxovirus. Humans are the only known natural host. Mumps disease is usually mild, characterized by fever and swelling of one or both parotid salivary glands. The parotiditis usually develops an average of sixteen to eighteen days after direct contact, through the nose or mouth, with the saliva of an infected individual. In approximately 20 to 40 percent of cases, however, mumps disease occurs asymptomatically or with an uncharacteristic presentation.

Even though mumps is regarded as a fairly benign disease in the twenty-first century, in the prevaccine era mumps caused much morbidity and mortality in the United States. In 1967, mumps accounted for over one-third of encephalitis cases and one death occurred out of approximately 20,000 mumps cases. Mumps infection during pregnancy is not associated with birth defects, but infection during the first trimester is associated with a greater occurrence of fetal death. Other conditions caused by mumps include meningitis, orchitis, mastitis, pancreatitis, neuritis, arthritis, nephritis, thryroiditis, pericarditis, and deafness.

Mumps parotiditis occurs equally among males and females. Severe mumps disease, however, such as encephalitis, has been observed to occur more frequently among boys than girls. Other gender-specific manifestations are also influenced by age. After puberty, orchitis commonly occurs among males, though sterility rarely results. Among post-pubescent females, mastitis is a common manifestation.

Mumps infection can be confirmed by isolation of the virus from throat swabs, urine, or spinal fluid. Blood tests to detect antibodies to mumps virus can be used to differentiate between a current mumps infection and a previous infection. Skin testing is not reliable.

In countries without mumps vaccination, epidemics occur every two to five years, affecting most frequently those ages five to nine. Mumps disease exhibits seasonally with more cases occurring during the winter and spring. Historically, mumps outbreaks occur in situations where individuals are grouped together, such as military camps, prisons, boarding schools, and aboard ships. In community outbreaks, school-aged children are often infected first and then infect family members at home.

The mumps virus was first identified in 1934. By 1948 a killed virus vaccine was licensed, but it was later discontinued because it did not produce long-lasting immunity. The current mumps vaccine in the United States is a live, attenuated vaccine (the Jeryl-Lynn strain) licensed in December 1967. Since introduction of the Jeryl-Lynn mumps vaccine, the reported number of mumps cases in the United States has decreased dramatically, from over 150,000 in 1968 to 387 cases in 1999 (see Figure 1).

The availability of this vaccine, the use of the combination measles, mumps, and rubella (MMR) vaccine beginning in 1986, and the two-dose recommendation in 1989 of MMR has immunized many children who would have otherwise have developed mumps disease.

Laurie Kamimoto

(see also: Communicable Disease Control; Immunizations )

Bibliography

American Academy of Pediatrics (2000). "Mumps." In 2000 Red Book: Report of the Committee on Infectious Diseases, 25th edition, ed. L. K. Pickering. Elk Grove Village, IL: American Academy of Pediatrics.

Baum, S. G., and Litman, N. A. (2000). "Mumps Virus." In Principles and Practice of Infectious Diseases, 5th edition, eds. G. L. Mandell, J. E. Bennett, and R. Dolin. Philadelphia: Churchill Livingstone.

Plotkin, S. A., and Wharton, M. (1999). "Mumps Vaccine." In Vaccines, 3rd edition, eds. S. A. Plotkin and W. A. Orenstein. Philadelphia, PA: W. B. Saunders.

mumps (epidemic parotitis), acute contagious viral disease, manifesting itself chiefly in pain and swelling of the salivary glands, especially those at the angle of the jaw. Other symptoms are fever, a general feeling of illness, and pain on chewing or swallowing. Mumps most often affects children between the ages of 5 and 15, the incubation period being 14 to 21 days; the acute phase rarely lasts more than 3 days. The disease is usually more severe in adults, the most common complications being pain and swelling of the testes (in 20% of adult male patients) and swelling of the meninges that cover the brain and spinal cord (in about 30% of cases). Sterility resulting from involvement of the testes and fatalities from the meningoencephalitis occur in a small minority of male cases. Other possible complications include pancreatitis and involvement of the heart or thyroid. The ovaries are sometimes affected in females. Treatment consists mainly of bed rest, intake of fluids, and the administration of analgesics. A live virus vaccine has been developed that can be given to susceptible children at 15 months.

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

mumps (mumps) n. a common virus infection mainly affecting children. Symptoms appear 2–3 weeks after exposure: fever, headache, and vomiting may precede a typical swelling of the parotid salivary glands. The infection may spread to other salivary glands and to the pancreas, brain, and testicles (see orchitis). See also MMR vaccine. Medical name: infectious parotitis.

mumps Viral disease, most common in children, characterized by fever, pain and swelling of one or both parotid salivary glands (located just in front of the ears). The symptoms are more serious in adults, and in men inflammation of the testes (orchitis) may occur, with the risk of sterility. Vaccination produces life-long immunity.

mump † grimace (sb.); (pl.) swelling of the parotid and salivary glands in the neck (with ref. to the appearance produced). XVI.
So mump vb. mumble, grimace, munch, sulk. XVI. symbolic repr. of the movement of the lips in mumbling or chewing. Cf. Du. momp(el)en mumble in speech, G. mumpf(el)en mumble in eating.

mumps / məmps/ • pl. n. [treated as sing.] a contagious and infectious viral disease causing swelling of the parotid salivary glands in the face, and a risk of sterility in adult males.

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