Mumps: No Kid Stuff

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What is Mumps?

Mumps (Infectious Parotitis) is a viral infection primarily of the parotid glands, and is known in the vernacular as "beke." These glands, which secrete saliva, are one of three pairs of salivary glands located by our jaws near the ears. In about 66% of mumps, both the left and right parotid glands are involved, swollen and tender, making the cheek(s) puff out. Mumps is an old expression for lumps and bumps of the cheeks.

What is the cause of mumps?

Mumps is caused by a member of a family of viruses known as paramyxovirus, which is readily transmitted from person to person through infected saliva. You can contract mumps by breathing in saliva droplets of an infected person who has just sneezed or coughed.

How is the virus transmitted?

The virus is transmitted when someone with mumps sneezes, coughs or talks, and the potential victim inhales the infected droplets. Mumps used to be more common in children but today it is seen more in young adults. Don't share eating utensils or cups with someone with mumps. That's another way the disease is spread through shared saliva. Kissing obviously is another mode of transmission.

What are the signs and symptoms?

The patient usually develops fever, weakness, fatigue, and swollen and painful salivary glands on either or both sides of the face. The pain is aggravated by chewing or swallowing, more especially so with sour foods or drinks that stimulates saliva production (where the inflammed glands are put to work). There could be orchitis (inflammation of the testicles, with swelling, pain and tenderness). The fever lasts about 3-4 days, and usually mild in young children. About 33% of patients have no symptoms whatsoever, and symptoms usually appear 2 to 3 weeks after the exposure.

Is mumps contagious?

Yes, it is. It is contagious one day before the salivary glands develop swelling, most contagious for about 3 days, and less contagious after the swelling has gone down.

When does one see a doctor?

The best thing to do is to see a doctor when mumps is suspected, because there are other more serious medical conditions which could mimic mumps. Swollen glands and a fever could be inflamed tonsils (tonsillitis) or a blocked salivary gland, or infectious mononucleosis, or lymphoma (cancer of the lymph glands), etc. And if any of the following situations occur, urgent medical consultation is needed: repeated vomiting, stiff neck (can't bend the neck), signs of dehydration, swelling of the glands staying longer than a week, or fever lasting more than 4 days, when testicles become painful, when the cheek skin over the parotid glands becomes reddened, or when abdominal pains persist. Anyone of the above is enough indication to seek immediate medical attention.

How is diagnosis made?

A detailed history and physical examination of the swollen glands are sufficient for a physician to make a diagnosis of mumps, especially in countries where mumps are very common, like in Asian countries. For practical purposes, no laboratory tests are ordered. In the United States, where mumps is not so common anymore, and physicians are therefore not as familiar with mumps as Asian doctors do, mumps virus antibodies are ordered to confirm the diagnosis. If it is mumps, the mumps antibody titer rises two weeks after the infection, and so when the positive results (high antibody titer) come in, majority of the patient are already well.

What are the possible complications of mumps?
  • Orchitis, the inflammation of one or both testicles, occurs in about 25% of teenage boys or adult men with mumps. It is painful and sometimes causes sterility (the inability to have a child) because orchitis can lead to decrease sperm count.
  • Encephalitis, the inflammation of the brain, can become life-threatening, but encephalitis is a rare complication.
  • Inflammation of the ovaries, which causes pain in the lower abdomen, may occur but infertility is very rare.
  • Pancreatitis, swelling of the pancreas, causes pain in the upper abdomen, nausea and vomiting, which could lead to dehydration.
  • Meningitis, the inflammation of the membranes and fluid surrounding the brain and spinal cord, can develop if the mumps virus spreads through the bloodstream to infect the central nervous system. Fortunately, like encephalitis, meningitis is a rare complication of mumps.
  • Hearing loss is another possible complication. Mumps was once one of the most frequent causes of nerve deafness, but less so than the measles virus.
What is the treatment for Mumps?

Viral infections are self-limiting (they "cure" themselves after their natural course), and since mumps is a viral infection, no antibiotic is needed as a part of the treatment. Viruses do not respond to antiobiotics. Bacterial infections, as a rule, do. Most patients recover fully from uncomplicated Mumps within two weeks.

How is Mumps prevented?

If you previously had mumps or have been vaccinated against it, your immunity will spare you from developing mumps. Those born before 1957 are considered immune because they most probably had been infected with the virus without knowing it and without symptoms. Mumps was then very common and widespread. So, natural immunity among these group has developed.

Is there a vaccine for it?

Yes, there is a vaccine against mumps. This viral illness used to be very common until the mumps vaccine came into use after it was licensed in 1967. Before the introduction of the vaccine, there were more than 200,000 cases of mumps every year in the United States. The number of cases has since declined to less than 1,000 cases a year.

What is the immunization called?

This popular immunization is known as MMR (Measles-mumps-rubella). This shot is given to children between the ages 12 to 15 months, and repeated at 3 to 6 years. Those who are not sure if they got the shot or not should consult their physician. Those approaching puberty, especially males, must be sure to get immunized before age 12. Since mumps is still prevalent in many developing countries, it is prudent to find out if you need vaccination before going abroad.

Can one get Mumps from the vaccine?

No, mumps vaccine does not cause mumps infection.

Who should not get the mumps vaccine?

As a rule, live virus vaccines (like MMR) are not given to pregnant women to protect the fetus. The vaccine is not effective for hose who received blood products like gamma globulin within the past three months. The vaccine is likewise not given to those with weakened immune system or have been taking immune-suppressing drugs, because the risk of the complication of the vaccine is much higher. Those who receive the vaccine after they had the mumps in the past are not at any extra risk.

What is the treatment?

Since mumps is viral, no specific drug therapy is effective. The illness simply has to run its natural course. Bed rest and good hydration are important till the fever subsides. For fever and pains, acetaminophen (Paracetamol, Tylenol, etc) may be used. Children should not use aspirin because of the risk of developing a potentially fatal condition called Reye's Syndrome. Adults may take aspirin. Isolate the patient to prevent spread to other members of the household. Use of cold compress to relieve the pains of the swollen parotid glands. To minimize chewing which is painful, limit the diet to broth or soft foods. Sour foods such as citrus fruits or juices initiates saliva production and causes more pains, hence should be avoided. Plenty of fluids (water, decaffeinated soda drinks and tea) is highly recommended to prevent dehydration. Use of supporter by those with orchitis helps reduce testicular pains. Children with mumps must be closely observed for any of those possible complications. If in doubt, consult your physician without delay.

©2003Raoul R. Diez, M.A.O.D.