Mumps overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Mumps is a highly contagious viral disease that leads to painful swelling of the salivary glands and is caused by the mumps virus. Mumps is spread through direct contact with an infected person. Symptoms include fever, glandular swelling, headache, sore throat, and orchitis. Mumps is a self-limiting disease, and the prognosis is generally good, even if other organs are involved.
Pathophysiology
Mumps is spread by droplets of saliva or mucus from the mouth, nose, or throat of an infected person, usually when the person coughs or sneezes. Most mumps transmission occurs before the enlargement of the salivary glands and within the 5 days after the swelling begins. Therefore, CDC recommends isolating mumps patients for 5 days after their glands begin to swell.
Causes
Mumps is caused by a paramyxovirus, and transmission of the virus occurs via respiratory secretions such as infected saliva, air droplets or via direct contact with articles that have been contaminated with infected saliva. The incubation period is usually 18 to 21 days. Infected patients remain contagious from approximately 6 days before the onset of symptoms until about 9 days after the onset of symptoms.
Epidemiology
Developed countries:
Before the routine vaccination program was introduced in the United States, mumps was a common illness in infants, children and young adults. Because most people have now been vaccinated, mumps has become a rare disease in the United States.
Developing countries:
Mumps still remains a significant threat to health among pediatric population in the developing countries.[1]
Risk Factors
Mumps is caused by a paramyxovirus, and transmission of the virus occurs via contact with infected saliva, air droplets or via direct contact with articles that have been contaminated with infected saliva. The parotid glands are most commonly involved.
Natural History, Complications and Prognosis
A majority of the patients infected with mumps usually recover completely. However, mumps can occasionally cause complications, and some of them can be serious. Complications may occur even if the patient does not have swollen salivary glands (parotitis) and are more common in people who have reached puberty.
Diagnosis
Symptoms:
- Approximately 20-30% cases infected with mumps may remain asymptomatic.[2]
- Mumps typically starts with a few days of fever, headache, muscle aches, tiredness, and loss of appetite, and is followed by swelling of salivary glands (classically the parotid gland).[3]
- Painful testicular swelling and rash may also occur.
Physical examination:
- Presence of swollen salivary glands, particularly parotid gland is characteristic of mumps.
Laboratory findings
- Laboratory testing for mumps virus can be useful, and may include virus isolation from swabs of affected salivary ducts, antigen detection by PCR, and serologic testing for IgM antibody or a significant rise in IgG antibody. However, there are many important caveats to be aware of when interpreting the results.[4]
- Elevated of serum amylase secondary to the involvment of parotid gland and suspected pancreatitis associated with mumps [5]
Treatment
Currently, there is no specific treatment for mumps. In addition, the disease itself is generally self-limiting, and runs its course before waning. Supportive care with analgesics may provide symptomatic benefit.
References
- ↑ Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, Isselbacher KJ, Eds. (2004). Harrison's Principles of Internal Medicine (16th ed.). McGraw-Hill Professional. ISBN 0-07-140235-7.
- ↑ "Mumps epidemic--Iowa, 2006". MMWR. Morbidity and Mortality Weekly Report. 55 (13): 366–8. 2006. PMID 16601665. Retrieved 2012-03-08. Unknown parameter
|month=ignored (help) - ↑ Enders G (1996). Paramyxoviruses–Mumps virus. In: Barron's Medical Microbiology (Barron S et al, eds.) (4th ed. ed.). Univ of Texas Medical Branch. (via NCBI Bookshelf) ISBN 0-9631172-1-1.
- ↑ "Mumps: Lab Testing for Mumps Infection". Centers for Disease Control and Prevention. 13 April 2010. Retrieved 30 October 2011.
- ↑ Skrha J, Stĕpán J, Sixtová E (1979). "Amylase isoenzymes in mumps". European Journal of Pediatrics. 132 (2): 99–105. PMID 499265. Unknown parameter
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