Mumps is an infectious disease caused by a virus that leads to inflammation of the salivary glands, known as "parotitis". It is marked by symptoms like headache, fever, fatigue, loss of appetite, and a general feeling of being unwell.

Mumps is a disease that can be found all over the world and there have been several outbreaks in the United States, Canada, and Europe since the mid-2000s.

What are signs and symptoms of Mumps?

Signs and symptoms of mumps include: - General symptoms such as fever, fatigue, headaches, muscle pain, and loss of appetite. - Inflammation and swelling of the salivary glands, which occurs in over 70% of mumps infections. The swelling usually affects both sides, but it can sometimes be seen on one side only. The affected area is painful and located between the earlobe and the chin. - Swelling and redness in the duct that drains saliva from the salivary gland. - Testicle inflammation, characterized by painful swelling and enlargement of one or both testicles. In around half of cases, the testicles shrink. Infertility can occur in about 30% of post-pubertal males with mumps testicle inflammation. - Swelling of the ovaries, although it is not very common in post-pubertal females. - Neurological complications such as meningitis, encephalitis, transverse myelitis, Guillain–Barré syndrome, cerebellar ataxia, facial palsy, and hydrocephalus. These complications are typically temporary and carry a low risk of long-term problems. - Other rare complications including pancreatitis, mastitis, myocarditis, thyroiditis, kidney inflammation, liver disease, arthritis, keratitis, and low platelet count. - Studies have had mixed results regarding the effect of mumps during pregnancy on newborns' health. Some earlier studies suggested an increased risk of miscarriage in the first trimester, but more recent studies have found no increased risk of miscarriage or premature birth due to mumps during pregnancy.

What else can Mumps be?

The doctor needs to rule out the following conditions when diagnosing Mumps: 1. Other viruses like the Epstein-Barr virus, influenza A, parainfluenza types 1 and 3, and enteroviruses. 2. Infectious parotitis caused by bacteria like Staphylococcus aureus, Streptococcus species, and atypical mycobacteria. 3. Non-infectious causes such as blocked salivary ducts (sialolithiasis), reactions to medications, or cancer. 4. Other conditions that can look like parotitis due to facial swelling such as lymphoma, infection of the mastoid bone behind the ear (mastoiditis), or a tooth infection (dental abscess).

What kinds of test are needed for Mumps?

The types of tests needed for mumps are: - Reverse transcriptase-polymerase chain reaction (RT-PCR) test, which involves taking a swab from the inside of the cheek or mouth to detect the mumps virus. - Blood test to check for immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. - If the initial blood test is negative, a repeat blood test may be necessary 7 to 10 days after symptoms start for more accurate results.

How is Mumps treated?

Mumps is usually a mild illness that typically resolves on its own. Treatment focuses on managing the symptoms that arise, such as using pain relievers and applying cold or warm compresses to reduce swelling in the salivary glands near the ears. If the testicles become swollen and sensitive, holding them higher and using a cold compress can help alleviate discomfort. It is important to note that there is no scientific evidence supporting the use of steroid medication for treating mumps or the painful swelling of the testicles. In some cases, a lumbar puncture may be performed to alleviate a headache associated with aseptic meningitis, a type of brain infection caused by the mumps virus. Additionally, it is crucial to keep individuals with mumps separated from others and take precautions to prevent the spread of the virus through droplets from the mouth or nose for at least 5 days after the salivary gland swelling begins.

What are the side effects when treating Mumps?

When treating mumps, the side effects that may occur include: - Swelling and sensitivity of the testicles (can be reduced by holding them higher and applying a cold compress) - Headache (can sometimes be alleviated with a lumbar puncture procedure) - Complications such as orchitis, oophoritis, meningitis, encephalitis, loss of sensory nerve function, mastitis, and pancreatitis (although the introduction of the mumps vaccine has significantly reduced the occurrence of complications)

Are there long term effects of Mumps?

The prognosis for mumps is usually great. Most people recover fully from the illness. In rare cases, mumps can cause loss of hearing, but this is not common.

What type of doctor should I see for Mumps?

You should see a doctor specializing in infectious diseases or a general practitioner for mumps.

Mumps

What is Mumps?

Mumps used to be a common illness among kids, but it’s a lot less common these days thanks to vaccines. It’s an infectious disease caused by a virus that is often marked by symptoms like headache, fever, fatigue, loss of appetite, and a general feeling of being unwell, before leading to inflammation of the salivary glands, known as “parotitis”. This symptom is a classic sign of mumps. Usually, mumps will get better on its own, and most people recover fully from it.

The virus that causes mumps belongs to a family of viruses called Paramyxoviridae and is the only known virus that can cause a widespread outbreak of parotitis. Mumps is a global disease and affects people all around the world. There’s a noticeable trend that in regions with temperate climates, most mumps cases are seen in the late winter and early spring.

What Causes Mumps?

Mumps is caused by a specific type of virus called the RNA paramyxovirus, which has a single strand of genetic material. The virus replicates, or duplicates itself, using proteins and its own genetic material in a structure known as the nucleocapsid. This nucleocapsid is covered by a fatty layer derived from the host – the individual infected by the virus. This fatty layer contains viral proteins which allow the virus to attach itself to cells and enter them.

The proteins that allow the virus to bind and enter the cells are the main targets for antibodies which can neutralize, or disable, the virus. To this point, scientists have identified 12 variations, or genotypes, of the mumps virus. The primary mumps virus circulating in the United States since 2006 is the Genotype G.

Factors that increase the risk for contracting mumps include having a weak immune system, traveling internationally, living in a crowded or tightly-knit community, and not being vaccinated.

Risk Factors and Frequency for Mumps

Mumps is a disease that can be found all over the world. It spreads quite easily through direct contact with drops of fluid from the nose and mouth of someone infected, as well as through their saliva or objects they’ve touched. Even though a third of infected people may not show any symptoms, they can still spread the disease.

The mumps virus was a big problem in the United States until a vaccine was introduced in 1967. As a result, the number of cases dropped by 99%. Still, there have been several outbreaks in the United States, Canada, and Europe since the mid-2000s. Before the vaccine was widely used, mumps often affected young school-age children. But now, because of vaccines, mumps outbreaks primarily affect teenagers and young adults in the 21st century.

The recent increase in mumps outbreaks could be due to a number of factors.
One reason could be that fewer people are getting vaccinated.
Another could be that some people don’t get the two doses of the vaccine needed for full protection.
Some European countries used vaccines that were not as effective in the past.
Also, the mumps vaccine is no longer a routine part of the vaccination schedule in Japan and other countries.
Recent outbreaks among college students who were fully vaccinated suggest that immunity to mumps may decrease over time.
In fact, a 2006 study showed that students who had been vaccinated 13 or more years before an outbreak were nine times more likely to get mumps than those who had been vaccinated less than two years before the outbreak.
Finally, the lifestyle of college and university students can make them more likely to spread mumps. This includes living in shared housing, being in close contact with others, and sharing saliva with others.

Signs and Symptoms of Mumps

Mumps is a viral illness that initially shows general symptoms, like fever, fatigue, headaches, muscle pain, and loss of appetite. These symptoms are soon followed by inflammation and swelling of the salivary glands, which is very common in mumps cases, occurring in over 70% of infections. The swelling usually affects both sides, but it can sometimes be seen on one side only. The affected area is painful and located between the earlobe and the chin. Swelling and redness can also be seen in the duct that drains saliva from the salivary gland. In most people, these symptoms improve within a week. However, some may deal with recurring inflammation of the salivary glands.

Following salivary gland swelling, the next common symptom of mumps is testicle inflammation, which is characterized by painful swelling and enlargement of one or both testicles. In around half of cases, the testicles shrink. Infertility can occur in about 30% of post-pubertal males that have mumps testicle inflammation, but it’s rare in boys who haven’t reached puberty yet. Swelling of the ovaries can also occur in post-pubertal females, but it’s not very common.

Mumps can also cause several neurological complications like meningitis, encephalitis, transverse myelitis, Guillain–Barré syndrome, cerebellar ataxia, facial palsy, and hydrocephalus, although these cases are typically temporary and carry a low risk of long-term problems. Other rare complications can include pancreatitis, mastitis, myocarditis, thyroiditis, kidney inflammation, liver disease, arthritis, keratitis, and low platelet count.

Studies aiming to understand the effect of mumps during pregnancy on newborns’ health have had mixed results. Some earlier studies suggested that mumps in the first trimester might increase the risk of miscarriage. However, more recent studies have found no increased risk of miscarriage or premature birth due to mumps during pregnancy.

Testing for Mumps

If you’re thought to have mumps, doctors will use a mix of observations and lab tests to confirm it. Mumps doesn’t always show the typical symptoms such as swollen testicles and puffiness in the cheeks. Sometimes, the signs can be different from one person to another. Particularly during a mumps outbreak, a diagnosis can often be made if you have swollen cheeks or jaw area and you’ve been exposed to someone with mumps. But if mumps isn’t very common in your area, doctors will have to rule out other potential causes of swelling in your cheek or jaw area.

There are two key tests doctors use to confirm mumps. The first is called a reverse transcriptase-polymerase chain reaction (RT-PCR), and the second tests for antibodies called immunoglobulin M (IgM) in your blood. If your doctor suspects you have mumps, they should take two samples: a swab from the inside of your cheek or mouth for the RT-PCR test, and a blood sample to check for IgM and IgG antibodies. Ideally, the cheek swab should be done within three days, but no later than eight days, after you first noticed swelling. To get a good sample, doctors may gently massage your cheek or jaw area for about 30 seconds before taking the swab.

One thing to note is that the IgM antibodies might not show up for about five days after your symptoms start if you’ve never been vaccinated against mumps. Also, these antibodies might not show up at all in blood tests if you’ve been vaccinated. That’s why sometimes, if the initial blood test is negative, doctors might need to repeat the blood test 7 to 10 days after your symptoms start to get more accurate results.

Lastly, if your doctor suspects or confirms that you have mumps, they should inform the local or state health department as per the rules of your state’s public health laws.

Treatment Options for Mumps

Mumps is usually a mild illness that tends to go away on its own. The main way to help someone with mumps is to treat the symptoms that show up. Things like pain relievers and cold or warm compresses can help to lessen swelling in the salivary glands near the ears. If a person’s testicles become swollen and sensitive, the discomfort can be reduced by holding them higher and putting a cold compress on them.

It’s important to note that there’s no solid scientific evidence showing that steroid medication helps to treat mumps or the painful swelling of testicles that can sometimes happen with it. A procedure called a lumbar puncture, which is done to remove some fluid from around your spinal cord, can sometimes alleviate a headache that comes along with a type of brain infection called aseptic meningitis caused by the mumps virus.

When a person has mumps, it’s crucial to keep them separated from others and to be careful about spreading the virus through small droplets from the mouth or nose. This should be done for 5 days after swelling of the salivary glands starts, to keep the virus from spreading to others.

Mumps is often the main reason for parotitis, an infection of the salivary glands, in children. If a child shows typical symptoms of parotitis during a mumps outbreak, a mumps diagnosis can usually be made based on those symptoms. However, if the symptoms aren’t typical or the child hasn’t been exposed to mumps recently, there could be other causes. This can differ based on the specific symptoms and signs the patient is experiencing.

The causes of parotitis may include:

Other viruses like the Epstein-Barr virus, influenza A, parainfluenza types 1 and 3, and enteroviruses
Infectious parotitis caused by bacteria like Staphylococcus aureus, Streptococcus species, and atypical mycobacteria
Non-infectious causes such as blocked salivary ducts (sialolithiasis), reactions to medications, or cancer
Other conditions that can look like parotitis due to facial swelling such as lymphoma, infection of the mastoid bone behind the ear (mastoiditis), or a tooth infection (dental abscess)

The causes of a different condition, aseptic meningitis, which is a non-bacterial inflammation of the brain covering may include:

Other viruses like enteroviruses, the herpes simplex virus, and the lymphocytic choriomeningitis virus
Non-infectious causes like Kawasaki disease, cancer, or reactions to medications

Lastly, inflammation of the testicles (orchitis) is typically caused by the mumps virus. Still, it can occur together with inflammation of the tube at the back of the testicle that carries sperm (epididymitis) or cause symptoms similar to those of twisted testicles (testicular torsion).

What to expect with Mumps

The outlook for someone with mumps is usually great. After an illness like aseptic meningitis, which is a type of meningitis not caused by bacteria, patients generally make a full recovery. Mumps can sometimes cause loss of hearing, but this is a rare occurrence.

Possible Complications When Diagnosed with Mumps

Before the introduction of the mumps vaccine, complications were seen in almost half of the males and one in four females infected with mumps. The most common complication in males was orchitis, which happened in about one in every five male mumps cases. Aseptic meningitis was the most common complication for both genders.

Presently, studies reveal that complications of mumps have significantly dropped, showing that community-wide vaccination programs have helped in preventing severe mumps infections. However, there have been limited studies comparing complication rates among those who have and haven’t received the vaccine, as there are very few unvaccinated children in the U.S. Even so, a study conducted in Israel during a mumps outbreak revealed that people who had been vaccinated showed lower rates of complications and hospitalization when they contracted mumps, compared to those who were unvaccinated.

Even with vaccination, there are still possibilities of complications from mumps, including:

Orchitis
Oophoritis
Meningitis
Encephalitis
Loss of sensory nerve function
Mastitis
Pancreatitis

Preventing Mumps

In today’s world where some people are against vaccinations, it’s essential for healthcare providers to promote the importance of the measles-mumps-rubella (MMR) vaccine. The rise in mumps outbreaks can be avoided if patients are correctly informed. Physicians, nurses, pharmacists, and other healthcare providers need to continually encourage parents to get their children vaccinated against mumps.

The MMR vaccine, which protects against mumps, is given in two doses in the United States. The first dose is usually given when a child turns 1, and the second dose is typically given between the ages of 4 and 6. Both children and adults who don’t have a documented immunity to measles, mumps, and rubella should get the MMR vaccine as soon as possible unless there’s a medical reason they can’t. The second dose can be given as soon as 28 days after the first.

A 2019 review found that a single dose of the MMR vaccine is about 72% effective in preventing mumps, and its effectiveness increases to 86% after the second dose. The most common side effects are fever, rash, temporary swelling of the glands, and temporary inflammation of the parotid gland (a salivary gland located in front of the ear). In children under 5 years, fever-related seizures may occur in about 1 in 1,000 to 1 in 2,000 cases. No credible evidence suggests that the MMR vaccine causes autism.

The MMR vaccine contains a live, weakened virus. It should not be given to pregnant women, and women who receive the vaccine should wait 4 weeks before trying to get pregnant. However, the vaccine is safe for women who are breastfeeding, as well as their kids and those living with them. People with life-threatening allergies to ingredients in the vaccine or weakened immune systems are not suitable candidates for vaccination. This includes people with AIDS, leukemia, lymphoma, common malignant diseases, and those undergoing treatment with chemotherapy, radiation, or corticosteroid therapy. Family members of individuals with severely weakened immune systems should get vaccinated. People with AIDS or HIV who show signs of weakened immune systems should not get the vaccine, but those who don’t show signs should.

In 2018, the Centers for Disease Control (CDC) suggested that people who have already had two doses of the MMR vaccine should receive a third dose if they are considered high-risk during an outbreak. This recommendation is supported by evidence from three studies that showed that people who got a third dose during an mumps outbreak were 61% to 88% less likely to get mumps than those who had two doses. Side effects after a third dose were not worse than those after a second dose.

Healthcare providers need to inform parents about the dangers of not vaccinating their children against mumps. In November 2023, the CDC stated that the rate of MMR vaccination amongst children in American kindergartens fell below the target set for the Healthy People 2030 initiative for the third time in a row. Decline in childhood vaccinations increases the risk of outbreaks of diseases that can be prevented by vaccines. The best and most practical way to prevent mumps is by vaccinating against it.