Epidemic Parotitis (Mumps)

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Overview

Mumps is a contagious viral infection that causes the painful increase of the parotid glands (salivary glands located between the ear and the jaw).


Causes


Mumps is transmitted when an infected person coughs or sneezes and also through contact with recently contaminated objects such as handkerchiefs, glasses or dirty hands.


Symptoms

The virus that causes mumps enters the body through the nose or throat. The symptoms occur when the virus multiplies and spreads in the brain and its coverings, salivary glands (usually the parotid glands), pancreas, testicles, ovaries and other body areas and these include:
- Painful increase in volume of one or both parotid glands; one or both cheeks are puffy, about 30-40% of those infected have this symptom which is considered by many a characteristic sign for the disease although it can occur in other diseases as well
- Fever between 38-40 degrees C
- Headaches , earache, dry throat sensation and pain when swallowing or opening the mouth
- Pain felt when eating sour foods or drinks such juices or citruses
- Fatigue with muscle or joint pain
- Lack of appetite and vomiting.
Approximately one third of those infected have any of these symptoms, especially children under 2 years. Those infected can spread the virus around 7-9 days after symptoms appear. The incubation period (the time period between the moment of infection and the occurence of symptoms) is usually of 16-18 days although it can be of more than 25 days as well. During the evolution of the disease, complications can occur, whose symptoms are stiff neck (neck rigidity) or severe headache (indicating meningitis), testicles increased in volume, sensitive and painful (indicating orchitis – affecting the testicles), diffuse abdominal pain that may indicate pancreatitis or the inflammation of the ovary.


Investigation

Mumps is frequently diagnosed by the history of exposure to the disease and symptoms such as swollen and sensitive parotid glands. If it is necessary, a blood test that can confirm the diagnosis can be performed. This test measures the level of antibodies that the body has produced against the virus that causes disease. This can be identified through the viral culture of a sample of urine, saliva or cerebrospinal fluid obtained through lumbar puncture.


Treatment – Overview

In uncomplicated cases, mumps is treated with bed rest and care at home. The home treatment includes drugs that can be bought without prescription and are used to reduce fever and pain. Acetaminophen or nonsteroidal anti-inflammatory drugs (Advil, Motrin, Aleve) are commonly used. Do not give aspirin to anyone younger than 20 years because it can cause a rare but serious disease called Reye syndrome. Complications require hospitalization. When there are complications such as orchitis, meningitis, pancreatitis, these treated with analgesic drugs (which reduce pain). Taking other medicines such as interferon for severe orchitis is in an experimental stage. Do not use antibiotics.


Home Treatment

Children with mumps should not go to kindergarten, school or other public places for 9 days since the onset of the disease (increased size of the parotid glands) or 3 days after glands returned to their normal size. It is not necessary for the patient to be separated from the family because usually the rest of the family has already been exposed. Acetaminophen is administered for headaches, do not administer aspirin to anyone younger than 20 years because it can cause a rare but serious disease called Reye syndrome. If the increase in volume of the gland causes pain, apply ice or warm compresses (choose the method that best suits the patient). Between the skin and the cool or warm compress a thin towel should be put in order to protect the skin. These pads are maintained for 20 minutes. A cold, intermittent compress can be applied on the swollen testicles or a gentle method of support may be tried. It is recommended to suck ice cream bars, ice or ice lollies. Food must be of a reduced consistency so that chewing should not be required. Sour foods and liquids should be avoided. Because of the infection, the salivary glands are very sensitive and swallowing the food can be difficult. New cases of mumps should be reported by the physician.


Prophylaxis

Mumps vaccine is part of the triple MMR (measles, mumps, and rubella ) vaccine, which also includes measles and rubella vaccine. The benefits of this vaccine far outweigh its risks. Until recently it was believed that the vaccine caused autism (disorder in which the child has major communication deficiencies, being isolated in his own world), but recent studies have demonstrated that there is no such risk. Also, the risk of allergic reactions associated with mumps vaccine is extremely low. If you make a trip in a country where mumps is spread, you should check your immune status (if you have protective antibodies against the virus that causes mumps).

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