Mumps

Definition

Mumps is a generalized viral  infection with swelling of the parotid gland being the main feature. It is caused by a type of virus known as an RNA paramyxovirus which has a particular inclination towards infecting the glandular tissue. The disease is present in all parts of the world and occurs with peak incidences in late winter and spring and occurs commonly in children below 15 years. The infection is less frequently seen these days with the introduction of vaccines and mass immunization of children.

Symptoms

A mild temperature with tenderness and enlargement of the parotids on one or both sides are the main symptoms. The  enlargement  of the gland is the most visible clinical sign. Persistent spasms of the cheek muscles along with swelling of the cervical lymph nodes. Meningitis is seen but is short lasting. Encephalitis rarely occurs but when it does, then it is often fatal.

Upon being infected through the respiratory tract, the virus multiples and is found abundantly in blood and urine (viremia and viruria). Glandular organs like salivary glands, pancreas, thyroid, ovaries or testes are affected. Acute pancreatitis may be found with typical abdominal pain and vomiting which resolves in 7 to 10 days. Inflammation of the ovaries occurs in some females but breast inflammation is more common. Testicular inflammation could be seen within a week in post-puberty males.

In the salivary gland, shedding of cells occurs which in turn blocks the the salivary ducts to some extent. Saliva accumulates within the gland and inflammation further enlarges the gland. Similar findings are seen in other glands. Myocarditis, arthritis or pneumonia could develop. Ear involvement may lead to deafness which is rare.

Causes

Mumps is an infectious viral disease. Infection is transmitted via respiratory droplets. The disease is contagious 7 days before and 9 days after subsidence of salivary gland swelling. The incubation period of mumps varies between 12 to 29 days. Permanent immunity is attained after a single infection. Earlier mumps was a very common disease of childhood. Today, vaccination is available for mumps and has decreased the incidence of the disease significantly. People who are not vaccinated are at risk of being infected.

Treatment

Mumps is a self limiting disease and can cure by itself even without any treatment. The treatment mainly involves symptomatic treatment. No effective specific antiviral therapy is available. Food such as spicy foods that would excessively stimulate the salivary glands is avoided as could cause pain. Antipyretics, analgesics and anti-inflammatories are used. Antibiotics can be used to prevent secondary bacterial infection. Excessive fluid intake and warm salt water gargles along with warm compresses over the parotid region are helpful. Abdominal pain due to pancreatitis can be treated symptomatically along with anti-emetics for nausea and vomiting.

Preventive treatment with vaccine is possible which has a long lasting effect. The vaccine is administered at around 15 months of age.  The mumps vaccine is contraindicated in pregnancy and within 3 months of receiving blood or blood products. People who have allergy to egg protein should not be given the vaccine. Vaccination programs are adopted by many governments to prevent outbreak of the disease. As the disease is confined to humans alone, widespread vaccination can completely eradicate the disease.

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