Mumps: Signs and Symptoms, Diagnosis,
Treatment and Prevention

Mumps is a disease caused by the mumps virus. The virus typically affects the parotid salivary glands. These glands are located just below the ears, in the area between the ears and the jaw. The parotid glands are the main saliva-producing organs and drain into the mouth via the cheeks.

When a person has mumps the parotid glands swell, giving the infected person the look of a hamster with food in its cheeks. When a person has mumps, the immune system builds anti-bodies to the virus, thus killing it. These anti-bodies will provide life-long protection against the mumps virus, so it is very unusual for a person to have mumps more than once.

Contagiousness:

The mumps virus is contagious. It is spread through tiny droplets of saliva that becomes airborne when a person sneezes, coughs or even laughs. The virus can also be transmitted by direct contact, like picking up contaminated tissue or using a contaminated drinking glass.

Incubation Period:

The incubation period is the time that lapses between getting infected and showing signs and symptoms. The incubation period for mumps is quite long when compared to other common diseases – it can be 12 to 25 days, with an average of 16 to 18 days.

Who Is At Risk:

Mumps infections are most common in children aged between 5 and 4. It is common in children younger than 1. During the past few years there has been a steady incline in people aged 15 and older. People in this age group has either not been immunized or had not been fully immunized against mumps.

People who have a weakened immune system are also at higher risk of contracting the disease.

Signs and Symptoms:

• Mumps begins with a fever of up to 39,4°C, even before glands start to swell.
• Headache and a loss of appetite soon follow the fever.
• The next sign is the telltale swollen parotid glands. The swelling can be uni- or bilateral and uneven, i.e. one side swells faster or more than the other side. The swelling gradually increases over 2-3 days. Swelling usually lasts about 8 days
• Dry mouth.
• Pain associated with swallowing, chewing and talking.
• Sore throat.
• After the parotid glands, the mumps virus' next favorite glands are the testes. There may be swelling of the testes in boys after puberty. In girls, the ovaries could also become swollen.

Symptoms are usually mild, but complications can be severe. It is for this reason that children are immunized.

Diagnosis:

Mumps is typically diagnosed from the symptoms that appear, particularly the swollen parotid glands. In cases with severe symptoms or where there are complications a diagnosis can be confirmed with a blood, urine or cerebrospinal fluid test.

Treatment:

Viruses can't be cured by medicine and because mumps is a virus, treatment is symptomatic. Your body produces anti-bodies to the mumps virus and thus heals itself.

Paracetamol and Ibuprofen can be given to a person with mumps. This will assist in bringing down a fever and relieve pain in the swollen glands. Children under 16 should not be given aspirin when they have mumps. The use of aspirin in such cases has been associated with the development of Reye Syndrome, which can lead to organ failure and even death.

Swollen glands can be soothed with warm or cold packs. The diet should be limited to soft, bland foods, which doesn't require much chewing. Avoid acidic drinks of foods as this stimulates the parotid glands and increases pain.

Where mumps involve the testes, a doctor will prescribe stronger pain medication.

Duration:

Most children recover within 12 days. Swelling usually disappears within one week. However, complications can set in, so monitor the child carefully.

Complications:

• Orchitis – inflammation of the testes. Approximately 1 in 4 men over 12 develops orchitis. This can be extremely painful. There is evidence suggesting that this could lower fertility, but contrary to popular belief, it is very rare to become sterile from mumps orchitis.
• Oophoritis – inflammation of the ovaries. Oophoritis is rare and causes pain and tenderness in the lower abdomen.
• Encephalitis – inflammation of the brain. Encephalitis is an uncommon complication of mumps. It typically causes drowsiness, headache, stiff neck, light sensitivity and vomiting. A common long-term consequence is deafness in one ear.
• Meningitis.
• The pancreas and thyroid glands may also become inflamed, which can be quite painful.
• Pregnant women who develop mumps during the first trimester of pregnancy have a higher risk of miscarriage. However, there is no evidence that mumps causes deformities in unborn babies.

Prevention:

The measles, mumps and rubella vaccine (MMR) is given in 2 doses. The first dose should be given at around 13 months of age, and the second just before a child starts school. Children who develop mumps should be kept from school and others for at least 5 days after parotid glands start to swell.

Vaccine contains live virus, so pregnant women who are not immune must not be vaccinated. Women are also advised to not become pregnant within one month of being vaccinated.

Important Considerations:

Mumps symptoms are usually mild, but complications could be severe. It is therefore important to consult with a doctor if you suspect that your child has mumps.

Monitor the child's fever; if a fever reaches 38.3°C or higher, call your doctor.

Keep a look out for possible complications. Call your doctor immediately if a child presents a stiff neck, seizures, extreme drowsiness, severe headache of changes in consciousness.

Watch for abdominal pain; this could indicate that the pancreas is affected or in girls, the involvement of the ovaries. In boys, look out for high fever and swollen testes.

Keep children with high fever well-hydrated in order to avoid dehydration.

Author: Annemien van Staden
Copyright 2008: Remedium. This article may not be copied, in whole or in part, without the written consent of Remedium.