MUMPS

Mumps, an infectious viral disease, may sound like a relic of the past, but it still poses a risk in various parts of the world. It is a viral infection that spreads easily through saliva and mucus, particularly among unvaccinated individuals. While the virus can affect various parts of the body, it primarily targets the saliva-producing glands located below and in front of the ears, known as the parotid glands. Swelling of these glands leads to distinctive symptoms such as puffy cheeks and a swollen jaw, characteristic signs of mumps.

Historically, mumps was more prevalent, but the introduction of the measles, mumps, and rubella (MMR) vaccine in 1967 has significantly reduced its incidence in the United States. The widespread vaccination has been instrumental in curbing the spread of mumps and preventing outbreaks.

Causes

Mumps is caused by the mumps virus, a member of the Paramyxoviridae family. It spreads through respiratory droplets or direct contact with saliva or mucus from an infected person. The virus primarily targets the salivary glands, leading to inflammation and swelling.

Contagiousness

It’s highly contagious and can be transmitted through various means:

Close Contact: Coming into contact with tiny droplets of saliva or mucus from an infected person, particularly through coughing, sneezing, or talking closely.
Direct Contact: Transmission can occur through activities like kissing or sharing items such as cups, water bottles, utensils, or personal hygiene items.
Poor Hand Hygiene: If an infected individual fails to wash their hands thoroughly and subsequently touches items that others come into contact with, transmission can occur.
Crowded Environments: Mumps outbreaks are more likely to occur in settings where individuals spend extended periods in close proximity to others, such as sleepaway camps or college campuses.

After exposure to the mumps virus, there is an incubation period before symptoms appear, typically lasting between 12 and 25 days. During this time, individuals may not feel sick but can still transmit the virus to others.

Once symptoms manifest, the duration of the illness is usually around 2 weeks. Children infected with mumps can typically return to school or daycare once they feel better and at least 1 week has passed since the onset of symptoms. However, it’s advisable to consult with a doctor for guidance on when it’s safe to resume normal activities.

Prevalence

While mumps vaccination has significantly reduced its incidence in many countries, outbreaks still occur, especially in areas with low vaccination rates. College campuses, schools, and other crowded settings are particularly susceptible to outbreaks.

Symptoms

Mumps presents with a range of symptoms, with the hallmark being pain and swelling in the face and jaw. Other symptoms may precede this, including:

Fatigue: Feeling excessively tired without apparent cause.
Fever: Elevated body temperature.
Headache: Aching sensation in the head.
Loss of Appetite: Decreased desire to eat.
Muscle Aches or Joint Pain: Discomfort or soreness in muscles and joints.
Weakness: Generalized feeling of bodily weakness.
Dry Mouth: Lack of moisture in the mouth.
Mild Belly Pain: Discomfort or tenderness in the abdominal region.
Trouble Chewing: Difficulty in chewing due to swollen glands.
Swollen Tongue: Enlargement or swelling of the tongue.
Testicle Pain or Tenderness: Pain or tenderness in the testicles, particularly in males.
Ear Pain: Pain or discomfort in the ears.

Additionally, individuals may experience symptoms resembling those of a cold. It’s important to note that some individuals infected with mumps may not exhibit any symptoms at all, although they can still transmit the virus to others.

Certain symptoms warrant immediate medical attention and a visit to the emergency room, including:

Trouble Breathing: Difficulty in breathing.
Trouble Staying Awake: Persistent drowsiness or difficulty in remaining alert.
Dehydration: Especially concerning in babies and young children, characterized by absence of tears when crying, no wet diapers for an extended period, and apparent tiredness or lack of energy.

While mumps is more common in children, it can affect individuals of any age. Adults who have not previously had mumps or received the MMR vaccine should consult with their doctor. Based on their health history, a doctor may recommend vaccination to provide protection against the virus.

Risk Factors

Unvaccinated individuals or those who haven’t received the full course of the MMR (measles, mumps, and rubella) vaccine are at a higher risk of contracting mumps. Additionally, close contact with an infected person increases the likelihood of transmission.

Mumps Complications

Complications from mumps are rare, they can lead to serious health problems, particularly in individuals who are unvaccinated. The complications are more prevalent in adults compared to children. Here are some potential complications associated with mumps:

Arthritis: The mumps virus can cause inflammation and swelling in the joints, resulting in joint pain. This typically resolves as the individual recovers from the illness.
Inflamed Testicles (Orchitis): More common in males after puberty, orchitis can cause one or both testicles to swell and may result in decreased fertility, although this is often temporary.
Swollen Ovaries (Oophoritis): In females, oophoritis can lead to symptoms such as severe nausea, pain, and fever, often mistaken for appendicitis.
Painful Breasts (Mastitis): Before widespread vaccination, some individuals assigned female at birth experienced painful inflammation of breast tissue (mastitis). However, this complication has become exceedingly rare due to vaccination.
Pancreatitis: Inflammation of the pancreas can cause abdominal pain, vomiting, and fever, affecting digestion and blood sugar control.
Meningitis: Inflammation of the membrane covering the brain and spinal cord can result in symptoms like fever and stiffness in the head and neck. Up to 10% of individuals with mumps-related jaw and neck swelling may develop meningitis.
Hearing Loss: Some individuals may experience temporary or permanent hearing loss as a result of mumps infection.
Encephalitis: Inflammation of the brain is a rare but severe complication of mumps, leading to seizures, coma, and potentially life-threatening consequences.

Additionally, mumps can affect various organs such as the eyes, thyroid, kidneys, and heart, highlighting the importance of vaccination in preventing these potential complications.

Mumps in pregnancy

Mumps during pregnancy typically doesn’t pose significant harm to the baby, but there are rare instances where it can lead to complications such as:

Miscarriage: Loss of pregnancy before the 20th week.
Premature Birth: Giving birth before the due date.
Low Birth Weight: Delivering a baby weighing less than 5.5 pounds.
Birth Defects: Abnormalities in the baby’s development.
Stillbirth: Loss of pregnancy after the 20th week.

The risk to the baby may be highest if the mother contracts mumps during the first trimester of pregnancy. Regardless of the pregnancy stage, if there is exposure to mumps, it’s crucial to inform the doctor promptly.

Babies and Mumps

Mumps infections in babies under 1 year of age are rare due to the protective antibodies passed from the vaccinated mother during pregnancy. However, these antibodies diminish after about a year, which is why babies receive their first mumps vaccine at 12 months of age.

Even if a baby contracts mumps, they may not exhibit symptoms, with up to 30% of infected babies being asymptomatic. Nevertheless, it’s important to remain vigilant and contact the doctor if the baby shows any signs of illness. Early detection and management are key in ensuring the baby’s health and well-being.

Diagnosis

Diagnosing mumps typically involves assessing symptoms and confirming the presence of the virus through laboratory tests, such as a saliva or blood test.

Treatments

Treatment for mumps primarily involves managing symptoms and allowing the virus to run its course, as antibiotics are ineffective against viruses. Here are some general tips to help alleviate symptoms:

Apply Heat or Ice: Gentle heat or ice packs applied to swollen glands can help ease pain. Experiment to see which option provides the most relief.
Manage Testicular Swelling: If experiencing testicular swelling, apply ice packs or cool washcloths to the affected area.
Stay Hydrated: Drink plenty of fluids to prevent dehydration. Avoid acidic beverages like orange or grapefruit juice, as they may exacerbate throat pain.
Eat Soft Foods: Consume soft foods to minimize jaw pain. Avoid hard or sticky foods and opt for options like soup or mashed potatoes.
Get Adequate Rest: Rest is essential for supporting the immune system in fighting off the infection.
Use Pain Relievers: Over-the-counter, non-aspirin pain relievers can help alleviate discomfort. However, refrain from giving ibuprofen to children under 6 months unless advised by a doctor, and never administer aspirin to children due to the risk of Reye’s syndrome.
Isolate Yourself: Stay home and avoid close contact with others for at least 5 days after the onset of gland swelling to prevent spreading the virus.

If symptoms persist or worsen after a week, it’s advisable to contact a doctor for further evaluation and guidance. While there is no specific medication for mumps, managing symptoms effectively can help ease discomfort and promote recovery.

Prevention

The most effective way to prevent mumps is through vaccination. There are two main options available:

MMR Vaccine: This vaccine protects against measles, mumps, and rubella and is suitable for both children and adults.
MMRV Vaccine: Specifically for children, this vaccine provides protection against measles, mumps, rubella, and chickenpox.

According to the CDC, children should receive two doses of the MMR vaccine. The first dose is typically administered at 12-15 months of age, with the second dose given between 4-6 years old. The MMRV vaccine can serve as the second dose, although the decision is made by the child’s healthcare provider.

For teenagers and adults who are unsure about their vaccination status, consulting with a doctor is recommended. The doctor can review immunization records and determine if vaccination is necessary. In cases where records are unavailable, the doctor may suggest repeating the vaccine or conducting lab tests to check for immunity.

Once an individual has had mumps, they typically develop lifelong immunity to the virus. After exposure, the body builds up immunity that provides protection against future mumps infections.

Mumps vaccine

Receiving the recommended two doses of the MMR vaccine significantly reduces the likelihood of mumps infection, making individuals nine times less likely to contract the virus. Even if an individual does become infected, their symptoms are typically very mild.

Numerous studies conducted in the United States and other countries have consistently demonstrated the safety of the MMR vaccine. A study published in 1998 initially suggested a link between the vaccine and autism; however, this study was later found to contain significant flaws, leading to its retraction by the medical journal that published it. Additionally, reputable organizations such as the CDC and the American Academy of Pediatrics have thoroughly investigated this claim and found no evidence supporting a connection between the MMR vaccine and autism.

Side effect of the vaccine

Common side effects associated with the MMR vaccine are similar to those observed with other vaccines and are generally mild. These may include:

Rash
Fever
Soreness around the injection site

Although rare, allergic reactions to the MMR vaccine can occur. If you or your child experience any of the following symptoms after vaccination, it’s important to contact your doctor promptly:

Difficulty breathing
Wheezing
Changes in skin tone
Unexplained fatigue

Before receiving the MMR vaccine, it’s important to communicate certain information to your doctor, including:

Any previous side effects or adverse reactions to the MMR vaccine.
Details of any other vaccinations received within the past month.
A comprehensive list of all medications and supplements currently being taken.
Any history of seizures or a family history of seizures.
Information regarding recent blood transfusions or administration of blood products, such as plasma.
Any existing health conditions or ongoing medical treatments.

Additionally, it’s essential to inform your doctor about how you or your child are feeling on the day of the vaccination. While mild illnesses like a cold typically do not contraindicate receiving the MMR vaccine, your doctor may recommend rescheduling the vaccination if you or your child are experiencing a more serious health issue.

It is not advisable to receive the mumps vaccine while pregnant or if there is a possibility of pregnancy.

To prevent the spread of mumps if you or your child are infected, follow these measures:

Thoroughly wash your hands, particularly before and after caring for the sick individual.
Encourage frequent handwashing for all members of your household, especially before and after meals.
Avoid sharing water bottles, plates, cups, or utensils to minimize the risk of transmission.
Dispose of used tissues in the trash to prevent accidental contact by others.
Regularly clean frequently touched surfaces such as doorknobs, light switches, and sink faucets to eliminate potential virus particles.
Clean or wash any toys belonging to the sick individual to prevent the spread of the virus.

When to See a Doctor

If you suspect you or your child has mumps, it’s important to consult a healthcare provider for proper diagnosis and management. Seek medical attention if you experience swelling of the salivary glands, especially if accompanied by fever or other symptoms.

Outlook/Prognosis

In most cases, mumps resolves on its own within a few weeks without causing serious complications. However, rare complications such as meningitis, encephalitis, or deafness can occur. Vaccination remains the best strategy for preventing mumps and its potential complications.

Sources

Centers for Disease Control and Prevention (CDC)
World Health Organization (WHO)
Mayo Clinic
Cleveland Clinic
U.S. Department of Health and Human Services
European Centre for Disease Control and Prevention
CMAJ: Canadian Medical Association journal
American Medical Association
Merck Manual
NHS
Stanford Medicine Children’s Health
University of Rochester Medical Center
Journal of Experimental Medicine: “Gα_s-coupled receptor signaling and sleep regulate integrin activation of human antigen-specific T cells.”