Mumps

Reviewed by Dr John Pillinger, GP

What is mumps?
Mumps is caused by a paramyxovirus. Of the more common childhood illnesses, it is the disease with the longest incubation period and can take as long as three weeks from infection to outbreak, which can make it difficult to track down the source of infection.

The virus is contagious for about two to three days before and up to seven to eight days after the disease breaks out.

How do you catch mumps?
Mumps is a viral infection spread by airborne droplets from the nose or throat. However, it is the least contagious of the five major children's diseases and requires close contact before infection can occur. Though small children can get mumps, the disease is most common after the age of two.

Today, most children are vaccinated against mumps with the MMR (measles, mumps, rubella) vaccination.

The virus enters the body through the airways, then passes around the body in the bloodstream. It can end up almost everywhere - the kidneys, thyroid gland, pancreas, sexual glands and, not least, the salivary gland. The virus thrives in the parotid salivary glands, which lie in the cheeks just in front of the ears.

What are the symptoms of mumps?
Mumps usually begins with two days of discomfort and an increasing temperature. This is followed by an uncomfortable feeling in the jawbone, later accompanied by a swelling of the parotid glands. Often the swelling occurs unevenly, on one side of the face before the other. The body temperature may rise to 40oC and the swelling can feel oppressive and sore. The earlobes stick out and the child's face eventually looks very swollen. The child experiences pain when opening their mouth. In mild cases the swelling may only last three to four days, but it can go on for a week or more.

How does the doctor make the diagnosis?
Usually the doctor makes the diagnosis based on the symptoms.

What complications may arise?
Although the swollen parotid glands and high temperature caused by mumps may be unpleasant, the most serious repercussions involve possible infection of other organs.

In 20 to 30 per cent of the cases of adult men with mumps, the disease infects the testicles (orchitis) causing swelling, pain, soreness and a higher temperature. This often occurs about a week after the disease has broken out, and is a serious infection that may cause sterility.

However, among the few sexually mature men who contract mumps, only half get orchitis. Of these patients, only 10 per cent are affected in both testicles, and even then it does not necessarily cause sterility. If sterility occurs, there is still a chance that fertility may return.

Boys who have not reached puberty and are not sexually mature rarely get this kind of inflammation of the testicles.

The risk of women contracting oophoritis – inflammation of the ovaries – is even smaller than inflammation of the testicles in men. However, should this happen, it has no effect on fertility.

Inflammation of the pancreas (pancreatitis) is a recognised but uncommon complication.

A less rare complication of mumps is meningitis, which may appear 3 to 10 days after the onset of mumps. This is an inflammation of the membranes of the brain or spinal cord. Meningitis is a serious disease, but in connection with mumps it is usually mild. However, it still requires close attention and special care of the patient.
The symptoms of mumps-meningitis are:

• headache
• aversion to bright light
• possible vomiting
• typically a stiff neck, leaving patients unable to touch their chest with their chin and causing the head to bend slightly backwards.

How are mumps treated?
Apart from staying in bed while the swelling and temperature is at its highest, mumps demands no special attention.

Prior to the development of a vaccine mumps was considered to be a part of growing up for many children. If the disease is contracted later in life, the risk of the unpleasant complications listed above is far greater.

Children can return to childcare institutions or school when they are feeling well and the swelling of the glands has subsided.

Who should be vaccinated?

Today it is recommended that all children get the MMR vaccination, which contains a vaccine against mumps. This vaccine gives the same lifelong immunity and protection against the disease as the disease itself.

The recent rise in the number of mumps cases among young students is thought to be entirely due to these children having missed being vaccinated earlier in their life.

In the UK, the vaccine is offered to all children between 12 and 18 months, with a second booster dose before starting school between the ages of three and five.

Based on a text by Dr Per Grinsted
Last updated 19.11.2008