About Mumps
Mumps is a disease caused by a virus that usually spreads
through saliva and can infect many parts of the body, especially
the parotid salivary glands. These glands, which produce saliva for
the mouth, are found toward the back of each cheek, in the area
between the ear and jaw. In cases of mumps, these glands typically
swell and become painful.
The disease has been recognized for several centuries, and
medical historians argue over whether the name "mumps"
comes from an old word for "lump" or an old word for
"mumble."
Mumps was common until the mumps vaccine was licensed in 1967.
Before the vaccine, more than 200,000 cases occurred each year in
the United States. Since then the number of cases has dropped to
fewer than 1,000 a year, and epidemics have become fairly rare. As
in the pre-vaccine era, most cases of mumps are still in kids ages
5 to 14, but the proportion of young adults who become infected has
been rising slowly over the last two decades. Mumps infections are
uncommon in kids younger than 1 year old.
After a case of mumps it is very unusual to have a second bout
because one attack of mumps almost always gives lifelong protection
against another. However, other infections can also cause swelling
in the salivary glands, which might lead a parent to mistakenly
think a child has had mumps more than once.
Signs and Symptoms
Cases of mumps may start with a
fever
of up to 103º Fahrenheit (39.4º Celsius), as well as a headache and
loss of appetite. The well-known hallmark of mumps is swelling and
pain in the parotid glands, making the child look like a hamster
with food in its cheeks. The glands usually become increasingly
swollen and painful over a period of 1 to 3 days. The pain gets
worse when the child swallows, talks, chews, or drinks acidic
juices (like orange juice).
Both the left and right parotid glands may be affected, with one
side swelling a few days before the other, or only one side may
swell. In rare cases, mumps will attack other groups of salivary
glands instead of the parotids. If this happens, swelling may be
noticed under the tongue, under the jaw, or all the way down to the
front of the chest.
Mumps can lead to inflammation and swelling of the brain and
other organs, although this is not common. Encephalitis
(inflammation of the brain) and meningitis (inflammation of the
lining of the brain and spinal cord) are both rare complications of
mumps. Symptoms appear in the first week after the parotid glands
begin to swell and may include: high fever, stiff neck, headache,
nausea and vomiting, drowsiness, convulsions, and other signs of
brain involvement.
Mumps in adolescent and adult males may also result in the
development of orchitis, an inflammation of the testicles. Usually
one testicle becomes swollen and painful about 7 to 10 days after
the parotids swell. This is accompanied by a high fever, shaking
chills, headache, nausea, vomiting, and abdominal pain that can
sometimes be mistaken for appendicitis if the right testicle is
affected. After 3 to 7 days, testicular pain and swelling subside,
usually at about the same time that the fever passes. In some
cases, both testicles are involved. Even with involvement of both
testicles, sterility is only a rare complication of orchitis.
Additionally, mumps may affect the pancreas or, in females, the
ovaries, causing pain and tenderness in parts of the abdomen.
In some cases, signs and symptoms are so mild that no one
suspects a mumps infection. Doctors believe that about 1 in 3
people may have a mumps infection without symptoms.
Contagiousness
The mumps virus is contagious and spreads in tiny drops of fluid
from the mouth and nose of someone who is infected. It can be
passed to others through sneezing, coughing, or even laughing. The
virus can also spread to other people through direct contact, such
as picking up tissues or using drinking glasses that have been used
by the infected person.
People who have mumps are most contagious from 2 days before
symptoms begin to 6 days after they end. The virus can also spread
from people who are infected but have no symptoms.
Prevention
Mumps can be prevented by vaccination. The
vaccine
can be given alone or as part of the measles-mumps-rubella (MMR)
immunization, which is usually given to children at 12 to 15 months
of age. A second dose of MMR is generally given at 4 to 6 years of
age. As is the case with all immunization schedules, there are
important exceptions and special circumstances.
If they haven't already received them, students who are
attending colleges and other post-high school institutions should
be sure they have had two doses of the MMR vaccine.
During a measles outbreak, your doctor may recommend additional
shots of the vaccine, if your child is 1 to 4 years old. Your
doctor will have the most current information.
Incubation
The incubation period for mumps can be 12 to 25 days, but the
average is 16 to 18 days.
Duration
Children usually recover from mumps in about 10 to 12 days. It
takes about 1 week for the swelling to disappear in each parotid
gland, but both glands don't usually swell at the same
time.
Treatment
If you think that your child has mumps, call your doctor, who
can confirm the diagnosis and work with you to monitor your child
and watch for complications. The doctor can also notify the health
authorities who keep track of childhood immunization programs and
mumps outbreaks.
Because mumps is caused by a virus, it cannot be treated with
antibiotics.
At home, monitor and keep track of your child's temperature.
You can use nonaspirin fever medications such as acetaminophen or
ibuprofen to bring down a fever. These medicines will also help
relieve pain in the swollen parotid glands. Unless instructed by
the doctor,
aspirin should not be used in children with viral illnesses
because its use in such cases has been associated with the
development of
Reye syndrome
, which can lead to liver failure and death.
You can also soothe the swollen parotid glands with either warm
or cold packs. Serve a soft, bland diet that does not require a lot
of chewing and encourage your child to drink plenty of fluids.
Avoid serving tart or acidic fruit juices (like orange juice,
grapefruit juice, or lemonade) that make parotid pain worse. Water,
decaffeinated soft drinks, and tea are better tolerated.
When mumps involves the testicles, the doctor may prescribe
stronger medications for pain and swelling and provide instructions
on how to apply warm or cool packs to soothe the area and how to
provide extra support for the testicles.
A child with mumps doesn't need to stay in bed, but may play
quietly. Ask your doctor about the best time for your child to
return to school.
When to Call the Doctor
Call the doctor if you suspect that your child has mumps. If
your child has been diagnosed with mumps, keep track of his or
her temperature and call the doctor if goes above 101º
Fahrenheit (38.3º Celsius).
Because mumps can also involve the brain and its membranes, call
the doctor immediately if your child has any of the following:
stiff neck, convulsions (seizures), extreme drowsiness, severe
headache, or changes of consciousness. Watch for abdominal pain
that can mean involvement of the pancreas in either sex or
involvement of the ovaries in girls. In boys, watch for high fever
with pain and swelling of the testicles.
Reviewed by:
Joel Klein, MD
Date reviewed: April 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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