Mumps

Symptoms of Mumps

Most children infected with the mumps virus are either asymptomatic or display only mild respiratory symptoms, similar to those of a common cold. When symptoms do occur, they typically appear 7 to 21 days after exposure.

Early symptoms

These are often seen in both children and adults:

• Low to moderate-grade fever
• General malaise (a feeling of discomfort or unease)
• Muscle aches
• Headache
• Loss of appetite
  
  

Progressive symptoms

These may develop a few days after the early signs:

• High-grade fever (up to 103°F–104°F or 39.5°C–40°C)
• Parotitis – swelling and pain in the parotid or other salivary glands
• Swollen, tender jaw
• Ear pain
• Difficulty in eating, chewing, swallowing (especially sour or acidic foods), or speaking
  
  

About parotitis

• Parotitis is the hallmark symptom of mumps.
• It refers to the inflammation and swelling of the parotid glands, the largest salivary glands located in front of and below the ears. 
• This swelling causes the characteristic puffy cheeks and tender jaw seen in mumps patients.
• It usually occurs 24 to 48 hours after other early symptoms (fever, headache, muscle aches, etc.), but in some cases, the swelling may not appear until up to a week after initial symptoms.
• Parotitis can occur on one or both sides of the face (unilateral or bilateral).

Causes Of Mumps

Mumps is caused by the paramyxovirus, a member of the rubulavirus family.

Transmission of the mumps virus

• Airborne droplets: The virus spreads when an infected person coughs, sneezes, or talks, releasing droplets into the air that can be inhaled by others.
  
  

• Direct contact: Mumps can also spread through direct contact with respiratory secretions or saliva, as well as contaminated objects like utensils or cups.
  
  

• Close contact: The virus is highly contagious in environments where people are in close proximity, such as schools, daycare centers, and households. Close-contact activities like kissing, dancing, or playing sports also facilitate transmission.
  
  

Incubation period

After exposure to the mumps virus, symptoms typically appear 16 to 18 days later, although this period can range from 12 to 25 days. 

Contagious period

Patients are most contagious 1–2 days before the onset of symptoms. They can continue spreading the virus at least five days before their salivary glands begin to swell, and they remain contagious for up to one week after the appearance of symptoms.

Risk Factors For Mumps

The following factors increase the likelihood of contracting mumps:

1. Age

Children aged 5 to 14 years are at a higher risk, especially those who have not been vaccinated. Although mumps is less common in younger children due to widespread vaccination, older children and adults can still get infected.

2. Close contact environments

Mumps spreads easily in close-contact settings such as schools, daycares, colleges, and households. It is primarily transmitted through respiratory droplets and saliva, which makes environments where people share utensils, engage in physical activities, or are in close proximity particularly high-risk for outbreaks.

3. Weakened immune system

Individuals with weakened immune systems, such as those with HIV/AIDS or those on immunosuppressive medications, are more vulnerable to the mumps virus and may experience more severe complications.

4. Travel to high-risk areas

Traveling to regions with low vaccination rates or areas experiencing mumps outbreaks increases the risk of contracting the virus.

5. Non-immune status

People who have never had mumps or have not received the MMR vaccine are at increased risk, especially adults, who tend to experience more severe symptoms and complications than children.

6. Seasonal variations

Mumps are most common during late winter and early spring, though they can occur at any time.

Diagnosis Of Mumps

Diagnosis of Mumps typically involves a combination of clinical evaluation and laboratory tests. Here's how it is generally diagnosed:

1. Clinical evaluation

• The healthcare provider will first assess the symptoms, including the hallmark signs of swollen and tender parotid glands (located near the ears).
  
  
• Medical history is reviewed, including vaccination status and potential exposure to someone with mumps.
  
  

2. Laboratory tests

If there is a suspicion of mumps, several tests can confirm the diagnosis:

• Blood tests: Serology to detect antibodies against the mumps virus (IgM and IgG). A rise in IgM levels indicates recent infection, while the presence of IgG shows past exposure or vaccination.

• Polymerase Chain Reaction (PCR): A more accurate test that detects mumps virus RNA in a sample taken directly from buccal (inner cheek) swabs, throat swabs, and saliva, particularly when obtained within 2 days of the appearance of symptoms. 

• Viral culture: The virus can be isolated from saliva or throat swabs, although this method is less commonly used due to its slower results.

• CSF analysis: In case of complications involving the central nervous system (CNS), a lumbar puncture (spinal tap) may be used to rule out other potential causes.
  
  

3. Imaging (in some cases)

• In rare cases, imaging tests (like ultrasound) may be used to assess swelling of the parotid glands or other complications, such as inflammation of the testicles (orchitis) or ovaries (oophoritis).

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Prevention Of Mumps

The best way to prevent mumps is through vaccination and adopting good hygiene practices to limit the spread of the virus.

1. MMR vaccination

• The MMR vaccine (Measles, Mumps, Rubella) is the most effective prevention method. It is a safe, effective, and essential part of routine childhood immunization.
  
  
• It is usually given in two doses:
  • First dose at 12–15 months of age
  • Second dose at 4–6 years of age
    
    

Adults who have not been vaccinated or are unsure of their immunization status should also consider getting the MMR vaccine.
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2. Avoiding exposure

• Stay away from people who are infected with mumps, especially during their contagious period (usually a few days before and after gland swelling begins).

• Avoid sharing utensils, drinks, toothbrushes, or personal items that may be contaminated with saliva.
  
  

3. Practice good hygiene

• Wash your hands frequently with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer.

• Cover your mouth and nose when coughing or sneezing.

• Disinfect surfaces and commonly touched objects, especially in communal settings like schools or offices.

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4. Stay home when sick

If you or your child has mumps, stay home for at least 5 days after the salivary gland swelling begins to prevent spreading the virus to others.

Specialist To Visit

If you or your child shows symptoms such as fever, swelling of the salivary glands, muscle aches, fatigue, or headaches, or has been in close contact with someone infected, you should consult one of the following specialists for proper diagnosis and care:

• General physician
• Paediatrician 
• Infectious disease specialist
• Internal medicine specialist

A general practitioner (GP) is typically the first point of contact for suspected mumps. They can perform a clinical evaluation, confirm the diagnosis, recommend supportive treatment, and provide guidance on isolation and monitoring for possible complications.

If the patient is a child, a pediatrician is the most appropriate specialist for diagnosis and management.

For unusual, severe, or complicated cases—particularly in adults or those with weakened immune systems—consulting an infectious disease specialist or an internal medicine specialist is recommended.

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Treatment Of Mumps

Mumps is generally a self-limiting illness, and there is no specific antiviral treatment for it. The treatment primarily focuses on relieving symptoms and managing discomfort while the body recovers. 

Pain relief

Over-the-counter pain relievers like paracetamol or ibuprofen can help alleviate headaches, muscle aches, and fever.

Note: DO NOT give aspirin to children, as it has been linked to Reye’s syndrome, a life-threatening disease that can cause liver failure and swelling of the brain.

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Home care for Mumps

Mumps is a self-limiting viral illness, and most cases can be managed effectively at home with simple supportive care. Follow these tips to help ease symptoms and prevent the spread of infection:

• Isolation: Mumps is contagious, and it’s important to stay home and avoid close contact with others for at least 5 days after the salivary gland swelling begins to prevent the spread of the virus.
  

• Rest: Get plenty of rest to allow your body to recover. Fatigue and muscle aches are common during mumps, so listen to your body and take breaks when needed.

• Warm or cold compresses: Applying a warm or cold compress to the swollen glands may help reduce pain and discomfort.

• Hydration: Drink plenty of fluids like filtered water, coconut water, soups, etc, to stay hydrated, especially if there’s difficulty eating or drinking due to swelling of the glands.

• Dietary adjustments: To ease swallowing difficulties caused by swollen salivary glands, it’s helpful to consume a soft, bland diet. This can include foods like mashed potatoes, oatmeal, yogurt, broth-based soups, or any other items that are easy to swallow and require minimal chewing.

Note: It’s also important to avoid acidic or sour foods, such as citrus fruits and juices, as these can stimulate salivation and worsen pain in the inflamed salivary glands.

Complications Of Mumps

Although mumps is typically a mild and self-limiting illness, especially in children, it can lead to serious complications, particularly in adolescents and adults. Prompt medical attention is important if symptoms become severe or unusual.

1. Orchitis 

• It refers to inflammation of the testicles. It is most common in post-pubertal males.
• It can cause testicular pain, swelling, and tenderness.
• In rare cases, it may lead to infertility, especially if both testicles are affected.
  
  

2. Oophoritis and mastitis

• In females, oophoritis (inflammation of the ovaries) or mastitis (inflammation of breast tissue) may occur.
• It can cause abdominal or pelvic pain and tenderness in the breast tissue.
  
  

3. Meningitis and encephalitis

• Meningitis is an inflammation of the membranes around the brain and spinal cord.
• Encephalitis is inflammation of the brain itself.
• Symptoms may include headache, neck stiffness, vomiting, drowsiness, and seizures.
  
  

4. Hearing loss

• Mumps can cause temporary or permanent hearing loss, typically in one ear.
• This is a rare but serious complication.
  
  

5. Pancreatitis

• Inflammation of the pancreas may occur, causing abdominal pain, nausea, and vomiting.
  
  

6. Miscarriage

• Pregnant women infected with mumps during the first trimester may have an increased risk of miscarriage, although congenital malformations are rare.
  
  

7. Other rare complications

• Myocarditis (inflammation of the heart muscle)
• Nephritis (kidney inflammation)
• Arthritis  (inflammation of the joints)
  
  

If you're experiencing symptoms or considering a second opinion, it's wise to consult a doctor for proper guidance.
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