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Management of Dengue Infection

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Mumps

Mumps

Also known as Epidemic parotitis, Viral parotitis, Infectious parotitis, Parotitis, Swollen gland disease etc.

What is Mumps?

Mumps is a contagious viral infection that primarily affects the salivary glands, particularly the parotid glands located near the ears. It is caused by the mumps virus, which belongs to the paramyxovirus family.

How Does It Spread?

Mumps spreads through respiratory droplets (tiny particles released when an infected person coughs or sneezes) or direct contact with infected saliva. Sharing food, drinks, utensils, or kissing an infected person can also transmit the virus.

Who Is at Risk?

  • Children (especially those between 2–12 years) who are not vaccinated.
  • Unvaccinated adults in crowded environments.
  • People in close-contact settings such as schools, universities, and military barracks.
  • Individuals with weakened immune systems.

Causes and Transmission

Cause of Mumps

  • The mumps virus is a single-stranded RNA virus from the Paramyxoviridae family.
  • It primarily infects the salivary glands, causing swelling and pain.
  • The virus can also affect other organs, leading to complications.

Modes of Transmission

  1. Airborne Droplets:

    • When an infected person coughs, sneezes, or talks, they release tiny virus-containing droplets into the air.
    • If a healthy person inhales these droplets, they can become infected.

  2. Direct Contact with Saliva:

    • Sharing cups, utensils, food, or drinks with an infected person can spread the virus.
    • Kissing or close face-to-face interactions increase the risk.

  3. Touching Contaminated Surfaces:

    • The virus can survive on surfaces (e.g., doorknobs, toys, or shared items).
    • If a person touches a contaminated surface and then touches their mouth, nose, or eyes, they can get infected.

Incubation Period (Time Between Exposure and Symptoms)

  • The incubation period for mumps is typically 12 to 25 days, meaning symptoms may not appear immediately after infection.
  • Infected individuals can spread the virus before showing symptoms (usually 2-3 days before swelling begins).


Symptoms of Mumps

Common Symptoms (Appear in Most Cases)

  1. Swollen and Painful Salivary Glands (Parotitis):

    • The most recognizable symptom.
    • Causes one or both cheeks to swell, making it difficult to chew or swallow.

  2. Fever:

    • Usually moderate to high (around 38–40°C or 100–104°F).

  3. Headache:

    • Common due to fever and viral infection.

  4. Muscle Aches (Myalgia):

    • Pain in muscles, making movement uncomfortable.

  5. Fatigue and Weakness:

    • General tiredness and reduced energy levels.

  6. Loss of Appetite:

    • Swollen glands and fever reduce the desire to eat.

Less Common Symptoms

  1. Ear Pain:

    • The swollen parotid gland may press on nearby structures, causing discomfort.

  2. Dry Mouth:

    • Due to reduced saliva production.

  3. Sore Throat:

    • Can occur due to the swelling of glands in the throat area.

Asymptomatic Cases

  • Some people (especially vaccinated individuals) may get infected but show no symptoms or only mild discomfort.
  • Even without symptoms, they can still spread the virus.


Typical unilateral mumps. 
A. Note the loss of angle of the jaw on the affected (right) side.
B. Comparison showing normal (left) side. 


Complications of Mumps

While most cases resolve without major issues, some individuals may develop serious complications, especially if they are adults or unvaccinated.

1. Orchitis (Testicular Inflammation in Males)

  • Occurs in about 30% of infected post-pubertal males.
  • Symptoms include swelling, pain, and tenderness in one or both testicles.
  • In rare cases, may lead to infertility, though this is uncommon.

2. Oophoritis (Ovary Inflammation in Females)

  • Affects about 5% of post-pubertal females.
  • Causes lower abdominal pain and discomfort.
  • Does not cause infertility in most cases.

3. Meningitis (Brain and Spinal Cord Inflammation)

  • Occurs when the virus spreads to the central nervous system (CNS).
  • Symptoms include stiff neck, headache, nausea, and sensitivity to light.

4. Encephalitis (Brain Inflammation)

  • A rare but severe complication that can cause seizures, confusion, and neurological damage.

5. Hearing Loss

  • Can be temporary or permanent, affecting one or both ears.

6. Pancreatitis (Inflammation of the Pancreas)

  • Causes abdominal pain, nausea, and vomiting.


Diagnosis of Mumps

Clinical Examination

  • A doctor will check for swollen parotid glands and other symptoms.

Laboratory Tests

  1. Blood Test (IgM Antibody Test):

    • Checks for mumps-specific antibodies in the blood.

  2. Saliva or Urine Test:

    • Used to detect the mumps virus.

  3. PCR Test:

    • Detects mumps virus RNA, giving an accurate diagnosis.


Treatment for Mumps

Since mumps is a viral infection, there is no specific antiviral treatment. Management focuses on relieving symptoms.

Symptomatic Management

  1. Rest:

    • Helps the immune system fight the infection.

  2. Hydration:

    • Drinking plenty of fluids prevents dehydration.

  3. Pain Relievers:

    • Acetaminophen (Tylenol) or ibuprofen (Advil) help reduce fever and pain.

  4. Cold or Warm Compresses:

    • Applied to swollen glands to ease discomfort.

  5. Soft Diet:

    • Avoid chewing hard foods to prevent pain.


Prevention of Mumps

1. MMR Vaccine (Measles, Mumps, Rubella)

  • The best protection against mumps.
  • Given in two doses:
    • 1st dose: 12–15 months of age.
    • 2nd dose: 4–6 years of age.
  • Highly effective (about 88% protection after two doses).

2. Preventive Measures

  • Handwashing: Regular hand hygiene prevents virus spread.
  • Avoiding Close Contact: Stay away from infected individuals.
  • Covering Mouth/Nose: When sneezing or coughing.


Epidemiology of Mumps

  • More common in unvaccinated populations.
  • Outbreaks occur in schools, universities, and military camps.
  • MMR vaccination has significantly reduced cases worldwide.


Conclusion

  • Mumps is a highly contagious but preventable viral disease.
  • Vaccination is the best way to prevent infection.
  • Early detection and supportive care help manage symptoms.
  • Public health measures play a crucial role in controlling outbreaks.

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