What is Mumps?
Mumps is an acute self-limited infection occurring in children and young adults, caused by a virus of the family Paramyxoviridae. It is characterised by fever and painful bilateral or unilateral parotid swelling, which refers to the salivary glands in front of the ears causing puffy cheeks. It may also cause serious complications, including but not limited to, Meningoencephalitis and Orchitis. It remains a significant public health concern in India, and health education regarding this vaccine-preventable disease is paramount.
How do Mumps spread and present?
Mumps is highly contagious and spread by respiratory droplets. The virus appears in the saliva from around 7 days before to 7 days after the onset of parotid swelling. It spreads quickly among children in close contact with each other. Typically, a child presents with fever, headache, vomiting and body ache, which is followed by swelling of the salivary glands. Parotid swelling may be initially unilateral but becomes bilateral in approximately 70% of cases. The parotid gland is painful to touch and maybe preceded or accompanied by ear pain on the same side. The swelling of the parotid gland subsides gradually over the next 7 days. Chewing may be painful, and the intake of sour foods or liquids may increase the pain. The child may also have a poor appetite.
The pathophysiology of mumps is initial viral replication in the upper respiratory tract, followed by spread to specifically targeted tissues through the lymph. The mumps virus causes cell death in the infected tissues.
How is Mumps diagnosed?
The diagnosis of mumps is made by history of exposure and findings of the characteristic clinical features. Blood tests may reveal a drop in the total white cell count. The serological confirmation is done by a nose or throat swab that detects the mumps virus.
What are the complications caused by Mumps?
Mumps generally leads to fewer complications than its counterparts – Measles and Rubella. It causes inflammation in multiple organs. The most common complications are Meningitis with or without Encephalitis (inflammation of the brain and surrounding tissues), Orchitis – which leads to pain and swelling of the testes but rarely causes infertility and Oophoritis (inflammation of the ovary) in girls, which may cause severe abdominal pain.
Young children and infants who develop Meningoencephalitis present with fever, lethargy and a general sense of uneasiness. Older children may complain of headache and vomiting and have positive meningeal signs. These symptoms most commonly ensue around 5 days after the parotid swelling Children who develop these symptoms and signs require urgent care and continuous monitoring.
Infection of pregnant women with mumps in the first trimester causes an increased risk of fetal loss. Mumps is also known to cause severe respiratory distress in infants born to mothers who acquire the infection closer to delivery.
How is Mumps be treated?
The management of mumps is symptomatic. There is no specific antiviral therapy available. Adequate pain relief and hydration are the key aspects of management . The infection takes about 10-14 days to settle. The prognosis of mumps is good, even in children who develop complications, although some fatalities have been reported. Children with Meningoencephalitis may develop transient, or occasionally, permanent hearing loss.
How can Mumps be prevented?
The occurrence of mumps has reduced greatly with the advent of vaccination, although it still causes outbreaks in unvaccinated groups. It is the second ‘M’ in the MMR vaccine. This live mumps vaccine is given in 3 doses at 9 months, 15 months and between 4-6 years, according to the immunisation schedule of the Indian Academy of Pediatrics. The vaccine should not be given to immunodeficient or immunosuppressed children or pregnant women, or children who have anaphylactoid reactions to egg or neomycin. Children with other allergies to egg may safely take the vaccine.
How can you protect your child against Mumps?
- Children should be advised to wash their hands well with soap and water.
- They should be taught to sneeze or cough into handkerchiefs or the crook of their elbows.
- They should be advised not to share water bottles or cups when they have any of the symptoms of Mumps and should be advised isolation once diagnosed.
- Disinfection of common spaces should be advocated.
- Vaccinations should be given as per schedule to prevent contraction of the disease and severity of symptoms.
Apart from getting the MMR vaccine, knowing the symptoms of Mumps can help keep you and the people around you safe. If you suspect your child has Mumps, contact your Pediatrician immediately.
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