Mumps is caused by a virus.
Symptoms include chills, headache, poor appetite, fever, and a feeling of illness, followed by swelling of the salivary glands.
The diagnosis is based on typical symptoms.
Most children recover with no problems, but infection can lead to meningitis or encephalitis.
Routine vaccination can prevent the infection.
Treatment is aimed at relieving symptoms.
Children become infected with mumps by breathing in small airborne droplets of moisture coughed out by an infected person or by having direct contact with objects contaminated by infected saliva. Mumps is less contagious than measles Measles Measles is a highly contagious viral infection that causes various cold-like symptoms and a characteristic rash. Measles is caused by a virus. Symptoms include fever, runny nose, hacking cough... read more or chickenpox Chickenpox Chickenpox is a highly contagious viral infection with the varicella-zoster virus that causes a characteristic itchy rash, consisting of small, raised, blistered, or crusted spots. Chickenpox... read more . In heavily populated areas, it occurs year-round but is most frequent in late winter and early spring.
Epidemics may occur when people without immunity are crowded together. However, small outbreaks have occurred among people who have been vaccinated, probably because some people (about 10 to 12%) do not develop immunity after vaccination and, in some others, immunity may decrease over time. Some people may not complete the recommended vaccination. Before routine immunization, mumps occurred most commonly in school-aged children. Now, however, the infection has become more common among adolescents and adults because of waning immunity.
In 1967, before children were routinely vaccinated against mumps, there were about 186,000 cases of mumps in the United States. Since vaccination began, the number of cases has decreased significantly. However, mumps still occurs. A 2006 mumps outbreak in the midwestern United States caused more than 6,584 cases. Young adults had the highest infection rates, which highlighted the need for continued use of vaccination. Since that time, sporadic outbreaks, mainly at college campuses and in other close-knit communities, have contributed to cases fluctuating from a low of 229 in 2012 to high of 6,109 in 2017.
The infection does not usually occur in children younger than 2 years, particularly those younger than 1 year. One infection with the mumps virus usually provides lifelong immunity.
Like measles, mumps may be imported by travelers or immigrants, who then transmit the infection, especially in places where many people group together (such as college campuses) or communities that limit contact with outsiders (such as traditional-observant Jewish communities, Amish, and Mennonites).
Locating the Major Salivary Glands
Symptoms of Mumps
Mumps symptoms begin 12 to 24 days after infection. However, about one quarter of people do not develop symptoms. Most children develop chills, headache, poor appetite, a general feeling of illness (malaise), and a low to moderate fever. These symptoms are followed in 12 to 24 hours by swelling of the salivary glands, which is most prominent on the second day and lasts 5 to 7 days.
Some children simply have swelling of the salivary glands without the other symptoms. The swelling results in pain when chewing or swallowing, particularly when swallowing acidic liquids, such as citrus fruit juices. The glands are tender when touched. At this stage, the temperature usually rises to 103 or 104° F (about 39.5 or 40° C) and lasts 1 to 3 days.
Complications of mumps
Mumps may affect organs other than the salivary glands, including the
Brain and tissue covering the brain
About 20% of men who become infected after puberty develop inflammation of one or both testes (orchitis Orchitis Orchitis is infection of the testes, most often by a virus such as mumps. Orchitis is usually caused by a virus. The testis swells and is painful. A doctor's examination and urinalysis are used... read more ). Inflammation of the testes causes swelling and severe pain. Once healed, the affected testis may be smaller, but testosterone production and fertility are usually unaffected. In women, inflammation of the ovaries (oophoritis) is less commonly recognized, is less painful, and does not impair fertility.
Mumps leads to inflammation of the layers of tissue covering the brain (meningitis Viral Meningitis Viral meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space) when it is caused... read more ) in 1 to 10% of people. Meningitis causes headache, vomiting, and a stiff neck. Mumps also causes inflammation of the brain (encephalitis Encephalitis Encephalitis is inflammation of the brain that occurs when a virus directly infects the brain or when a virus, vaccine, or something else triggers inflammation. The spinal cord may also be involved... read more ) in 1 out of 1,000 to 5,000 people. Encephalitis causes drowsiness, coma, or seizures. Most people recover completely, but some have permanent nerve or brain damage, such as deafness or paralysis of the facial muscles, usually affecting only one side of the body. Mumps is thought to be a major cause of one-sided deafness in children in parts of the world where vaccination rates are low.
Inflammation of the pancreas (pancreatitis Overview of Pancreatitis Pancreatitis is inflammation of the pancreas. The pancreas is a leaf-shaped organ about 5 inches (about 13 centimeters) long. It is surrounded by the lower edge of the stomach and the first... read more ) may occur toward the end of the first week of infection. This disorder causes abdominal pain, severe nausea, and vomiting. These symptoms disappear in about a week, and the person recovers completely.
Other complications, such as swelling of the liver, kidneys, or heart muscle, occur but are extremely rare. All complications are less common among people who have been already been vaccinated.
Diagnosis of Mumps
A doctor's evaluation
Doctors diagnose mumps based on the typical symptoms, particularly when they occur during an outbreak of mumps.
Laboratory tests can identify the mumps virus and its antibodies. Such tests can be used to confirm the diagnosis and are usually done to document outbreaks for public health purposes.
A spinal tap Spinal Tap Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. Electroencephalography (EEG) is a simple, painless procedure in which... read more is done for people who have signs of meningitis or encephalitis.
Prognosis for Mumps
Almost all children with mumps recover fully without problems, but in rare cases symptoms may worsen again after about 2 weeks.
Prevention of Mumps
The first dose of the mumps vaccine Measles, Mumps, and Rubella Vaccine The measles, mumps, and rubella (MMR) vaccine is a combination vaccine that helps protect against these three serious viral infections. The vaccine contains live but weakened measles, mumps... read more , one of the routine immunizations of childhood Childhood Vaccination Schedule Most doctors follow the vaccination schedule recommended by the Centers for Disease Control and Prevention (CDC—see the schedule for infants and children and the schedule for older children... read more , is given between 12 months and 15 months of age. The second dose is given between 4 years and 6 years of age. The vaccine that is used is a combined vaccine. The combination contains measles, mumps, and rubella (MMR) vaccines, and sometimes also varicella (chickenpox) vaccine. There is no longer a separate vaccine just for mumps. During an outbreak, people who have been vaccinated but who have an increased risk of developing mumps (such as college students or others living in areas where there has been an outbreak of mumps) may be given a third dose.
Adults born during or after 1957 should have one dose, unless they have had mumps diagnosed by a health care practitioner. Pregnant women and people with an impaired immune system should not be given live mumps virus vaccine.
Treatment of Mumps
Acetaminophen or ibuprofen for discomfort
There is no specific treatment for mumps. To minimize discomfort, children should eat a soft diet and avoid foods that require much chewing or are acidic. Analgesics, such as acetaminophen and ibuprofen, may be used for headache and discomfort.
Boys or men with inflammation of the testes need bed rest. The scrotum may be supported with an athletic supporter or by an adhesive-tape bridge connected between the thighs. Ice packs may be applied to relieve pain.
If pancreatitis causes severe nausea and vomiting, fluids may be given by vein (intravenously), and intake by mouth should be avoided for a few days. Children with meningitis or encephalitis may need intravenous fluids and acetaminophen or ibuprofen for fever or headache. If seizures develop, antiseizure drugs may be needed.
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