Mumps

Dr. Parang Mehta, MD.

Mumps is a common viral disease of childhood.  It is usually a mild disease that lasts a few days, but mumps can cause serious complications.  Some of these are life-threatening, while others leave long-lasting defects.  We do not have a specific drug to treat mumps in children.

Mumps virus can affect many organs of the body, but the most common is the salivary glands.  These are the glands that produce saliva.  The most commonly affected in mumps are the parotid glands, which are in front of, and slightly below, the ears (one on each side).  The other salivary glands are the sublingual (below the tongue), and the sub-mandibular (below the chin).

Mumps - The Disease

Mumps is most common in children five to nine years of age.  However, in countries where mumps vaccine is given routinely to children, it is often a disease of young adults.  This population is vulnerable because they did not receive the mumps vaccine in childhood.

Mumps is caused by an RNA virus, which is classified as a paramyxovirus.  The virus is spread from person to person by airborne droplets, direct contact, and objects contaminated by saliva (towels, toys, pillows, etc).  Children are infectious to others from a day before the swelling appears to three days after it subsides.  An episode of mumps usually confers lifelong immunity.

Mumps usually starts with swelling and pain in the parotid glands.   Swelling first appears in front of the lower part of the ear.  As it progresses, the cheek and neck become swollen and painful.   The swelling usually reduces over a week.  In some children, only one gland may be affected.  In rare cases, some other salivary glands are affected, and the parotid glands are not affected.  Diagnosing mumps is difficult in such children.

The swollen areas are painful, especially on touching and eating.  Sour, salty, and other strongly flavoured food elicit significant discomfort.

Mumps is diagnosed clinically.  Although laboratory tests are available, they are rarely done.

Treatment of Mumps

Mumps is mostly a mild illness, and requires no specific treatment.  The swelling and pain subside on their own in 3-7 days. Hot fomentation helps relieve the pain.

Pain and fever are treated with paracetamol (acetaminophen) or ibuprofen.  Bed rest is not really needed for most children.  Rest does not prevent or reduce complications.

Eating can be painful.  A soft, bland diet is easiest for a child with mumps to have.

Complications of Mumps

Meningoencephalitis: This is a rare but serious complication of mumps.  It affects less than one percent of children with mumps, and is seen either at the same time as the salivary gland swelling, or about ten days after the original disease.
Since it affects the brain, the child has disturbed consciousness, and seizures (fits).  In more advanced stages, the child becomes comatose.  The mortality from mumps meningoencephalitis is about 2 percent.

Orchitis: This is a swelling of the testes.  It is rare in children, and is seen more often in adolescent boys and adults.  The affected testis is swollen and painful, and there is often fever, chills, and pain abdomen also.  In about a third of affected people, both testes are affected.

Orchitis lasts about 4 days, and then subsides.  Sometimes, the testis becomes shrunken.  Infertility (sterility) is much feared after this complication, but it is rare, even if both testes are affected.

Apart from these two common complications, mumps also affects the thyroid gland (thyroiditis), the heart muscle (myocarditis), the ovaries in girls (oophoritis), the joints (arthritis) and the pancreas (pancreatitis).  Rarely, mumps can also cause deafness.

Prevention of Mumps

The disease can be prevented by the MMR vaccine.  Apart from mumps, it protects the child from measles and rubella.  This vaccine should be given to all children at the age of 12-15 months.  A second dose of the vaccine is recommended at school entry (4-6 years).

 

Last Revision: May 22, 2020