Mumps is a relatively mild short-term viral infection of the salivary
glands that usually occurs during childhood.
Typically, mumps is characterized by a painful swelling of both cheek
areas, although the person could have swelling on one side or no
perceivable swelling at all. The salivary glands are also called the
parotid glands; therefore, mumps is sometimes referred to as an
inflammation of the parotid glands (epidemic parotitis). The word mumps
comes from an old English dialect, meaning lumps or bumps within the
Mumps is a very contagious infection that spreads easily in such highly
populated environments as daycare centers and schools. Although not as
, mumps was once quite common. Prior to the release of a mumps vaccine in
the United States in 1967, approximately 92 percent of all children had
been exposed to mumps by the age of 15. In the pre-vaccine years, most
children contracted mumps between the ages of four and seven. Mumps
epidemics came in two to five year cycles. The greatest mumps epidemic was
in 1941 when approximately 250 cases were reported for every 100,000
people. In 1968, the year after the live mumps vaccine was released, only
76 cases were reported for every 100,000 people. By 1985, fewer than 3,000
cases of mumps were reported throughout the entire United States, the
equivalent of about one case per 100,000 people. The reason for the
decline in mumps was the increased usage of the mumps vaccine. However,
1987 noted a five-fold increase in the incidence of the disease because of
the reluctance of some states to adopt comprehensive school immunization
laws. After that, state-enforced school entry requirements achieved
student immunization rates of nearly 100 percent in kindergarten and first
grade. In 1996, the Centers for Disease Control and Prevention (CDC)
reported only 751 cases of mumps nationwide, that is, about one case for
every 5 million people.
Causes and symptoms
The paramyxovirus that causes mumps is harbored in the saliva and is
spread by sneezing, coughing, and other direct contact with another
person's infected saliva. Once the person is exposed to the virus,
symptoms generally occur in 14 to 24 days. Initial symptoms include
, loss of appetite, and a lack of energy. However, an infected person may
not experience these initial symptoms. Swelling of the salivary glands in
the face (parotitis) generally occurs within 12 to 24 hours of the above
symptoms. Accompanying the swollen glands is
on chewing or swallowing, especially with acidic
beverages, such as lemonade. A
as high as 104°F (40°C) is also common. Swelling of the glands
reaches a maximum on about the second day and usually disappears by the
seventh day. Once individuals have contracted mumps, they become immune to
the disease, despite how mild or severe their symptoms may have been.
While the majority of cases of mumps are uncomplicated and pass without
incident, some complications can occur. Complications are, however, more
noticeable in adults who get the infection. In 15 percent of cases, the
covering of the brain and spinal cord becomes inflamed (
). Symptoms of meningitis usually develop within four or five days after
the first signs of mumps. These symptoms include a stiff neck, headache,
, and a lack of energy. Mumps meningitis is usually resolved within seven
days, and damage to the brain is exceedingly rare.
The mumps infection can spread into the brain causing inflammation of the
). Symptoms of mumps encephalitis include the inability to feel pain,
seizures, and high fever. Encephalitis can occur during the parotitis
stage or one to two weeks later. Recovery from mumps encephalitis is
usually complete, although complications, such as seizure disorders, have
been noted. Only about one person in 100 with mumps encephalitis dies from
About one-fourth of all post-pubertal males who contract mumps can develop
a swelling of the scrotum (orchitis) about seven days after the parotitis
stage. Symptoms include marked swelling of one or both testicles, severe
, and headache. Pain and swelling usually subside after five to seven
days, although the testicles can remain tender for weeks.
Girls occasionally suffer an inflammation of the ovaries (oophoritis) as a
complication of mumps, but this condition is far less painful than
orchitis in boys.
When mumps reaches epidemic proportions, diagnosis is relatively easy on
the basis of the physical symptoms. The doctor will take the
child's temperature, gently palpate (touch) the skin over the
parotid glands, and look inside the child's mouth. If the child has
mumps, the openings to the ducts inside the mouth will be slightly
inflamed and have a "pouty" appearance. With so many people
vaccinated as of the early 2000s, a case of mumps must be properly
diagnosed in the event the salivary glands are swollen for reasons other
than viral infection. For example, in persons with poor
, the salivary glands can be infected with bacteria. In these cases,
are necessary. Also in rare cases, the salivary glands can become
blocked, develop tumors, or swell due to the use of certain drugs, such as
iodine. A test can be performed to determine whether the person with
swelling of the salivary glands actually has the mumps virus.
In late 2002, researchers in London reported the development of a bioassay
for measuring mumps-specific IgG. This test would allow a doctor to check
whether an individual patient is immune to mumps and allow researchers to
measure the susceptibility of a local population to mumps in areas with
low rates of
When mumps does occurs, the illness is usually allowed to run its course.
The symptoms, however, are treatable. Because of difficulty swallowing,
the most important challenge is to keep the patient fed and hydrated. The
individual should be provided a soft diet, consisting of cooked cereals,
mashed potatoes, broth-based soups, prepared baby foods, or foods put
through a home food processor. Aspirin (only for individuals over the age
, or ibuprofen can relieve some of the pain due to swelling, headache, and
fever. Patients should void fruit juices and other acidic foods or
beverages that can irritate the salivary glands. They should also avoid
dairy products that can be hard to digest. In the event of complications,
a physician should be contacted at once. For example, if orchitis occurs,
a physician should be called. Also, supporting the scrotum in a cotton bed
on an adhesive-tape bridge between the thighs can minimize tension. Ice
packs are also helpful.
When mumps is uncomplicated, prognosis is excellent. However, in rare
cases, a relapse occurs after about two weeks. Complications can also
delay complete recovery.
A vaccine exists to protect against mumps. The vaccine preparation (MMR)
is usually given as part of a combination injection that helps protect
against measles, mumps, and
. MMR is a live vaccine administered in one dose between the ages of 12
and 15 months, between four and six years of age, or 11 and 12 years of
age. Persons who are unsure of their mumps history and/or mumps
vaccination history should be vaccinated. Susceptible healthcare workers,
especially those who work in hospitals, should be vaccinated. Because
A young child with mumps.
(Photo Researchers, Inc.)
still prevalent throughout the world, susceptible persons over the age of
one year who are traveling abroad would benefit from receiving the mumps
The mumps vaccine is extremely effective, and virtually everyone should be
vaccinated against this disease. There are, however, a few reasons why
people should not be vaccinated against mumps:
—Persons who carry a disease and are usually capable of
transmitting the disease but who do not exhibit symptoms of the disease
are said to be asymptomatic.
—A developmental disability that appears early in life, in which
normal brain development is disrupted and social and communication
skills are retarded, sometimes severely.
—Inflammation of the brain, usually caused by a virus. The
inflammation may interfere with normal brain function and may cause
seizures, sleepiness, confusion, personality changes, weakness in one or
more parts of the body, and even coma.
—The medical name for mumps.
Immunoglobulin G (IgG)
—Immunoglobulin type gamma, the most common type found in the
blood and tissue fluids.
—An infection or inflammation of the membranes that cover the
brain and spinal cord. It is usually caused by bacteria or a virus.
—Inflammation of one or both testes, accompanied by swelling,
pain, fever, and a sensation of heaviness in the affected area.
—A genus of viruses that includes the causative agent of mumps.
—Inflammation and swelling of one or both of the parotid salivary
In the fall of 2002, the
New England Journal of Medicine
published a major Danish study disproving the hypothesis of a connection
between the MMR vaccine
and autism. A second study in Finland showed that the vaccine is also not
associated with aseptic meningitis or encephalitis. Since these studies
were published, U.S. primary care physicians have once again reminded
parents of the importance of immunizing their children against mumps and
other childhood diseases.
Gutierrez, Kathleen A. "Mumps Virus." In
Practice of Pediatric Infectious Diseases
, 2nd ed. Edited by Sarah S. Long et al. St. Louis, MO: Elsevier, 2003.
Maldonado, Yvonne A. "Mumps." In
Nelson Textbook of Pediatrics.
Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2004.