Mumps is an illness caused by the paramyxovirus, a member of the Rubella family. Mumps commonly occur in childhood. This viral infection was more prevalent in children before the introduction of the MMR (Measles, Mumps and Rubella) vaccine.
Mumps primarily replicate in the upper respiratory tract and spread through direct contact with infected saliva or respiratory droplets. The longer and closer the contact with an infected individual the greater the risk of transmission.
Physical Signs of Mumps
Mumps is characterised by tenderness and swelling of the salivary glands, particularly by the parotid glands, which are located on the sides of the face below the ears. The swelling can result in a noticeable “chipmunk cheek” appearance. Swelling and tenderness of the parotid salivary glands in mumps can occur unilateral (one-sided) or bilateral (both-sided). The swelling of the parotid gland reaches its peak within 1 to 3 days and then gradually subsides over the course of the next week.
How Long is The Infectious Period?
The infectious period refers to the period of time in which an individual is capable of transmitting an infectious disease to others. The infectious period for parotitis commonly known as mumps, is considered from 2 days before the onset of symptoms to 5 days after. However, recent studies have shown that the virus can be present in saliva up to 7 days before the onset of symptoms and up to 9 days after. This means that people with mumps should be isolated for a longer period of time to prevent transmission of the virus.
Complications of Mumps
There exist various complications associated with mumps. In adults, complications of mumps can be more common and severe compared to children. Potential complications include
Swollen Testicles
Pain and swelling of the testicles, medically known as orchitis, is a common condition affecting up to one in three males occurring in post-pubertal male patients. The onset of swelling is usually sudden and typically affects just one testicle, which may feel warm and tender. In boys and men affected by this condition, the swelling of the testicle typically begins four to eight days after the swelling of the parotid gland.
It is worth noting that almost half of males who experience mumps-related orchitis may notice a slight shrinking of their testicles, while an estimated one in ten men may experience a temporary drop in their sperm count.
Swollen Ovaries
The occurrence of swollen ovaries, medically known as oophoritis may be experienced by 1 in 15 females. This can lead to various symptoms namely, lower abdominal pain, high temperature, and nausea.
However, it is important to remember that these symptoms usually subside as the body effectively fights off the underlying mumps infection.
Viral Meningitis
Viral meningitis is a condition that can occur when the mumps virus spreads to the protective outer layer of the brain, known as the meninges. Although it is not as severe as bacterial meningitis, which is a medical emergency, it is still a serious infection and should not be taken lightly.
The symptoms of viral meningitis include sensitivity to light, headaches, and neck stiffness. These symptoms can last up to 14 days before subsiding.
Pancreatitis
About 1 in 25 cases of mumps can lead to short-term inflammation of the pancreas, known as acute pancreatitis. Symptoms include sudden pain in the centre of the belly, along with nausea, diarrhoea, loss of appetite, high temperature and belly tenderness. While mumps-related pancreatitis is generally mild, hospital admission may be necessary to support body functions until the pancreas recovers.
It is noteworthy that these complications can occur even without parotitis and are less common in vaccinated individuals.
How is Mumps Diagnosed?
The diagnosis of mumps typically involves a combination of a medical history review, physical examination and laboratory tests designed to detect the virus. While healthcare providers consider the patient’s symptoms and clinical presentation, specific tests such as saliva or urinary culture tests are required to confirm the diagnosis.
How Can Mumps Be Prevented?
The measles, mumps and rubella (MMR) vaccine is a highly effective measure to prevent mumps. Most individuals who receive the vaccine develop immunity. The vaccination schedule involves the first dose at 12 to 15 months and a second at 4 to 6 years. In some cases, a second dose may be administered earlier if 28 days have passed since the first dose. It’s important to follow recommended vaccination schedules to ensure optimal protection.
Can You Still Get Mumps Even if You Are Vaccinated?
It is true that no vaccine is 100% effective, and breakthrough cases can occur. However, vaccines like the MMR significantly reduce the severity of the disease in vaccinated individuals. In outbreaks, the attack is typically lower among those who have been vaccinated compared to those who haven’t, highlighting the overall effectiveness of the vaccine in preventing severe cases and complications. Regular vaccination remains crucial for maintaining community immunity.
Mumps and Pregnancy
Pregnant women who are concerned about mumps should rest easy knowing it is generally not more severe than in non-pregnant women. Past beliefs suggest a link between mumps and miscarriage, but there is little evidence to support this. It is recommended to take preventative measures and avoid close contact with individuals who have an active mumps infection or any contagious disease. This will ensure that both the mother and the baby are safe and healthy throughout the pregnancy.
The availability of the vaccine against mumps has likely influenced the prevalence and severity of the infection during pregnancy. It’s reassuring that the mumps infection during pregnancy hasn't been linked to an increased risk of premature delivery or birth defects.