Mumps
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Background

  • Mumps is a NOTIFIABLE DISEASE in the UK
  • Another viral respiratory tract infection. Caused by the mumps virus.
  • Most common in winter/spring
  • Spread by droplet infection
  • Not as infectious as measles
  • Viral replication occurs in epithelial cells of the respiratory tract, before the virus gets into the parotid glands, and then spreads to other tissues.
  • After previous infection, immunity is lifelong
  • A patient is infectious from about 2 days before clinical signs to up to 9 days afterwards. Many cases are also subclinical, and thus many asymptomatic patients are infectious.
  • Intrauterine infection can occur in pregnancy

Clinical features

The incubation period lasts between 15-24 days. In up to 30% of cases, there will be no clinical features of infection at all!
Painful swelling of the parotids (Parotitis)
  • Often unilateral initially, becoming bilateral in 70% of cases
  • May present as ear ache, or pain on eating and drinking
  • The parotid duct may appear swollen and red on examination
Child with parotid swelling due to mumps
Child with parotid swelling due to mumps

Fever – usually lasts 3-4 days
Malaise
Orchitis – can be present in boys. It is uncommon before puberty, and is usually unilateral. It can sometimes reduce sperm count, but infertility is extremely rare.

  • Symptoms are generally less severe in young children, and worse in older children and adults
The patient is infective for up to 7 days after the appearance of parotid swelling. Children should be kept off school for a minimum of 7 days after the appearance of swelling

Investigations

Raised plasma amylase – due to pancreatic involvement. May also be associated abdominal pain.

Complications

Hearing lossrelatively common, but usually self- limiting – typically presents several days after the clinical features have resolved
Meningitisa CSF picture compatible with meningitis is seen in about 50% of cases. However:
  • Only 10% of cases have meningeal symptoms.

Encephalitisseen in 1 in 5000
Orchitis – can cause infertility
Pancreatitis

Treatment

Again, specific treatment is rare, and usually just supportive. The disease is usually self limiting. Anti-virals may be useful in some cases of immunodeficiency.

 

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) currently works as a GP Registrar and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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