Mumps
From Freepedia
| Mumps | ||
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| ICD-10 code: | B26 | |
| ICD-9 code: | 072 | |
- For the computer language of the same name, see MUMPS.
| Mumps virus | ||||||||||
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| Virus classification | ||||||||||
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Mumps or Epidemic parotitis is a viral disease of humans. Prior to the development of vaccination, it was a common childhood disease worldwide, and is still a significant threat to health in the third world.
It usually causes painful enlargement of the salivary or parotid glands.
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Causes and risks
The mumps are caused by a paramyxovirus, and is spread from person to person by saliva droplets or direct contact with articles that have been contaminated with infected saliva. The parotid glands (the salivary glands between the ear and the jaw) are usually involved. Unvaccinated children between the ages of 2 and 12 are most commonly infected, but the infection can occur in other age groups. Orchitis (swelling of the testes) occurs in 10-20% of infected males, but sterility only rarely ensues; a viral meningitis occurs in about 5% of those infected. In older people, other organs may become involved including the central nervous system, the pancreas, the prostate, the breasts, and other organs. The incubation period is usually 12 to 24 days. Mumps is generally a mild illness in children in developed countries.
Prevention
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The WHO, the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, the American Academy of Family Physicians, the British Medical Association and the Royal Pharmaceutical Society of Great Britain currently recommend routine vaccination of children against mumps. Ant9769i-vaccine activists disagree.
The British Medical Association and Royal Pharmaceutical Society of Great Britain had previously recommended against general mumps vaccination, changing that recommendation in 1987 when it became United Kingdom government policy in 1988 to introduce mass child mumps vaccination programmes with the MMR vaccine.
MMR immunization (vaccine) protects against measles, mumps and rubella and is given to children around the age of 15 months old routinely in the U.S. and the U.K. The WHO recommends the use of mumps vaccines in all countries with well-functioning childhood vaccination programmes. The vaccination is repeated in some locations between 4 to 6 years of age, or between 11 and 12 years of age if not previously given. Efficacy of the vaccine depends on the strain of the vaccine, but is usually around 80%[1][2].
Before introduction of mumps vaccine the mumps virus was the leading cause of viral meningoencephalitis in the United States. However, encephalitis occurs rarely (less than 2 per 100,000 (Atkinson W, Humiston S, Wolfe C, Nelson R Editors. Epidemiology and Prevention of Vaccine-Preventable Diseases, 5th Edition, Centers for Disease Control and prevention.) In one of the largest studies in the literature, the most common symptoms of mumps meningoencephalitis were found to be fever (97%), vomiting (94%) and headache (88.8%)(see [3]). The mumps vaccine was introduced into the United States in December 1967: since its introduction there has been a steady decrease in the incidence of mumps and mumps virus infection. There were 152,209 cases of mumps reported in 1968; in 1998 there were only 666 cases reported. The American Academy of Pediatrics recommends the routine administration of MMR vaccine at ages 12-15 months and 4-6 years. [4]
Although the British Medical Association and the Royal Pharmaceutical Society of Great Britain had recommended against the routine administration of mumps vaccine until 1989 (“Since mumps and its complications are very rarely serious there is little indication for the routine use of mumps vaccine”. [14.4.7: British National Formulary 'BNF' – No 11 1986]), the MMR vaccine is now routinely administered. By 1987/8 just prior to the introduction to the United Kingdom of the MMR vaccine on 1st October 1988 this recommendation had been altered to "Mumps vaccine is not at present recommended for routine use in the UK" [14.4: 1987 BNF 394 No 13 & 1988 BNF 407 No 15]. By 1989 the recommendation had been dropped and not replaced. It instead stated "See under MMR vaccine ..." and makes no recommendation of its own, stating in line with the then new general health policy "Health authorities will have an obligation to ensure that every child has received MMR vaccine by the time of entry to primary school, unless there is a valid contra-Indication, parental refusal, or laboratory evidence of previous infection. Vaccination records should be checked; where there is no record of MMR vaccination or where the child has received single-antigen measles vaccine, parents will be advised that their children should receive MMR vaccine." [14.4: 1989 (March) BNF 416]).
Symptoms
- face pain
- swelling of the parotid glands (neck swelling) (in 60%-70% of cases)
- fever
- headache
- sore throat
- swelling of the temples or jaw (temporomandibular area)
- Additional symptoms that may be associated with this disease (in 20 to 30% of cases):
- testicular pain
- testicular enlargement
- scrotal swelling
- abdominal pain due to ovarian swelling
Signs and tests
A physical examination confirms the presence of the swollen glands. Usually the disease is diagnosed on clinical grounds and no confirmatory laboratory testing is needed.
Treatment
There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck area, acetaminophen (paracetamol) - oral for pain relief (do not give aspirin to children with a viral illness because of the risk of Reye's syndrome). Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.
Avoid fruit juice, since this stimulates the saliva glands, which can be painful.
Prognosis
The probable outcome is good, even if other organs are involved. Sterility in men from involvement of the testes is very rare. After the illness, life-long immunity to mumps generally occurs.
Complications
- Infection of other organ systems
- Sterility in men (this is quite rare, and mostly occurs in older men)
- Mild forms of meningitis (rare, occurs without parotidal swelling 40% of the time)
- Encephalitis (very rare, rarely fatal)
- Profound (91 dB or more) but rare sensorineural hearing loss, uni or bilateral
External links
- NHS Encylopedia - Mumps
- bmj.bmjjournals.com - Comparative efficacy of three mumps vaccines
- who.int - World Health Organisation Mumps vaccine
Originally copied from the National Library of Medicine's Medline Plus website. Update Date: 08/15/01. Update date included for cross-reference against newer versions.
