What is mumps?
Mumps is a contagious viral infection that is passed through nasal secretions, saliva, and other forms of personal contact with an infected person.
The parotid glands are primarily affected by the virus. These glands, which are also a known as the salivary glands as they are responsible for the production of saliva, are three sets of glands located on either side of the face. They are found below and slightly behind the ears. The token symptom of mumps is the inflammation of these parotid glands. Both sides of the face or only one side can become infected and swollen.
Mumps was once a common condition affecting people worldwide. However, since the introduction of the mumps vaccine in 1967, which was later combined with and now forms part of the MMR (measles, mumps and rubella) and MMRV (measles, mumps, rubella, and varicella/chickenpox) vaccines administered today, the number of infections have significantly dropped. Getting vaccinated helps stop the spread of the disease. It was once thought that this vaccine resulted in children developing autism, however, this has since been proven as falsified research and parents and children alike are encouraged to get the vaccine.
The complications of mumps are rare but they can be serious as they can result in the loss of hearing, meningitis which affects the brain, amongst other severe conditions. The treatment for mumps is not specified as the condition can often naturally resolve on its own in a period of 10 days. The swelling of the parotid glands often results in a large amount of pain experienced between the jaw and ears of the patient. In some cases, patients do not experience swelling and may feel as though they have a bad flu or cold. Regardless, in all situations, it is advised that the patient consults with their doctor should they feel as though their symptoms resemble those of mumps.
In the article that follows we will explore what one needs to know about mumps, the causes, symptoms, diagnosis and treatment in order to gain a thorough understanding of the condition and how to deal with it.
What are the symptoms of mumps?
The symptoms of mumps can range from mild to severe. Different people experience the condition in different ways. When the symptoms and signs develop, they tend to appear roughly between two and three weeks’ post exposure.
Symptoms typically include:
- Fatigue and weakness
- Painful swallowing or chewing
- Painful and swollen salivary glands (behind and below the ears) – can be on one or both sides of the face
- Loss of appetite
As stated, the primary and hallmark symptom of mumps is the swelling of the parotid glands, this is known as parotitis. Parotitis results in the cheeks looking ‘puffy’ and swollen. In actual fact, the word mumps was once used an expression for bumps or lumps in the cheeks.
When to see a doctor
It is advised that you immediately consult with your doctor should you suspect that you or your child has mumps. It is best to phone your doctor beforehand so as to ensure that you see him or her right away and not wait in the waiting room and risk possibly infecting others.
Due to the vaccine for mumps being introduced and implemented for a number of years now, mumps is seen as an illness that is uncommon. With this in mind, it may be possible that similar symptoms and signs are the results of another condition.
Salivary glands that are swollen as well as a fever may well be caused by inflamed tonsils and therefore the cause of the symptoms may be tonsillitis. There are a number of different illnesses that may also result in inflamed glands, therefore, it is advised that you seek medical attention so as to ensure an accurate diagnosis.
What causes mumps?
As previously mentioned, mumps is a virus, therefore the cause of the condition is the mumps virus. It is very contagious and spreads easily via infected saliva. The virus is contracted through breathing in the infected saliva when an infected person sneezes or coughs. It can also be contracted through sharing a glass or other utensils with an infected person.
What are the complications of mumps?
The complications from mumps are rare but can be potentially serious. The following complications listed have been known to arise in certain cases of mumps.
Inflammation of the:
- Testicles – When one or both of the testicles become inflamed, this is known as orchitis. It is a very painful condition, however, it is unlikely to lead to sterility, although sterility can be a result in extremely rare cases. Orchitis is often caused by mumps, however, it can be managed through the use of cold packs being placed on the testicles over the course of the day. The doctor may also recommend that painkillers are prescribed if necessary.
- Pancreas – Upper abdominal pain, nausea and vomiting is known as pancreatitis – the swelling of the pancreas which is the organ located in the abdominal cavity. If this condition is induced by mumps, it is normally a temporary condition.
- Breasts and ovaries – Females who are yet to reach puberty may suffer from inflammation of the breasts, which is known as mastitis, or inflammation of the ovaries, known as oophoritis. The inflammation can sometimes be a painful experience, however, these conditions do not cause harm to the breasts or ovaries. The issue comes in when a woman is pregnant which may result in a higher chance of suffering from a miscarriage – however, there is still a large amount of speculation around mumps leading to miscarriages and the theory is yet to be proven.
- Brain – Being a viral infection, mumps can result in the inflammation of the brain which can lead to a number of neurological issues which may, in turn, be life-threatening. Two of these potentially fatal conditions are encephalitis or meningitis. Encephalitis is a condition resulting in the inflammation of the brain itself. Meningitis is the swelling of the fluid and membranes around the spinal cord and brain and occurs when mumps spreads through the blood stream and infects the central nervous system – it is an inflammation of the meninges, which is a collective word for the membranes that surround the brain and central nervous system (spinal cord). These three membranes are known as the arachnoid mater, pia mater and the dura mater.
In the case of mumps, meningitis develops when the virus spreads to the membranes surrounding the brain and spinal cord, infecting and inflaming them. Meningitis can result in a fever, vomiting, feeling confused and drowsy, severe headaches and a stiff neck, as well as a number of other symptoms.
Other rare complications
- Hearing loss – In some rare cases, hearing loss can be caused by mumps. In roughly five in every 10,000 cases, mumps can result in the permanent loss of one’s hearing. This is due to the virus damaging the structure of the inner ear (known as the cochlea) that is responsible for facilitating hearing.
How is mumps diagnosed?
Mumps is typically diagnosed according to the symptoms and the patient’s history of exposure to the virus. A blood test can also be conducted in order to rule out any other conditions and confirm mumps as the diagnosis.
A blood test for mumps does this by detecting the antibodies present in the immune system that are fighting off the infection. Different antibodies are created by the immune system for different conditions.
Mumps can also be diagnosed through the use of a viral culture test which uses a sample of saliva, urine or cerebrospinal fluid to test for the virus. However, viral culture tests are rarely conducted.
What is the treatment for mumps?
Due to mumps being a virus, the condition will not respond to antibiotics. Because of this, treatment follows a plan of medicating symptoms until the patient is not contagious. Rest and time are often the best treatments and little can be done by a doctor to help speed up the recovery. Certain steps can be taken to aid in easing the discomfort and pain and stop others from being infected.
The following are a number of steps that can be taken:
- Resting in bed until your fever comes down.
- Isolating yourself in order to prevent the disease spreading. If you have mumps you can be contagious for up to one week after the initial onset of the symptoms. The time it will take for the symptoms to show after you are infected can be between 12 and 25 days. This means that you or your child should stay home for at least five days after mumps has been diagnosed.
- Taking over-the-counter pain killers such as acetaminophen or anti-inflammatory medications such as ibuprofen in order to ease the swelling. Caution should be taken when giving aspirin and other pain killers to children who have viral infections as this has been linked with the development of Reye’s syndrome. This is a serious, but rare condition which results in liver damage and swelling in the brain. Children who are in the recovery period from a viral infection or the flu and are taking aspirin, are often the most at risk.
- Using a warm or cold compress on the glands to help ease the swelling.
- Wearing an athletic supporter for tender testicles to help ease the pain.
- Avoiding foods that require large amounts of chewing and jaw movement. Instead, eat soups or soft foods such as oatmeal or mashed potatoes in order to ensure you are still receiving the nourishment needed for your body’s recovery.
- Avoiding sour food and drinks that can stimulate the production of saliva such as citrus juices or fruits.
- Drinking plenty of fluids in order to stay hydrated.
How is mumps prevented?
Mumps is prevented through the MMR vaccine. People are considered immune if they have previously been infected as they cannot become infected for a second time or if they have had the vaccine and are therefore immunised against mumps.
The MMR vaccine, also known as the Measles, Mumps and Rubella vaccine, is recommended for children before they start school. The following is a list of criteria for the administration of the vaccine:
- Being between the ages of 12 and 15 months old – this is when the first dose of the vaccine is given.
- Being between the ages of four and six years old, or between the ages of 11 and 12 – this is when the second dose of the vaccine is given.
- You are an adult and have not had the vaccine or your antibody titer test shows that your levels of immunity to measles, mumps or Rubella is low. An antibody titer test detects the presence and quantity of antibodies in the blood.
Patients who do not need or should not get the MMR vaccine
The vaccine does not need to be administered if:
- The patient has had two doses of the vaccine after the age of 12 months old or if they have had one dose of the MMR vaccine and a second dose administered of the measles vaccine.
- The patient has had one dose of the MMR vaccine and is not at high risk of exposure to measles or mumps.
- The patient has had blood tests that illustrate their immunity to mumps, measles as well as rubella.
- The patient is a man who was born before the year 1957 (those born before this year are thought likely to have already been exposed to measles or mumps in childhood, however, this is not a hard and fast rule).
- The patient is a woman and was born before the year 1957 and doesn’t plan to conceive any more children – this recommendation is due to the fact that an inactive form of the measles virus was used in a vaccine that was administered between 1963 and 1967 and may no longer be effective.
- The patient is pregnant or plans on falling pregnant in the next couple of weeks.
- The patient has a life-threatening reaction to the antibiotics neomycin or gelatine.
- The patient has an immune system that is severely compromised or is taking oral steroids. However, in some cases, immunisation against the virus can outweigh the risks and your doctor will be able to advise you on the best course of action.
Patients who should get the MMR vaccine
If the patient does not fall into the criteria above, the patient can get vaccinated if they:
- Are not pregnant or do not plan on falling pregnant
- Attend trade school, college or postsecondary school institutions as one has a higher risk of infection in highly populated environments.
- Work in a medical facility, school, child-care centre or hospital
- Plan on travelling overseas or going on a cruise
Patients who should wait to get the MMR vaccine
Patients should consider delaying the vaccine if:
- They are severely or moderately ill - It is advised that one wait until fully recovered.
- They are planning to fall pregnant - It is generally advised by manufacturers of the MMR vaccine that pregnancy be postponed for 3 months after receiving it, while the Advisory Committee on Immunisation Practices (ACIP) recommends waiting for 4 weeks after vaccination before trying to fall pregnant). The MMR vaccine has been linked to birth-defects and can impact the health of the foetus.
- They are pregnant - It is important to wait until giving birth and possibly until breastfeeding is finished so as not to compromise the pregnancy or the health of the newborn infant.
Patients who should check with their doctors
Patients should check with their doctor before being vaccinated with the MMR vaccine for mumps if they:
- Currently have cancer
- Have a blood condition or disorder
- Have a disease that impacts the immune system, such as HIV and AIDS.
- Are being treated with drugs that impact the immune system such as steroids.
- Have received another vaccine for a different condition in the last four weeks.
Side effects of the MMR vaccine
A patient cannot contract mumps from the MMR vaccine and the majority of people who are given the vaccine, do not experience any side effects. Some people may experience a mild rash or a fever and some adults may also suffer from achy joints after the administration of the vaccine.
Concerns have been raised in the past regarding the link between the MMR vaccine and autism. Some people believed that the vaccine could lead to the development of autism in children. However, extensive research has been conducted to prove this theory wrong and this research concluded that there is no scientifically proven evidence to back the theory of the link between autism and the MMR vaccine.