Mumps: Symptoms, Treatments, Medications and Prevention
Mumps is a contagious viral infection that primarily affects the salivary glands, particularly the parotid glands, located near the ears. The infection can lead to swelling in these glands, causing discomfort and visible enlargement of the face and neck. While mumps was once a common childhood disease, widespread vaccination efforts have significantly reduced its incidence. However, outbreaks still occur, particularly in areas with low vaccination coverage or in close-contact settings such as schools, colleges, and sports teams.
What is Mumps?
The Mumps Virus
Mumps is caused by the mumps virus, a paramyxovirus that primarily targets the salivary glands, but can also affect other organs and tissues, including the pancreas, testes, and ovaries. Mumps is an RNA virus and is part of the same viral family as measles and respiratory syncytial virus (RSV).
Mumps is a highly contagious disease that spreads through respiratory droplets, such as those expelled when an infected person coughs, sneezes, or talks. It can also spread through direct contact with contaminated objects or surfaces, such as cups, utensils, or tissues.
How Mumps Spreads
The mumps virus is most commonly spread in the following ways:
- Person-to-person contact: Close contact with an infected individual can lead to transmission, especially if the person is coughing or sneezing nearby.
- Sharing personal items: Using contaminated items like utensils, towels, or cups can spread the virus.
- Respiratory droplets: The virus is airborne and can spread through inhalation of droplets released by an infected person.
- Touching contaminated surfaces: If an infected person touches a surface and someone else touches that same surface and then their face, they could become infected.
The virus incubates in the body for about 12 to 25 days, with symptoms typically appearing 16-18 days after exposure. An individual is contagious for several days before symptoms appear and can remain contagious for about five days after the onset of symptoms.
Who is at Risk of Mumps?
Although the introduction of the MMR vaccine (Measles, Mumps, and Rubella) has greatly reduced the incidence of mumps, certain populations remain at risk of contracting the virus. Understanding who is most at risk can help in identifying outbreaks and reinforcing vaccination efforts.
High-Risk Groups for Mumps
1. Unvaccinated Individuals
People who have not received the MMR vaccine or have not completed the full vaccination series are at the highest risk of contracting mumps. The vaccine is highly effective, but incomplete vaccination leaves individuals vulnerable to infection.
2. People Living in Close Contact Settings
Mumps spreads quickly in places where people are in close contact, such as schools, colleges, dormitories, military barracks, and sports teams. Outbreaks often occur in such environments due to the ease of transmission in confined spaces.
3. Adolescents and Young Adults
Before widespread vaccination, mumps was primarily a childhood disease. However, in areas with insufficient vaccination coverage, adolescents and young adults are now the most affected age group. College students and those living in group settings are particularly susceptible to outbreaks.
4. Healthcare Workers
Healthcare professionals who come into contact with infected patients are at a higher risk of contracting mumps, particularly if they have not been vaccinated or do not use proper protective measures when treating infected individuals.
5. People with Compromised Immune Systems
Individuals with weakened immune systems, such as those undergoing chemotherapy or living with conditions that suppress immune function, are at increased risk of contracting mumps and experiencing more severe complications.
6. International Travelers
Travelers to countries where mumps vaccination rates are lower or where the disease is still common are at higher risk of exposure. International travelers should ensure they are fully vaccinated before visiting high-risk areas.
7. Infants (before vaccination)
Infants who are too young to receive the MMR vaccine are at risk if they are exposed to mumps in unvaccinated communities or during outbreaks. Infants typically receive the MMR vaccine between 12-15 months of age, leaving a window of vulnerability before immunization.
Symptoms of Mumps and How It Is Diagnosed
Mumps symptoms vary in severity, with some individuals showing mild or no symptoms (asymptomatic), while others experience classic signs of the disease. The hallmark symptom is the swelling of the parotid glands, which can lead to a noticeable change in facial appearance and pain. Mumps can also cause a range of complications, particularly in adults.
Common Symptoms of Mumps
1. Swollen Salivary Glands (Parotitis)
The most recognizable symptom of mumps is the painful swelling of the parotid glands, located near the jaw and below the ears. This swelling can occur on one or both sides of the face, leading to a puffy, swollen appearance.
2. Fever
A moderate fever (typically between 101°F and 104°F) often accompanies the onset of mumps. The fever usually lasts for several days.
3. Headache
Many individuals with mumps experience headaches, which may be mild to moderate in severity and persist throughout the course of the illness.
4. Muscle Aches (Myalgia)
Muscle pain and general discomfort, known as myalgia, is a common symptom of mumps. This can affect various muscle groups, including the neck, back, and limbs.
5. Fatigue and Weakness
Mumps can cause a general feeling of fatigue and weakness, making individuals feel tired and lethargic throughout the infection.
6. Loss of Appetite
People with mumps often experience a loss of appetite, which can be exacerbated by difficulty chewing or swallowing due to swollen salivary glands.
7. Pain When Chewing or Swallowing
The swelling of the parotid glands can make chewing and swallowing painful, particularly when eating foods that require significant jaw movement.
Complications of Mumps
While most individuals recover from mumps without serious complications, the disease can lead to severe health issues, especially in adults.
1. Orchitis (Testicular Inflammation)
In males who have reached puberty, mumps can cause orchitis, or inflammation of one or both testicles. This can be extremely painful and, in rare cases, lead to infertility.
2. Oophoritis (Ovarian Inflammation)
Females may develop oophoritis, or inflammation of the ovaries, though this is less common than orchitis in males. It can cause abdominal pain and discomfort but rarely leads to fertility issues.
3. Meningitis
In rare cases, the mumps virus can infect the meninges, the membranes surrounding the brain and spinal cord, leading to viral meningitis. Symptoms include severe headache, stiff neck, sensitivity to light, and altered mental status.
4. Encephalitis
Encephalitis, or inflammation of the brain, is a rare but serious complication of mumps. It can cause seizures, confusion, and long-term neurological damage.
5. Hearing Loss
Mumps can lead to hearing loss, typically in one ear. While most hearing loss is temporary, permanent deafness in one ear is a rare but recognized complication.
How Mumps Is Diagnosed
Diagnosing mumps is typically based on a combination of clinical symptoms and laboratory tests. Healthcare providers may suspect mumps based on the presence of characteristic symptoms, such as parotid gland swelling, fever, and headache, but laboratory confirmation is often necessary to distinguish mumps from other viral infections with similar presentations.
1. Clinical Examination
A healthcare provider will begin by conducting a thorough physical examination, focusing on the patient’s symptoms, including swelling of the parotid glands, fever, and muscle aches. The patient’s vaccination history and potential exposure to individuals with mumps will also be considered.
2. Viral Culture
A viral culture involves taking a sample of saliva, throat swabs, or urine to detect the presence of the mumps virus. The sample is placed in a culture medium to see if the virus grows, confirming the infection. However, this test can take several days to yield results.
3. Polymerase Chain Reaction (PCR) Testing
PCR is a more accurate and faster diagnostic test that detects the genetic material (RNA) of the mumps virus in saliva, urine, or cerebrospinal fluid. PCR is the preferred method for diagnosing mumps due to its sensitivity and speed.
4. Blood Tests for Antibodies
A blood test can detect mumps-specific IgM antibodies, which are produced by the immune system in response to a mumps infection. The presence of IgM antibodies indicates a current or recent infection. IgG antibodies can also be measured to assess immunity or past exposure to the virus.
Treatments for Mumps
There is no specific antiviral treatment for mumps, and management focuses on relieving symptoms and preventing complications. Most cases of mumps resolve on their own within 1 to 2 weeks, but supportive care is important to ensure comfort and reduce the risk of complications.
Supportive Care for Mumps
1. Rest and Isolation
Individuals with mumps should get plenty of rest and avoid strenuous activities during the course of the illness. Isolation is essential to prevent the spread of the virus, as mumps is highly contagious. Infected individuals should remain isolated for at least 5 days after the onset of symptoms, particularly after gland swelling begins.
2. Hydration
It is important for patients to stay hydrated, especially if they are experiencing fever or difficulty swallowing. Drinking plenty of fluids, such as water, clear broths, or herbal teas, helps maintain hydration. Cold drinks or ice pops can also soothe throat discomfort.
3. Pain Relief
Over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil), can help reduce fever, muscle pain, and headaches associated with mumps. These medications should be taken as directed by a healthcare provider.
4. Cold Compresses
Applying cold compresses to the swollen salivary glands can provide relief from pain and swelling. Ice packs wrapped in a towel can be placed on the affected area for 20-minute intervals to help reduce inflammation.
5. Soft Foods
Because chewing can be painful for individuals with mumps, it is helpful to offer soft, easy-to-eat foods that require minimal jaw movement. Foods such as yogurt, soups, mashed potatoes, and smoothies are good options for patients with painful swelling of the parotid glands.
Treatment of Complications
If complications arise, such as orchitis, meningitis, or hearing loss, additional treatments may be necessary.
1. Orchitis Treatment
For males experiencing testicular inflammation (orchitis), supportive care is essential, including bed rest, scrotal support, and pain relief with acetaminophen or ibuprofen. In severe cases, corticosteroids may be prescribed to reduce inflammation.
2. Meningitis and Encephalitis
If mumps leads to viral meningitis or encephalitis, hospitalization may be required for close monitoring and supportive care. In such cases, patients may receive intravenous fluids, pain management, and, in severe cases, anticonvulsant medications if seizures occur.
3. Hearing Loss
If hearing loss occurs due to mumps, prompt evaluation by an audiologist or ear, nose, and throat specialist (ENT) is recommended. While hearing loss is often temporary, permanent damage may require further treatment or rehabilitation, such as hearing aids.
Most Common Medications for Mumps
There is no antiviral medication specifically designed to treat mumps. Instead, treatment focuses on relieving symptoms through supportive care and common over-the-counter medications.
1. Acetaminophen (Tylenol)
- Use: Acetaminophen is widely used to reduce fever and relieve pain associated with mumps, including headaches and muscle aches.
- Dosage: The recommended dosage varies depending on age and weight. It is important to follow the dosing instructions to avoid potential liver toxicity.
2. Ibuprofen (Advil, Motrin)
- Use: Ibuprofen is another over-the-counter medication used to alleviate pain and fever. It is a non-steroidal anti-inflammatory drug (NSAID) and can reduce swelling in the affected salivary glands.
- Dosage: As with acetaminophen, dosing should be carefully followed to prevent adverse effects, particularly in children.
3. Cold Compresses and Topical Pain Relief
- Use: Applying cold compresses to swollen glands can help reduce pain and discomfort. While not a medication, this is an effective non-drug method to manage the swelling and pain caused by mumps.
4. Antiemetic Medications (for Complications)
- Use: In cases where mumps leads to complications such as vomiting due to meningitis or other severe conditions, antiemetic medications may be prescribed to control nausea.
Where is Mumps Most Prevalent?
Mumps used to be a widespread childhood illness, but vaccination efforts have dramatically reduced its prevalence in many parts of the world. However, mumps remains a public health concern in areas with low vaccination rates, during outbreaks, and in certain high-risk populations.
High-Prevalence Regions
1. Countries with Low Vaccination Coverage
Mumps is more prevalent in regions where vaccination rates are low, either due to lack of access to vaccines or vaccine hesitancy. Countries with inadequate healthcare infrastructure may struggle to maintain high MMR vaccination rates, leading to sporadic outbreaks. This includes parts of Africa, Asia, and Eastern Europe.
2. Outbreaks in Developed Countries
Even in countries with relatively high vaccination coverage, such as the United States, Canada, and the United Kingdom, mumps outbreaks can still occur, particularly in communities with lower vaccination rates or in close-contact environments like college campuses and sports teams.
3. Refugee Camps and Displaced Populations
Populations living in refugee camps or areas with poor healthcare access may experience higher rates of mumps due to overcrowded living conditions and disruptions in vaccination programs. The virus can spread quickly in such environments, leading to outbreaks.
Prevention of Mumps
The most effective way to prevent mumps is through vaccination. However, additional measures, including public health campaigns and individual protective practices, play crucial roles in preventing the spread of the virus.
1. Vaccination with the MMR Vaccine
The Measles, Mumps, and Rubella (MMR) vaccine is the most important tool in preventing mumps. The vaccine is safe, highly effective, and provides long-lasting immunity against the mumps virus.
Who Should Get Vaccinated?
- Children: The MMR vaccine is typically given in two doses: the first dose between 12-15 months of age and the second dose between 4-6 years of age.
- Adults: Adults who did not receive the MMR vaccine during childhood or do not have evidence of immunity should be vaccinated, particularly if they are at risk of exposure, such as healthcare workers, college students, or international travelers.
- Outbreak Situations: In the event of a mumps outbreak, public health authorities may recommend additional vaccinations (booster doses) for individuals at high risk, even if they have already received two doses of the MMR vaccine.
Vaccine Effectiveness
The MMR vaccine is approximately 88% effective after two doses and 78% effective after one dose. While breakthrough infections (where vaccinated individuals contract mumps) can occur, the severity of the illness is typically reduced in vaccinated individuals.
2. Good Hygiene Practices
In addition to vaccination, practicing good hygiene can reduce the risk of mumps transmission, particularly during outbreaks:
Hand Washing: Regular hand washing with soap and water is essential for preventing the spread of the virus, especially after coughing, sneezing, or using the restroom.
Covering Coughs and Sneezes: Individuals should cover their mouths and noses with a tissue or the crook of their arm when coughing or sneezing to prevent the spread of respiratory droplets.
Avoiding Close Contact: During an outbreak or if someone is symptomatic, it is important to avoid close contact with others, especially people who have not been vaccinated or are immunocompromised.
3. Isolation of Infected Individuals
Individuals diagnosed with mumps should be isolated for at least 5 days after the onset of symptoms, particularly if they have swelling of the parotid glands. This isolation period helps prevent the spread of the virus to others, especially in close-contact settings like schools or workplaces.
4. Public Health Campaigns and Education
Educating the public about the importance of vaccination, the symptoms of mumps, and how to prevent its spread is crucial for controlling outbreaks. Public health campaigns can target communities with low vaccination coverage or populations at higher risk of exposure.
