Mumps (Parotitis)

Mumps– An acute, contagious viral disease characterized by unilateral or bilateral edema and enlargement of the salivary glands.

Causes and Incidence

The causative agent is the paramyxovirus, and the disease is spread by droplet or direct contact with infected saliva. It is most communicable immediately before and during the glandular swelling. Mumps is most often seen in children 5 to 15 years of age, although it may occur at any age. Adults are more likely to have a severe course of the disease. Permanent immunity occurs after infection. About 25% to 30% of cases are subclinical.

Disease Process

After a 2- to 3-week incubation period, the virus invades one or more salivary glands, causing tissue edema and infiltration of lymphocytes. Cells in the glandular ducts degenerate and produce necrotic debris, which plugs the ducts.

Symptoms

Onset begins with fever, headache, and malaise about 24 hours before swelling of the gland or glands (usually the parotid glands), either unilaterally or bilaterally. Pain is noted on chewing and swallowing. The glands remain swollen about 72 hours before receding.

Potential Complications

Occasionally, particularly in adults, other glands in the testes, ovaries, breasts, and thyroid are involved, and the disease course is often more severe. Complications include meningoencephalitis, pericarditis, deafness, arthritis, nephritis, and in rare cases sterility in men.

Diagnostic Tests

Characteristic swelling plus positive cell cultures from saliva or urine.

Treatments

Surgery
None.

Drugs
Analgesics, antipyretics; live mumps virus vaccine for active immunity.

General
Bed rest; hydration; isolation during communicability; compresses on swelling; support of scrotum with orchitis.