Mumps is an Acute infectious disease, highly contagious and used to be common in children (school aged) before the advent of MMR Vaccine in 1988.
Mumps is recognized by a painful swelling, located at the side of the face under the Ears (Swelling of the parotid glands), giving the patient a distinctive “hamster face” appearance; the swelling can be one side while and other organs may be involved.
Constitutional symptoms vary and may be inapparent, and include headaches, joint pains and a high temperature. Although the infection is usually not serious, mumps share symptoms with more serious types of infections such as glandular fever and tonsillitis, but it is always best to visit your GP to confirm or rule out mumps.
Mumps occurs throughout the World with an annual incidence of about 100 to1000 cases per 100,000 populations in the absence of immunization. It has an epidemic peak every 2-5 years.
Mumps is largely an endemic disease, can occur throughout the year with the peak incidence in winter and spring. Epidemics are often associated with over-crowding.
The Mumps virus is an RNA virus known as Myxovirus parotiditis, classified as genus Rubulavirus of the family paramyxoviridae. It can be isolated from the saliva or from swabs taken from the surface of the stenson’s duct (of the parotid glands). The virus is also found in blood, urine, human milk e.t.c.
MODE OF SPREAD:
Mumps is spread the same way as cold and flu. Infected droplets of saliva can be inhaled or picked up from surfaces and passed into the mouth or nose. It can also be by direct contact with an infected person.
A person with mumps is most contagious one to two days, sometimes up to Six days before the onset of symptoms, and Five days or more after the symptoms appear. It is important at this stage to prevent spreading the infection to others, particularly teenagers and young adults who have not been vaccinated.
Maximum infectivity is just before and at the onset of parotiditis. Incubation period (period from time of contact with person with the disease to manifestation of symptom) varies from two to three weeks, usually Eighteen days.
Once the swelling of the glands has subsided, the patient may be regarded as no longer infectious. Infection to members of same household (secondary attack rate) is estimated at about 86%.
WHO IS AFFECTED?
Mumps is the most common case of Parotiditis in school age children between 5 to 9 years. However, no age is exempted if there is no previous immunity. It tends to be more severe in adults than children. Most children below six months of age are immunized because of material antibodies.
Once infected with the virus, It confers a lifelong immunity.
Symptoms may be apparent or inapparent. Patients with inapparent symptoms account for 30-40% of all cases and appear to be responsible for maintaining the cycle of infection.
In the case where symptoms are apparent, they include;
1. Pain and swelling on either side of the face under the ears and may also be seen below the jaw (Sublingual and submandibular glands).
2. The child often complains of “ear ache” in the affected side prior to the onset of swelling.
3. There may be pain or stiffness on opening the mouth before the swelling of the gland is evident.
4. Organs like the testes, ovaries, central nervous system, pancreas, prostrate, may be affected.
5. There may be constitutional symptoms like fever, headaches, e.t.c which may last three to five days. The swelling normally subsides slowly over one to two weeks.
CONTROL AND TREATMENT:
There is currently no cure for Mumps. It usually run its course and should pass within two weeks. Treatment is given as symptoms evolve and these include:
- Using pain-killers as Ibuprofen or Paracetamol.
- Applying a cold compress to swollen glands to reduce pain.
The control of mumps is difficult because the disease is infectious even before diagnosis is made.
The long and variable incubation period and the occurrence of subclinical cases make control of spread difficult. Cases should be isolated till the clinical manifestations subside.
- Articles used by patients should be disinfected immediately.
- Contacts should be kept under surveillance (Continuous monitoring).
Mumps will normally subside without causing serious damage to a person’s health. Complications occur, but are not serious. They include inflammation of extra salivary gland organ.
- This is testicular swelling and tenderness
- It is the commonest extra salivary gland manifestation of mumps in adults
Unilateral (affecting one testis) in about 75 percent of cases.
- Bilateral orchitis (affecting two testes) is rare
- In about 20-40 percent of post-pubertal men, it is accompanied by fever which develops typically 7-10 days after the onset of Parotiditis.
- It is not yet a fact that orchitis lead to sterility in men.
2. Oophooritis (inflammation of the ovaries)
3. Pancreatitis (inflammation of the Pancreas)
4. Thyroditis (inflammation of the Thyroid gland)
5. Neuritis (inflammation of the Neurons)
6. Myocarditis (inflammation of the heart muscles)
7. Meningoencephalitis (inflammation of the Brain coverings)
Rare complications include;
1. Nerve deafness
5. Cerebral edema
6. Cerebella ataxis (Involves a very unsteady gait)
7. Serious neurologic manifestation and sometimes, death
8. Facial palsy
Mumps is one of the main infectious causes of sensorineural deafness affecting approximately 5 per 100,000 mumps patients.
In the first 3 months of pregnancy, mumps infection can cause spontaneous miscarriage, not necessarily congenital malformation.
Ensure your children are protected against mumps by making sure they are given the combined MMR Vaccine (Mumps, Measles and Rubella).
First dose should be given around 12-13 months of age and a second booster dose before they start school. With both doses, the vaccine provides 95% protection against mumps.
It should not be administered to pregnant women, patients receiving immune suppressing therapy or to severely ill patient.
DR. E.I. OKEREKE