Mumps is a contagious disease marked by painful swelling of the salivary glands. It is caused by a virus that attacks glandular and nervous tissue hi particular. Mumps chiefly affects children from five to ten years of age, and approximately 85% of all infections are acquired by persons under 15 years of age. However, all ages are susceptible, males and females equally. Mumps occurs in all geographical areas. In the temperate zone, there is a concentration of cases in the winter and spring months.
A patient with mumps is usually contagious from several days before the onset of symptoms to the subsidence of salivary-gland swelling, approximately seven to ten days later. Signs of infection usually develop after an incubation period of 16 to 18 days. Approximately 30% to 40% of all exposed susceptible individuals acquire the disease in an inapparent form with no signs or symptoms of illness. The remaining 60% to 70% develop a disease of variable severity with symptoms that are dependent on the sites of infection.
Symptoms and Effects of Mumps
In most cases, the mumps virus attacks the parotid, submaxillary, and sub-lingual salivary glands. The illness begins with fever, pain in front of the ear aggravated by chewing, and swelling of one or both parotid glands. In most cases, the symptoms of salivary-gland involvement subside without complication after a period of one to six days, depending on the severity of the infection.
Other relatively common signs of mumps are inflammation of the testes (orchitis) in the male past puberty and inflammation of the brain and spinal cord (meningoencephalitis). Orchitis is the second most common manifestation of mumps infection in the male, occurring unilaterally in 20% to 30% of males who develop the disease after puberty. Involvement of the testes is very rarely seen in boys before puberty. The common belief that mumps orchitis causes sterility has no factual basis. Mumps meningitis has been estimated to occur in about 10% of all cases. The symptoms are similar to those of nonparalytic poliomyelitis- fever, headache, vomiting, and stiff neck. In most cases, recovery is complete within a period of five to ten days. Deafness is a very rare but serious complication of mumps. In most cases it is unilateral and permanent.
Less common manifestations of mumps include involvement of the pancreas (pancreatitis), ovaries (oophoritis), breasts (mastitis), thyroid (thyroiditis), and other glands. These signs may occur singly or in combination and may precede, accompany, follow, or occur without salivary gland involvement.
Treatment of Mumps
Mumps is a self-limited generalized infection. Treatment is symptomatic and supportive. Aspirin usually controls the pain.
Prevention of Mumps
The high incidence of inapparent cases and the infectivity of patients before onset of illness both combine to make isolation and quarantine of mumps patients ineffective. Mumps vaccine has been shown to be only partially effective. The protective effect of this vaccine is usually temporary. Children before puberty should not be immunized. It is not rational to delay the development of mumps in childhood, when it is generally mild, to an adult age, when it is usually more severe.