Introduction

Mumps is a disease caused by a virus that usually spreads through saliva and can
infect many parts of the body, especially the parotid salivary glands. These glands,
which produce saliva for the mouth, are found toward the back of each cheek, in the
area between the ear and jaw. In cases of mumps, these glands typically swell and
become painful.

The disease has been recognized for several centuries, and medical historians
argue over whether the name "mumps" comes from an old word for "lump" or an
old word for "mumble."

Mumps was common until the mumps vaccine was licensed in 1967. Before the
vaccine, more than 200,000 cases occurred each year in the United States. Since
then the number of cases has dropped to fewer than 1,000 a year, and epidemics
have become fairly rare. As in the pre-vaccine era, most cases of mumps are still in
children ages 5 to 14, but the proportion of young adults who become infected has
been rising slowly over the last two decades. Mumps infections are uncommon in
kids younger than 1 year old.

After a case of mumps it is very unusual to have a second bout because one attack
of mumps almost always gives lifelong protection against another. However, other
infections can also cause swelling in the salivary glands, which might lead a parent
to mistakenly think a child has had mumps more than once.

Signs and Symptoms

Cases of mumps may start with a fever of up to 103° Fahrenheit (39.4° Celsius), as
well as a headache and loss of appetite. The well-known hallmark of mumps is
swelling and pain in the parotid glands, making the child look like a hamster with
food in its cheeks. The glands usually become increasingly swollen and painful over
a period of 1 to 3 days. The pain gets worse when the child swallows, talks, chews,
or drinks acidic juices (like orange juice).

Both the left and right parotid glands may be affected, with one side swelling a few
days before the other, or only one side may swell. In rare cases, mumps will attack
other groups of salivary glands instead of the parotids. If this happens, swelling may
be noticed under the tongue, under the jaw, or all the way down to the front of the
chest.

Mumps can lead to inflammation and swelling of the brain and other organs,
although this is not common. Encephalitis (inflammation of the brain) and
meningitis (inflammation of the lining of the brain and spinal cord) are both rare
complications of mumps. Symptoms appear in the first week after the parotid
glands begin to swell and may include: high fever, stiff neck, headache, nausea and
vomiting, drowsiness, convulsions, and other signs of brain involvement.

Mumps in adolescent and adult males may also result in the development of
orchitis, an inflammation of the testicles. Usually one testicle becomes swollen and
painful about 7 to 10 days after the parotids swell. This is accompanied by a high
fever, shaking chills, headache, nausea, vomiting, and abdominal pain that can
sometimes be mistaken for appendicitis if the right testicle is affected. After 3 to 7
days, testicular pain and swelling subside, usually at about the same time that the
fever passes. In some cases, both testicles are involved. Even with involvement of
both testicles, sterility is only a rare complication of orchitis.

Additionally, mumps may affect the pancreas or, in females, the ovaries, causing
pain and tenderness in parts of the abdomen.

In some cases, signs and symptoms are so mild that no one suspects a mumps
infection. Doctors believe that about 1 in 3 people may have a mumps infection
without symptoms

Contagiousness

The mumps virus is contagious and spreads in tiny drops of fluid from the mouth
and nose of someone who is infected. It can be passed to others through sneezing,
coughing, or even laughing. The virus can also spread to other people through
direct contact, such as picking up tissues or using drinking glasses that have been
used by the infected person.

People who have mumps are most contagious from 2 days before symptoms begin
to 6 days after they end. The virus can also spread from people who are infected
but have no symptoms.

Prevention

Mumps can be prevented by vaccination. The vaccine can be given alone or as part
of the measles-mumps-rubella (MMR) immunization, which is usually given to
children at 12 to 15 months of age. A second dose of MMR is generally given at 4 to
6 years of age. As is the case with all immunization schedules, there are important
exceptions and special circumstances.

If they haven't already received them, students who are attending colleges and
other post-high school institutions should be sure they have had two doses of the
MMR vaccine.

During a measles outbreak, your doctor may recommend additional shots of the
vaccine, if your child is 1 to 4 years old. Your doctor will have the most current
information.

Incubation

The incubation period for mumps can be 12 to 25 days, but the average is 16 to 18
days.

Duration
Children usually recover from mumps in about 10 to 12 days. It takes about 1 week
for the swelling to disappear in each parotid gland, but both glands don't usually
swell at the same time.

Treatment Plan

If you have mumps, you should be kept out of school or work for 7 - 10 days after
symptoms begin, as you are considered highly contagious during that period. You
should eat soft foods, avoid acidic foods and beverages, such as citrus or tomato
products, and take pain relievers as needed. A male with swollen testicles should
rest in bed until symptoms subside. Pain may be relieved with ice packs, or by
supporting the scrotum with cotton or gauze, or an athletic supporter. A health care
provider may perform a hearing test on young children who develop mumps, to
detect any possible loss of hearing. If the patient develops pancreatitis
(inflammation of the pancreas) with nausea and vomiting, the provider may
administer IV fluids.