Saturday, August 23, 2014

Definition

Mumps is an acute viral illness characterized by swelling of the parotid glands, just below and in front of the ear, and at times, the salivary glands under the jaw.

Description

Occasional complications include meningitis (inflammation of membranes around the brain) and pancreatitis (inflammation of the pancreas), but these usually resolve with no permanent adverse effects.

Causes

Mumps occurs most often in children ages two through twelve, although unvaccinated adults are also susceptible.

People with mumps are contagious for about a week before and two weeks after the onset of symptoms, which occurs about two to three weeks after exposure to the mumps virus.

The mode of transmission is through direct contact and airborne droplets with disease beginning from 14 to 24 days after exposure.

Symptoms

The symptoms and signs of mumps are:

  • Soreness or swelling of the parotid glands on one or both sides. Discomfort may range from vague tenderness to obvious pain when opening the mouth or swallowing
  • Fever, usually lasting about two to three days
  • Sore muscles
  • Loss of appetite
  • Headache
  • Earache that is aggravated by chewing
  • In men and adolescent boys, swelling in one or both testes (often subsides within four days)
  • Aversion to light, lethargy, and a stiff neck (which may indicate meningitis)
  • Upper abdominal pain, nausea and vomiting (which may indicate pancreatitis)
  • Lower abdominal pain in women (may indicate swelling of the ovaries, which is rare)

Although uncomfortable, mumps is usually harmless and symptoms normally subside within ten days. Many children with mumps have no symptoms.

Diagnosis

Serologic antibody testing can verify the diagnosis when parotid or other salivary gland enlargement is absent. If comparison between a blood specimen obtained during the acute phase of the illness and another specimen obtained three weeks later shows a fourfold rise in antibody titer, the patient most likely has mumps.

Treatment

Treatment includes analgesics for pain, antipyretics for fever, and adequate fluid intake to prevent dehydration from fever and anorexia. If the patient cannot swallow, I.V. fluid replacement may be used.

Acetaminophen or ibuprofen are commonly used to reduce fever and relieve discomfort. Bed rest is advised for the duration of the fever. Ice packs or heating pads may ease the pain of swollen glands.

For males with orchitis, doctors may prescribe stronger pain medication as well as corticosteroids to reduce inflammation.

Questions

Can you make a definitive diagnosis of mumps?

How serious is it?

Will you prescribe pain medications?

Is bed rest advised?

What can be done to reduce the fever?

Prevention

For prevention, the MMR (measles, mumps, rubella) vaccine should be given to children.

There is no effective post-exposure treatment.