However, starting in there has been an increase in mumps cases with several peak years. From year to year, the number of mumps cases can range from roughly a couple hundred to a several thousand, with majority of cases and outbreaks occurring among people who are fully vaccinated and in close-contact or congregate settings.
The mumps virus replicates in the upper respiratory tract and is transmitted person to person through direct contact with saliva or respiratory droplets of a person infected with mumps. The risk of spreading the virus increases the longer and the closer the contact a person has with someone who has mumps. The infectious period is considered from 2 days before to 5 days after parotitis onset, although virus has been isolated from saliva as early as 7 days prior to and up to 9 days after parotitis onset.
Mumps virus has also been isolated up to 14 days in urine and semen. When a person is ill with mumps, they should avoid contact with others from the time of diagnosis until 5 days after the onset of parotitis by staying home from work or school and staying in a separate room if possible. Mumps complications include orchitis, oophoritis, mastitis, meningitis, encephalitis, pancreatitis, and hearing loss.
Complications can occur in the absence of parotitis and occur less frequently in vaccinated patients. Some complications of mumps are known to occur more frequently among adults than children. Mumps orchitis has not been linked to infertility, but may result in testicular atrophy and hypofertility. However, these complications may be more difficult to recognize and are likely underreported.
Cases of nephritis and myocarditis and other sequelae, including paralysis, seizures, cranial nerve palsies, and hydrocephalus, in mumps patients have been reported but are very rare. Death from mumps is exceedingly rare. There have been no mumps-related deaths reported in the United States during recent mumps outbreaks. Mumps that occurs in pregnant women is generally benign and not more severe than in women who are not pregnant.
Like other infections, there is a theoretical risk that mumps during the early months of pregnancy may cause complications. Most studies on the effects of gestational mumps on the fetus were conducted in the s—60s when the disease was more common before mumps vaccine was available. One study from reported an association between mumps infection during the first trimester of pregnancy and an increase in the rate of spontaneous abortion or intrauterine fetal death 1 , but this result has not been observed in other studies 2.
One study of low birth weight in relation to mumps during pregnancy found no significant association 1. While there are case reports of congenital malformations in infants born to mothers who had mumps during pregnancy, the only prospective, controlled study found rates of malformations were similar between mothers who had mumps and those who did not have mumps during pregnancy 3.
Learn more about preventing infections during pregnancy. People who previously had one or two doses of MMR vaccine can still get mumps and transmit the disease. During mumps outbreaks in highly vaccinated communities, the proportion of cases that occur among people who have been vaccinated may be high. Mumps is caused by the mumps virus, which belongs to a family of viruses known as paramyxoviruses.
These viruses are a common source of infection, particularly in children. When you get mumps, the virus moves from your respiratory tract your nose, mouth and throat into your parotid glands saliva-producing glands found either side of your face , where it begins to reproduce. This causes the glands to swell.
Most of their gene sequence is conserved though, making the discriminatory differences less noticeable. Both the F and HN proteins within the mumps genome have been identified as the primary virulence factors.
Antibodies that target the F and HN proteins have provided definitive evidence of the neutralization of the infectivity of the virus in vitro and provide protection in vivo. Most people that become infected with mumps fully recover. Although some people are asymptomatic there are general symptoms associated with mumps that usually develop within two weeks of infection.
Normally the mumps virus causes fever, headache, muscle aches, malaise, loss of appetite, and swollen salivary glands. Complications from mumps usually occur in people past puberty. Inflammation of the brain, encephalitis, and inflammation of the tissue covering the brain and spinal cord, or meningitis, can develop as well.
Encephalitis is due to a primary infection of the neurons, or is caused by post-infection encephalitis with demyelination [4] , [7].
Also, temporary or permanent hearing loss can result because of a vestibular reaction. In rare cases pancreatitis will manifest, but the patient often recovers within a week. Symptoms of pancreatitis include, abdominal pain, fever, nausea, and possibly vomiting [10].
The symptom most often associated with mumps is the swelling of the parotid gland that takes place over several days, otherwise known as parotitis [4]. Mumps has become an uncommon illness and is sometimes misdiagnosed with a high fever and swollen salivary glands that are actually indicative of tonsillitis [3].
If mumps occurs during pregnancy there is an increased risk of miscarriage, especially in the first weeks. More mild symptoms that can accompany a case of mumps would be ear pain while chewing, a sour taste in the mouth while swallowing, joint ache, and mild nausea [11]. Mumps can be diagnosed upon physical examination, especially if the patient has developed swollen glands. Laboratory test are often used to confirm and specify the viral strain of the diagnosis.
In the laboratory, several tests can be used to identify the mumps virus. However, it is often difficult to use laboratories to confirm a mumps case in vaccinated individuals or repeat cases. In a case of mumps involving parotitis or pancreatitis, serum amylase levels are elevated. In the blood system, white blood cell levels can fluctuate, reflecting lymphocytosis.
Elevated C-reactive protein or erythrocyte sedimentation rate ESR act as sera inflammatory markers that indicate a nonspecific systemic inflammatory response.
In a general case of the mumps, viral particles can be detected in the urine in the first two weeks of sickness. Isolation of the mumps virus can also come from fluid from the oral cavity, nasopharyngeal swabs, and blood from seven days before and up to nine days after the onset of parotitis. In a cell culture the virus can be isolated from spinal fluid, urine or throat fluid. In a case of mumps infection, diagnosis can be confirmed illustrating an increase in mumps-specific immunoglobulin G IgG antibodies.
Processes used to detect IgG antibodies include, complement fixation, hemagglutinin inhibition, or enzyme immuno assay. The detection of IgM antibodies is a strong indicator of presence of the mumps virus as well. In some cases, interpretation of the mumps virus could cross-react with other parainfluenza viruses.
Mumps cases involving meningitis or encephalitis often use computed tomography CT scanning to provide a more concise diagnosis [4] , [7]. Mumps is a self-limiting disease, therefore it will be resolved if proper medical care is taken in cases without complications.
Current research shows that patients with mumps should be isolated for five days after the initiation of symptoms. For physical relief in mild to normal cases, increased fluid intake will allow the patient to stay hydrated with a fever [10].
Foods and liquids with high acidity are not recommended because they could be difficult to ingest and cause gastric irritation. Ibuprofen is prescribed to relieve pain from headaches and tenderness from parotitis.
Repeated applications of warm or cold packs to swollen areas will help relieve additional discomfort. Hospital management is used to treat the more serious complications in association with mumps. Most of the time, complications are not life threatening, and with proper treatment can be resolved [4]. If a person has previously been infected with mumps or received the vaccine, they are considered immune. In an effective vaccine was developed.
Currently, this vaccine is delivered in combination with a vaccination against measles and rubella; known as the MMR inoculation.
The mumps-measles-rubella-varicella vaccine is also administered, but poses a slightly higher risk of febrile seizures in children of months than the MMR and varicella vaccines. For the most effective results, two doses of the vaccine are recommended. The first should be delivered between the ages of 12 and 15 months of age; the second should be delivered between the ages of four and six years old.
If a child was not previously vaccinated then a dose should be administered between the ages of 11 and
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