Mumps

Infectious agent: Mumps virus

Transmission:
- Mumps is spread through airborne droplets, when an infected person coughs or sneezes close to a non-immune person.
- Sharing saliva with an infected person can also spread the virus.
Incubation period:
- 12-25 days (average 17 days).
Infectious period:
- most infectious from 2 days before to 5 days after the onset of parotitis
- may be infectious for up to 7 days before to 9 days after the onset of parotitis
- virus detectable in the urine for up to 14 days after the onset of parotitis.
- Asymptomatic cases can also be infectious.
Case exclusion:
- Cases should stay away from work, school, group gatherings and contact with anyone who may not be immune, until 5 days after the onset of parotitis/swelling.
Differential Diagnosis
- Adenitis
- Allergic reactions
- Drug reactions
- Encephalitis
- Mastoiditis
- Measles
- Myocarditis
- Orchitis
- Pediatric HIV infection
- Pediatric Meningitis
- Pediatric rubella

Symptoms and Signs
- nonspecific symptoms such as fever, malaise, headache, myalgias, and anorexia
- shortly followed by parotitis
- Mumps parotitis
  - most common manifestation
  - occurring in over 70% of infections
  - Parotid swelling is usually bilateral, but unilateral swelling can occur
  - may involve the submaxillary and submandibular glands
  - Glandular inflammation most often presents but then subsides within one week
  - Recurrent sialadenitis is a frequent complication of parotitis.
- Mumps during pregnancy
  - lead to premature birth/low birth weight/fetal malformation
- Orchitis
  - next most common manifestation of mumps
  - painful swelling, enlargement, and tenderness of the testes which is most often bilateral.
  - Testicular atrophy develops in one half of those affected.
  - Sterility and subfertility after mumps infection is rare and occurs in less than 15% of cases.
- Oophoritis
  - rare amongst infected females with less than 5% developing infertility or pre-menopause
- Neurological manifestations
  - meningitis
  - encephalitis
  - transverse myelitis
  - Guillan-Bare syndrome
  - cerebellar ataxia
  - facial palsy
  - Neurological complications are typically self-resolving, and there is a low incidence of morbidity and mortality
- systemic rare complications
  - pancreatitis, myocarditis, thyroiditis, nephritis, hepatic disease, arthritis, keratitis, and thrombocytopenic purpura

Prognosis
- The prognosis for a patient with mumps is excellent.
- Even after aseptic meningitis, recovery is usually complete. Deafness can occur after mumps but is also rare.
- Mumps during pregnancy can increase the risk for fetal loss, spontaneous labor and fetal death