What is Mumps?
Mumps is a contagious viral infection caused by the Mumps virus, an RNA virus. The virus is primarily transmitted through inhaling airborne droplets from an infected person. The incubation period for mumps is typically 2-4 weeks.
Pathogenesis
Once the virus enters the body, it replicates in the nasopharynx before spreading to regional lymph nodes. From there, the virus enters the bloodstream, leading to viremia. The virus then targets various tissues in the body, including the salivary glands, pancreas, testes, ovaries, thyroid, meninges, heart, liver, kidneys, and joints.
Signs and Symptoms
The clinical features of mumps typically begin with a prodromal stage lasting 1-2 days. This stage is characterized by symptoms such as
- anorexia,
- fever,
- myalgia,
- malaise,
- headache,
- vomiting,
- sore throat, and earache on chewing and swallowing.
At the end of the prodromal stage, the parotid gland usually has
- painful swelling, starting as unilateral but later becoming bilateral in about two-thirds of cases.
Complications
The complications of mumps can include.
- Orchitis or epididymo-orchitis in males
- Oophoritis in females
- Aseptic meningitis or meningoencephalitis
- Myocarditis
- Transient myelitis
- Polyneuritis
- Hearing loss
- Pancreatitis
- Carditis
- Thyroiditis
- Arthralgia, arthritis, and nephritis.
How to diagnose?
Mumps are diagnosed based on clinical, a history of contact with an affected patient and characteristic clinical features. Investigations such as
- complete blood counts (CBC) and peripheral blood film (PBF) are nonspecific.
- Serum amylase levels may be elevated in both mumps parotitis and pancreatitis, while serum lipase levels are elevated only in pancreatitis.
Treatment
- Primarily supportive and includes counselling parents about the disease and its complications.
- Usual diet with plenty of fluids.
- Prescribing paracetamol for fever and pain.
- Oral hygiene with warm saline mouthwash and regular tooth brushing.
- In cases of orchitis, steroids may be used to reduce pain and oedema.
Prevention
It is possible through vaccination with the MMR vaccine, which is administered in two doses:
- The first dose at 12-15 months of age
- The second dose at 4-6 years of age