Mumps

Mumps is a viral disease caused by the mumps virus. Initial signs and symptoms often include fever, muscle pain, headache, poor appetite, and feeling generally unwell. This is then usually followed by painful swelling of one or both parotid salivary glands.

1. Respiratory infections MUMPS Vd Rakesh Shukla Lecturer, Dept of Swasthavritta GAAC, Ahmedabad

2. Pathogenesis Mumps virus is transmitted by droplet nuceli , saliva, and fomites . Replication of virus in the epithelium of the upper respiratory tract leads to viremia , which is followed by infection of the CNS.

3. Mumps is an acute infectious disease caused by RNA virus whose most distinctive feature is swelling of 1 or both parotid glands. Involvement of other salivary glands, the meninges , the pancreas and the gonads are also common. Agent factors: Agent - M yxovirus parotiditis is a RNA virus of myxo virus family. Source of infection – both clinical and sub clinical cases. Virus can be isolated from the saliva, can be found in the blood, urine, stool and some occasions on csf . Period of communicability: 4-6 days before the onset of symptoms and a week or more there after Secondary attack: estimated to be about 86%

4. Host factors Age and sex – 5 – 9 years, the diseases tends to be more severe than in children. Immunity – one attack clinical or sub clinical is assumed to induce life long immunity. Environmental factors Largely and endemic disease, peak incidence is in winter and springs often associated with over crowding Mode of transmission Droplet infection and after direct contact with infected persons. Incubation period: 2 – 3 weeks usually 18 days.

5. Clinical features Pain and swelling at 1 or both the parotid glands but may also involve the sublingual and sub mandibular glands. Often the child complains of ear ache on the affected side prior to the onset of swelling. There may be pain and stiffness on opening the mouth before the swelling of gland is evident. Mumps may also infect the testis, pancreas, CNS< ovaries, prostrate, etc. in severe cases there may be fever, headache and other constitutional symptoms which may last from 3-5 days. The swelling subsides slowly over 1-2 weeks.

6. Parotid and Submandibular glands enlarged in a child with Mumps

7. Prevention Live attenuated vaccine is available to prevent Mumps. In India Mumps vaccine is combined with Measles and Rubella (MMR = Mumps, Measles and Rubella ) IAP recommends MMR at 9 months of age (measles containing vaccine ideally should not be administered before completing 270 days or 9 months of age), second dose at 15-18 months and third dose at 4-6 years of age .

8. Prevention of transmission  - Patients diagnosed with mumps should stay away with others for at least 5 days from the onset of symptoms. Encourage the patient for good hand washing practices. Encourage the patient to cover mouth and nose during coughing and sneezing with tissue, (put used tissue in the trash can) and if tissue is not available cover with upper sleeve or elbow, not the hands. Drinks and eating utensils of patient should not be shared by others. Frequently touched surfaces, such as toys, doorknobs, tables, counters should be kept clean.

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