Clinical Background
Mumps is an acute, generally self-limiting, contagious disease of short duration.
Epidemiology
- Prevalence - from 2001 to 2003, fewer than 300 cases in U.S.
- Since 2003 - several outbreaks involving >1,000 people
- Incidence has decreased greatly since the MMR vaccine was licensed in 1971; this vaccine protects patients against measles, mumps and rubella
- Age - highest incidence is found in 16-24 year olds
- Transmission
- Infections are transmitted by droplets spread from the upper respiratory tract
Organism
- Family - Paramyxoviridae; genus - Rubulavirus
- Mumps virus is an RNA virus
- Immunity after infection appears to be lifelong
- Silent re-infections occur infrequently
Clinical Presentation
- The incubation period for this RNA virus is 18-21 days
- 25-30% of all infections are silent
- Bilateral or unilateral parotitis is the most common clinical feature; 60-70% of infections
- Secondary involvement of testes (orchitis), ovaries (oophoritis), central nervous system (aseptic meningitis, encephalitis) and, rarely, the pancreas, peripheral nervous system, eye, inner ear and myocardium (myocarditis)
- Testicular involvement, particularly in teenagers, can lead to infertility or decreased fertility
Treatment
- Supportive
Prevention
- Preventive strategies include MMR vaccine which is 75-90% effective
- Mumps is uncommon in the U.S., secondary to current vaccination programs
- Administer vaccine to infants (12-15 months of age) with revaccination of children (between 4 and 12 years)
- Since the vaccine is a live attenuated virus, it is not recommended for patients who are:
- Significantly immunosuppressed (e.g., HIV, cancer, chronic corticosteroid therapy)
- Allergic to gelatin (component of the vaccine)
- Pregnant
See Also
