Mumps

Question 1

Define

Answer 1

Mumps paramyxovirus:

• Transmission by respiratory secretions
• Long incubation period (15-24 days)
• Infectious 5 days before and 5 days after the parotid swelling (should pass totally in 1-2 weeks)
• Can still get infected if they have had the vaccine but likely to be reduced clinical symptoms

Question 2

Signs and symptoms

Answer 2

Asymptomatic (in 30% of cases)

Headache, fever, malaise, parotid swelling
* earache or pain when eating/ drinking
* The fever usually subsides after 3-4 days

Other – pancreatitis, neuritis, arthritis, mastitis, nephritis, thyroiditis, pericarditis

Hearing loss can rarely follow mumps, but it is usually unilateral and transient

Sings on examination:
* Examination of the parotid duct may show redness and swelling
* Abdominal pain: consider pancreatic involvement

Question 3

Investigations

Answer 3

Oral fluid IgM sample

Amylase is raised in the blood

Question 4

Management

Answer 4

Notify the local Health Protection Unit (HPU)

Find out the immunisation status of close contacts and tell them to watch out for symptoms of mumps

Advise and educate:

1. That it is a self-limiting condition
2. Advise patient to rest and take in adequate fluids
3. Paracetamol and ibuprofen can be used for symptomatic relief
4. Stay away from school or 5 days after the development of parotitis
5. Advise patient/ parents to seek help if they experience symptoms suggestive of meningitis or epididymo-orchitis

Question 5

Complications

Answer 5

Safety net for complications:

Mumps orchitis -> infertility (very rare)

Viral meningitis -> encephalitis (very rare)

Deafness (unilateral and transient)