Mumps Flashcards

1
Q

What is the aetiology of mumps

A

Acute infectious disease caused by a paramyxovirus
Transmitted via respiratory droplets, fomites or saliva
Most infectious from around 1-2 days before symptom onset, to about 9 days afterwards
Replicates in the upper airway respiratory mucosa
Incubation period 16-18 days

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2
Q

What is the epidemiology of mumps

A

In 2017, over 90% of confirmed cases were in people aged 15 years or over.
Children <1 year rarely get mumps as they usually acquire passive immunity from placental transfer of maternal antibodies

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3
Q

What are the symptoms of mumps

A

Asymptomatic mumps infection is common in children

Swollen parotid glands (sides of the face)
- One parotid gland is affected first, reaching maximal size after 2-3 days and the other gland closely follows it
- 1/4 have unilateral parotitis
- The ear lobe over the affected gland may be deflected upward and outward
- The angle of the mandible may be obscured
Tender glands
Earache
Difficulty with pronunciation of words and chewing
Non-specific symptoms: fever, headache, malaise, muscle ache, low appetite

Abdominal pain → consider pancreatic involvement

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4
Q

What are the differentials for mumps

A

EBV
Parainfluenza
Adenovirus
Influenza type A
Coxsackivirus
Parvovirus B19
Acute suppurative parotitis from acute bacterial infection
parotid duct obstruction (salivary stones/cysts/tumours)
Sjogren’s syndrome

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5
Q

What investigations should be done for mumps

A

Clinical diagnosis

Saliva/oral fluid swab: IgM mumps antibody present

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6
Q

What is the management for mumps

A
  1. Notify the local health protection unit (HPU)
  2. Advice
    - Self-limiting, takes 1-2 weeks
    - No long-term consequences, Abx not required
    - Warm or cold packs to the parotid gland to ease discomfort
    - Isolate for 5 days after development of parotitis
  3. Safety net: severe headache, vomiting, neck stiffness, altered consciousness, pain and swelling of testicles

+ follow up 1 week after parotitis onset

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7
Q

What is the management for exposure to a close contact with mumps

A

Not fully immunised → offer MMR vaccine
Pregnant women → seek medical advice (MMR contraindicated)
Immunocompromised → do not routinely give the MMR

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8
Q

What are the complications for mumps

A

Submandibular and sublingual salivary gland enlargement → obstruction of lymphatic drainage → pre-sternal oedema
Epididymo-orchitis → subfertility
Encephalitis (seizures, decreased level of consciousness, and focal neurological symptoms)
Oophoritis (7% of childbearing women)
Aseptic meningitis
Transient hearing loss, deafness (1 in 20,000)
Myocardial complications
Pancreatitis
Spontaneous abortion

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9
Q

What is the prognosis for mumps

A

Usually a self-limiting illness that resolves 1-2 weeks
Most people recover without any long-term complications
Nearly all people develop life-long immunity to mumps after one episode of infection
However 1-2% of cases are through to be re-infections

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