Mumps Flashcards
What is the aetiology of mumps
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
What is the epidemiology of mumps
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
What are the symptoms of mumps
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
What are the differentials for mumps
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
What investigations should be done for mumps
Clinical diagnosis
Saliva/oral fluid swab: IgM mumps antibody present
What is the management for mumps
- Notify the local health protection unit (HPU)
- 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 - Safety net: severe headache, vomiting, neck stiffness, altered consciousness, pain and swelling of testicles
+ follow up 1 week after parotitis onset
What is the management for exposure to a close contact with mumps
Not fully immunised → offer MMR vaccine
Pregnant women → seek medical advice (MMR contraindicated)
Immunocompromised → do not routinely give the MMR
What are the complications for mumps
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
What is the prognosis for mumps
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