Mumps

Question 1

Transmission route of mumps

Answer 1

Respiratory

Airborne or droplet spread

Question 2

Clinical symptoms of mumps

Answer 2

30-50% asymptotic or respiratory only

Prodrome - headache, fever, malaise, myalgia

3 days later bilateral (usually) parotid swelling

Question 3

Complications of mumps infection

Answer 3

Orchitis
Encephalitis
Meningitis
Oophritis
Pancreatitis
Nephritis
Myocarditis

Long term sequelae

Seizures
Paralysis
Cranial nerve palsies
Hydrocephalus
Deafness

Question 4

What are the risks of CNS disease in mumps infection? Why is this?

Answer 4

CNS involvement occurs in around 50% of cases

0.4% encephalitis
5-10% meningitis
4% deafness (most common cause of unilateral hearing loss in children) most commonly transient

Mumps is a highly neurotropic virus

Question 5

Diagnostic tests for mumps infection?

Answer 5

PCR in buccal swab - within 3 days of symptoms

Urine PCR can be done also as sheds in urine

Saliva IgM within 1-6 weeks of parotitis

Blood IgM can be used but specificity issues

Genotyping can be performed for epidemiological investigation with sequencing of the small hydrophobic region

Question 6

Post exposure prophylaxis for mumps

Answer 6

None

Antibody from MMR not fast enough and no evidence for HNIG

Question 7

Risks of mumps in pregnancy

Answer 7

No increased severity in pregnant women

No congenital abnormalities

Weak links to increased risk of first trimester foetal loss, endocardia fibroelastisis and respiratory distress and thrombocytopenia at birth in peri natal infection