A Family Doctor's Tale - MUMPS

DOC I HAVE MUMPS

Mumps is seldom seen today due to mumps vaccination. In the past most children were infected with mumps at the age of 5-15 years typically with both cheeks swollen. In the Chinese patients some parents applied blue lotion on the cheeks of their infected child or write the Chinese word 'Tiger' on the swollen cheek


Mumps is a highly contagious viral infection that causes painful swelling in the salivary glands (the glands which produce saliva) which include the parotid, submandibular and submental glands.



The mumps (paramyxovirus) virus is spread by coughing, sneezing and through the saliva of an infected person. 

It can also be spread by contact with contaminated items and surfaces. 
It is contagious 1 - 2 days before the appearance of symptoms to 1 - 2 days after the symptoms disappear. 
The incubation period is about 18 days. 

An attack gives lifelong immunity.


Although mumps may affect adults, children between the ages of 5 - 15 years are most prone.


Symptoms
Prodromal symptoms such as fever, headache and sore throat
Facial pain and swelling
pain or lumps in their testicles
Abdominal pain

 Signs:
1.Swollen and tender parotid glands in front of the ear, cheek and neck.
Submandibular glands below the jaws are less affected
2.Dry mouth - less saliva ,fever
3.Males may experience pain or lumps in their testicles, and swelling in the scrotum. This condition is called orchitis.
However this rarely causes infertility problems.
4.Pain in the abdomen may indicate pancreatitis, a rare complication
5.Meningoencephalitis (infection of the central nervous system) with fever, headache and neck rigidity. 
It usually does not cause permanent damage.


Mumps is a viral disease and cannot be cured. 
It normally run its course within 1 week.

Treatment of  mumps is therefore symptomatic.
1.Rest and soft diet.
2.Lots of fluids
3.Paracetamol can be given to reduce fever and relieve pain.
 For children, aspirin should not be given because of the risk of Reye's syndrome which can damage the brain.
4.Warm or cold compresses can be given to relieve pain and swelling in the parotid glands. The blue lotion applied by the Chinese on the swollen cheek also soothes the pain.
5.Cool compresses and scrotal support can be given to reduce pain and swelling in the testicles.

6.Avoid foods that stimulate the secretion of the saliva of the parotid glands (stimulating the glands causes pain) such as fruit juices and tart beverages.

Complications of Mumps are rare:

1.The mumps virus may affects many different glands including the brain.
2.It can affect the testes (orchitis)in boys or ovaries (oophoritis) in girls during puberty rarely causing infertility.
3.It can also affect the pancreas in some patients giving rise to Juvenile Diabetes or pancreatitis.
4.In the brain rarely encephalitis or meningitis may occur with damage to some brain cells.


Prognosis is good in all cases.
Very rarely do complications such orchitis or meningitis occur.


Mumps can be prevented by administering the Mumps, Measles, Rubella vaccine (MMR). 
This vaccine is given at the age of 15 months and again at 12 years old.