Mumps: Viral infection with swollen parotid glands

Mumps is an epidemic inflammation of the parotid glands caused by a virus. The salivary glands produce saliva, a fluid that moistens food and is necessary for chewing and swallowing. Children are especially affected by mumps. The infectious disease causes a characteristic painful swelling of the parotid glands. General symptoms are also associated with this, such as headache, weight loss and fever. The disease is very easy to diagnose clinically. The treatment of the viral infection is based on a number of self-care measures in combination with pain relief. Most patients recover from the disease within a few weeks and without complications. However, occasionally some serious complications occur. Finally, mumps can be prevented through vaccination.

  • Synonyms of mumps
  • Infectious disease epidemiology
  • Causes: Mumps virus
  • Symptoms: Swollen and painful parotid glands
  • Diagnosis and examinations
  • Therapy
  • Prognosis of viral infection is excellent
  • Brain complications
  • Prevention through vaccine

Synonyms of mumps

Mumps is also known by these synonyms:

  • dikoor
  • parotitis epidemica

Infectious disease epidemiology

Most often, unvaccinated school-age children and young adults are affected by the disease, but the disease can occur at almost any age. Only babies and toddlers under the age of two are almost never affected by mumps. The mumps vaccine has been available in the Netherlands since 1987; the prevalence of the disease has since greatly reduced.

Causes: Mumps virus

Mumps is the result of infection with the mumps virus, which belongs to the paramyxovirus family. This is spread in the same way as a cold (mild infection with symptoms in the nose and throat) or flu, namely through drops of fluid from the nose and mouth such as when sneezing (droplet infection) or through direct contact (sharing or touching) with objects or surfaces contaminated by the virus. Humans are the only known natural hosts. A patient is most contagious to others a few days before and after the symptoms manifest. During this period it is important to prevent infection in unvaccinated people.

Symptoms: Swollen and painful parotid glands

Approximately one in three infected patients develop no or only very mild symptoms of mumps. They often don’t even know that they are sick. Nevertheless, these patients are also capable of spreading the disease. The incubation period (time between infection and the appearance of visible symptoms) for mumps is on average eighteen days (twelve to twenty-five days). With mumps, patients have swollen and painful parotid glands. Swollen armpits sometimes occur.

General symptoms

General symptoms associated with mumps are non-specific and include joint pain, morning headaches and headaches, sore throat, fever of 38°C or higher, malaise (a generally ill feeling), mild abdominal pain, muscle aches, fatigue, a loss of appetite and weight loss.

Specific symptoms

Other, more specific symptoms usually follow a few days later. Mumps causes severe pain and swelling of one (unilateral) or both (bilateral) parotid glands (located between the ear and the jaw), giving the cheeks a somewhat puffy appearance. The patient also sometimes experiences a bump in the neck (skin lump). Other symptoms related to mumps include a rash on the palms of the hands, facial pain, dry mouth (xerostomia), and difficulty chewing and swallowing. As a result of the pain, a jaw cramp (jaw lock) may also occur, making it difficult to open the mouth.

Diagnosis and examinations

Physical examination

The diagnosis of mumps is based on the clinical features. The doctor examines and palpates the swelling, examines the position of the tonsils in the mouth and checks the patient’s temperature to see if it is higher than normal. He usually makes the diagnosis of mumps based on this physical examination.

Diagnostic research

In cases of doubt, a blood test confirms the diagnosis. The immune system normally produces antibodies that help fight an infection. In a patient with mumps, the presence of antibodies in the blood can be detected. These fight against the mumps virus.

Differential diagnosis

Although mumps is not usually a serious infection, the condition has a similar clinical picture to more serious infections, such as mononucleosis caused by the Epstein-Barr virus (glandular fever: viral infection with sore throat, swollen lymph nodes, fatigue and low-grade fever that mainly occurs in adolescents and young adults) and tonsillitis (tonsillitis). It is therefore important to always consult a doctor if the symptoms present.

Therapy

The treatment of mumps is supportive. Bed rest is important until symptoms subside. In addition, the patient pays attention to a good, soft diet (soup, mashed potatoes, scrambled eggs, etc.) and sufficient fluid intake to prevent dehydration. Oral care is also important with mumps. For example, gargling with warm, salty water reduces symptoms. Furthermore, the patient applies either warm or cold compresses to the neck. Over-the-counter pain relievers such as acetaminophen and ibuprofen relieve the symptoms of mumps. Aspirin is not a good medicine for children under the age of sixteen because this medication may result in Reye’s disease, where the brain and liver are swollen.

Prognosis of viral infection is excellent

Patients with mumps usually recover well within a few weeks, even when organs are affected. After they recover from the disease, they are immune to mumps for life.

Brain complications

Serious complications are rare. However, complications involving the brain, among other things, do occur.

Brain

Occasionally the central nervous system (the brain) is affected by mumps. Clinical meningitis occurs in 5% of infected patients. The virus moves into the outer layer of the brain and, as a result, inflammation of the tissues covering the brain and spinal cord occurs. Brain inflammation (encephalitis) is also a possible complication.

Other complications

Pancreatitis (inflammation of the pancreas with abdominal pain and digestive problems), inflammation of the ovary (oophoritis), inflammation of the heart muscle (myocarditis), inflammation of the breast tissue (mastitis), inflammation of the liver (hepatitis), polyarthritis and infertility due to testicular problems (male infertility) are also possible. Very sporadically, a patient presents with hearing loss or deafness as a result of mumps. Occasionally, a pregnancy results in a miscarriage when the mother suffers from mumps. The National Service for Public Health and the Environment (RIVM) reports rheumatism as a possible complication on its website. Finally, lagophthalmia sometimes occurs. This is a symptom in which the patient can no longer close the eyelids completely.

Good hand hygiene is necessary / Source: Gentle07, Pixabay

Prevention through vaccine

Preventing mumps

Mumps can be treated preventively with a vaccine, which doctors in most developed countries administer to children between the ages of fourteen months and nine years old. The MMR vaccine protects people against mumps, measles (viral infectious disease accompanied by symptoms in the eyes (conjunctivitis) and a skin rash) and rubella (rubella). Vaccination is not indicated in patients with a weakened immune system, in patients with very serious diseases and in pregnant women.

Preventing the spread of mumps

A patient with mumps prevents the spread of the infection by:

  • use a tissue when sneezing or coughing, and throw it away in the trash immediately afterwards
  • washing hands regularly with soap (good hand hygiene)
  • Avoid school or work for at least five days after symptoms appear