Mumps, also known as infectious parotitis, epidemic parotitis or mumps, is a viral infection, very common in childhood, which is transmitted by the respiratory tract and which attacks the parotid gland.
The parotid gland, or simply parotid, is the largest of the three glands that make up the salivary gland, responsible for the production of saliva. Mumps virus lodges in the parotid, making it swollen and painful. Mumps may also affect the other salivary glands.
In this text we will cover the main aspects of mumps, including transmission, symptoms, complications, treatment and vaccination.
Infectious parotitis is transmitted from person to person through the secretions of the airways, similar to what happens with other respiratory viruses such as influenza and cold. Mumps virus is highly contagious and easily transmitted to susceptible people.
The incubation period of mumps ranges from 14 to 25 days. Between 3 and 5 days before the onset of typical symptoms of mumps, the patient presents what we call prodromes, non-specific symptoms that may be confused with an onset of influenza, such as headache, low fever, loss of appetite, muscle pain.
The infected patient is already able to transmit the virus three days before the prodromal symptoms appear, remaining contagious for up to 5 days after the appearance of typical symptoms of mumps, which is the indicated time of isolation of the patients.
Not all people infected with the mumps virus will develop symptoms. About 20 to 30% do not usually present symptomatology, at the most unspecific complaints that go almost unnoticed.
In the symptomatic patients, 95% presented parotitis, with pain and edema (swelling) of the parotid glands, provoking the classic clinical manifestation of mumps. The parotite is usually bilateral, but eventually it can affect only one side. This swelling in the face usually lasts up to 10 days.
In addition to parotid edema, infectious parotitis also causes fever, tiredness and malaise.
The diagnosis can be confirmed by serology, but the clinical picture is so typical that this laboratory confirmation does not have to be made compulsorily.
Complications of mumps are rare, but they are often severe. Most of these occurred prior to the advent of the vaccine, but can still be found in adults these days. The fact that complications may occur even in those patients who do not develop parotitis is an important cause of delay in the correct diagnosis of mumps.
Among the complications, we can mention:
Orquitis: the involvement of the testicles by the virus is the most famous and most common complication of mumps. It is a complication that occurs in up to 40% of men who contract mumps after the onset of adolescence. Changes in fertility occur in up to 13% of patients with orchitis, however, sterility is rare.
Symptoms of orchitis due to mumps are high fever, testicular pain and edema in the scrotum. The interval between mumps and orchitis is usually 10 days.
Oophoritis: similarly to what happens with men, mumps can also attack the ovaries, causing oophoritis. It is a less common complication and occurs in approximately 7% of postmenopausal women.
Meningitis: occurs in less than 10% of cases and, unlike bacterial meningitis, usually has a good prognosis, with spontaneous resolution and without leaving sequels. Encephalitis, a brain infection, is a rare complication.
Deafness: Before the vaccine, mumps were an important cause of childhood deafness. Nowadays it is a rare complication.
Abortion: mumps infection in the first trimester is an important risk factor for abortion. However, when pregnancy can follow its course, there does not seem to be a greater risk of malformations.
Other rarer complications of infectious parotitis include:
There is no specific treatment for mumps; in general we prescribe only symptomatic, such as analgesics and antipyretics. As it is a disease of viral origin, there is no indication for the use of antibiotics.
Mumps are, in the vast majority of cases, a self-limiting disease, with spontaneous resolution within 2 weeks, with no need for any specific treatment.
Immunization against mumps is part of the current vaccination schedule and is administered through the MMR vaccine that protects against mumps, measles and rubella.
All adults not immunized against infectious parotitis during childhood may receive the vaccine, especially if people are close to the disease. Contraindications include pregnancy, patients with immunosuppression, and people allergic to the antibiotic neomycin.
The efficacy of the vaccine is above 96% and newly immunized patients do not transmit the vaccine virus, so do not need to avoid contact with any group of patients.
