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Understanding Mumps and How to Protect Children from Its Outbreaks

Mumps, a contagious viral disease 1, can be a significant health concern for children 1. Despite being preventable through vaccination 2, outbreaks continue to occur 1,3, especially in communities with low vaccination rates3.

In fact, mumps disease is endemic worldwide 3, with >500,000 cases reported to the World Health Organization (WHO) annually on average 3.

This blog post will discuss the details of mumps, including its causes, symptoms, complications, and most importantly, how to protect your child from potential outbreaks.

What is Mumps Disease?

Mumps, also called epidemic parotitis 4, is a contagious viral infection caused by the mumps virus 1,5. It primarily affects the salivary glands, especially the parotid glands, which are located near the ears, in the cheek and jaw area 1,5.

The infection typically leads to swelling in one or both of these glands, resulting in puffy cheeks and a swollen, painful jaw 1,5. Swelling usually peaks within 1 to 3 days and then decreases over the next week 5. Most individuals experience mild symptoms and recover fully within 2 weeks 1.

However, mumps disease can lead to serious complications, including meningitis (inflammation of the brain tissues), hearing loss, encephalitis (inflammation of the brain), viral pneumonia, and hemorrhagic conditions (excessive bleeding) 1,5.

Mumps is most commonly seen in children aged 2 to 12 who haven't been vaccinated but can affect anyone 6. In recent years, the outbreaks have become more common among adolescents and young adults 4.

Causes of Mumps Disease

Mumps is an illness caused by the mumps virus 1. This virus belongs to the Paramyxoviridae family and the Rubulavirus genus 3. It is a single-stranded, negative-sense RNA virus with an envelope 3.

The virus initially replicates in the upper respiratory tract and then spreads to the lymph nodes, leading to inflammation of the salivary glands 4. Transmission occurs through direct contact with saliva or respiratory droplets from an infected person's nose, mouth, or throat 1,5. The virus can spread through 1:

  • Coughing, sneezing, or talking
  • Sharing items contaminated with saliva, such as water bottles or cups
  • Close-contact activities like sports, dancing, or kissing

The risk of transmission is higher with prolonged and close contact with an infected individual 5. The infectious period generally spans from 2 days before to 5 days after the onset of parotitis (swelling of the salivary glands) 5. However, the virus can be detected in saliva as early as 7 days before and up to 9 days after parotitis begins, and it may also be present in urine and semen for up to 14 days 5.

Certain groups are more likely to contract mumps, including 1:

  • Unvaccinated individuals
  • School-aged children and students in higher education
  • Healthcare workers
  • Travellers to areas experiencing mumps outbreaks

Symptoms of Mumps Disease

Some individuals with mumps experience very mild symptoms, and some may not experience any symptoms at all 7, making it difficult for them to realize they have the disease.

Additionally, symptoms of mumps do not appear immediately after infection 7. The average incubation period for mumps disease is between 16 and 18 days, but it can vary from as few as 12 days to as many as 25 days 7.

Mild mumps symptoms can include 7:

  • Fever
  • Tiredness or fatigue
  • Headache
  • Muscle aches
  • Loss of appetite

A few days after these initial symptoms, an infected person might develop painful swelling of the parotid glands, which are salivary glands located between the ears and jaw 1,7. This swelling, known as parotitis, can affect one or both sides of the face 7. The swollen glands push the angle of the ear upward and outward, causing the cheeks to puff out and the jaw to swell and become tender, which can give a “chipmunk cheeks” appearance 5,6,7. Parotitis occurs in over 70% of mumps cases 4. The swelling can make it difficult to feel the jawbone and eating may be painful 5,7.

Most people with mumps disease make a full recovery within two weeks 1.

Complications of Mumps Disease

Mumps is usually a mild illness 7, but in some cases, it can lead to severe complications, including 5,7:

  • Orchitis: Inflammation of the testicles that may result in a decrease in testicular size (testicular atrophy)
  • Oophoritis: Inflammation of the ovaries and/or breast tissue (mastitis)
  • Pancreatitis: Inflammation of the pancreas
  • Encephalitis: Inflammation of the brain, which can lead to death or permanent disability
  • Hearing loss: This can be either temporary or permanent
  • Cerebellar ataxia: A condition that disrupts coordination and balance
  • Viral pneumonia: Inflammation of the lungs caused by a viral infection
  • Hemorrhagic conditions: Disorders characterised by excessive bleeding or blood vessel damage

Diagnosis of Mumps Disease

Mumps is usually diagnosed through a combination of clinical evaluation and laboratory tests 4,5. Initially, your doctor will assess your child's symptoms, which commonly include fever, headache, and swelling of the parotid glands, and perform a physical examination 4.

To confirm the diagnosis, several laboratory tests may be conducted. One such test is the Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR), which detects the presence of the mumps virus directly from a swab taken from the inside of the cheek or throat. This test is most effective if performed within 3 days of the onset of parotid swelling and no later than 8 days after the appearance of mumps symptoms 4,5.

Another crucial test is the serum immunoglobulin M (IgM) antibody test. This blood test identifies IgM and IgG antibodies that the body produces in response to the mumps virus. This test is generally conducted during the suspected period of illness 4,5.

Combining clinical symptoms and laboratory results can provide your doctor with an accurate mumps diagnosis 4,5.

Preventive Measures to Protect Your Child Against Mumps Disease

The best way to protect your child from mumps is through vaccination 2. The mumps vaccination works by stimulating the immune system to build defences against the virus 8. It is typically administered as part of the measles, mumps, and rubella (MMR) combination vaccination, which also protects against measles and rubella 2. The MMR vaccination is given in two doses 2:

  • The first dose: between 12 and 15 months
  • The second dose: between the ages of 4 and 6

For comprehensive protection against mumps, measles, and other serious diseases, you can consider the 7-Star Protection programme for your child. Recommended by the Indian Academy of Pediatrics Advisory Committee on Vaccination & Immunization Practices (ACVIP)9, this programme offers 7 vaccinations to protect your child against 14 illnesses, including mumps.

Speak with your child’s paediatrician to learn about the mumps vaccination and the 7-Star Vaccination programme.

Conclusion

Mumps, a contagious viral disease 1, remains a significant health concern for children, despite the availability of effective vaccinations 1,2. Understanding Mumps’ causes, symptoms, and complications is essential for its prevention.

Ensuring your child receives the recommended mumps vaccination can reduce their risk of contracting the disease and experiencing its associated complications 2. Remember, mumps vaccination is crucial in protecting public health and preventing the spread of infectious diseases 2.

If you have any concerns about mumps prevention or your child's vaccination status, it's best to consult your doctor for expert advice and guidance.

References

  1. CDC. About. Mumps. https://www.cdc.gov/mumps/about/index.html (Accessed; Nov 2024).
  2. CDC. Mumps vaccination. Mumps. https://www.cdc.gov/mumps/vaccines/index.html (Accessed; Nov 2024).
  3. Mumps. (n.d.). Cdc.gov. , from https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/mumps (Accessed; Nov 2024).
  4. Davison, P., Rausch-Phung, E. A., & Morris, J. (2024). Mumps. StatPearls Publishing.
  5. CDC. Clinical overview of. Mumps. https://www.cdc.gov/mumps/hcp/clinical-overview/index.html(Accessed; Nov 2024).
  6. Mumps. Familydoctor.org. https://familydoctor.org/condition/mumps/(Accessed; Nov 2024).
  7. CDC. Mumps symptoms and complications. Mumps. https://www.cdc.gov/mumps/signs-symptoms/index.html(Accessed; Nov 2024).
  8. CDC. Explaining how vaccines work. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/hcp/conversations/understanding-vacc-work.html(Accessed; Nov 2024).
  9. Rao M IS, Kasi SG, et al. Indian Pediatr. 2024 Feb 15;61(2):113-125
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