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Revision as of 00:55, 27 February 2018 by Patrick Bookjans (Talk | contribs)

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Synonyms: epidemic parotitis
German: Mumps

1 Definition

Mumps is an acutely presenting generalized viral infection. It primarily effects the salivary glands. After the infection patients are normally left with lifelong immunity.

2 Epidemiology

The pathogen causing mumps is the mumpsvirus. It belongs to the group of paramyxoviruses. It was previously referred to as paramyxovirus parotitidis. The disease has been marked by its high contagion index of 40%. The virus is not restricted regionally and has a world-wide presence. The index of manifestation is about 50%, meaning that roughly half of the infections will have a symptomatic course.

Affected are especially children between the age of 4 until 15. About 90% of the population are immunized.

3 Transmission

Transmission happens exclusively from human to human by either droplet infection or smear infection. The pathogens are excreted in urine, saliva and breast milk. The infection occurs in the mucous membrane of the oral cavity and nasopharynx.

4 Time of Incubation and infectiousness

The incubation period is in average 2-4 weeks. The patient remains contagious from the 5th day (before the swelling of the salivary glands) until the complete reduction of swelling (about 8 days later). It is important to note that also asymptomatic courses are contagious.

5 Clinic

During the first 1-2 days prodromal stage the patient experiences unspecific symptoms such as fever, headaches and joint pain. This is followed by the characteristic swelling of the parotid gland, typically on the left side.

The inflammation of the salivary gland is not purulent but is very painful. Patients often complain about pain occurring when chewing or moving of the head. Diffuse earaches can also be present.

In about 75% of the cases 1-2 days later the swelling of the second parotid gland takes place. This gives rise to the patient displaying the typical mumps-look: Both earlobes protrude prominently and the skin is oedematous and stretched over the swollen glands.

The buccal part of the parotid gland duct can be reddened and swollen (papilitis). This leads to increased pain when chewing. Coinfection of the submandibular gland and the sublingual gland can be observed occasionally. An isolated infection of one of these glands is very rare.

6 Diagnosis

6.1 Clinic

The diagnosis of mumps is primarily made by observation of the typical symptoms and course of the disease. Laboratory tests can be used to confirm the diagnosis.

6.2 Laboratory

  • Detection of specific IgM antibodies
  • Extremely elevated levels of amylase

In case the pancreas is involved in the infection increased lipase and elastase levels can be observed.

6.3 Serology and pathogen detection

Proof of a mumps infection is given when the IgG antibody titre of 2 blood samples of chronological interval display at least a fourfold increase. An increase of the IgM antibodies proves a new infection.

A direct proof for the presence of pathogens is possible using PCR and isolation of the virus. However, this is not considered a routine test.

6.4 Differential Diagnoses

7 Complications

Meningitis (10%) with good prognosis, rarely (0.1%) meningoencephalitis with grim outlook. About 50% of serous meningitides are caused by an inapparent mumps infection.

8 Therapy

Treatment is solely symptomatic:

  • Local application of heat
  • Analgesics
  • Liquid and mashed foods
  • In case of orchitis and encephalic manifestation corticosteroids are indicated.

9 Prophylaxis

With the beginning of the 12 month of life active vaccination in combination with measles and rubella (MMR vaccination) is recommended.

10 Notifiable disease

In Germany, §6 of the infection protection law categorizes mumps as a notifiable disease. This means that clinical as well as laboratory diagnosis have to be reported.

This page was last edited on 27 February 2018, at 00:55.

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