MUMPS

What is it?
Mumps is a paramyxoviral disease causing painful swelling of the salivary glands and, less commonly, of the testes, brain and its coverings, pancreas, and ovaries. Most patients are children. . Infectivity occurs via saliva and urine and precedes the symptoms by about 1 day and is maximal for 3 days but may last a week.

How do you get it?
An uninfected child gets the illness when respiratory droplets from an infected child are inhaled. Respiratory droplets are formed during coughing, sneezing and during speech. The virus also gets transmitted when spit or sputum contaminated objects (Eg: Toys) are handled by an uninfected child.

Clinical features:
The incubation period is 14-21 days. Up to one-third of affected individuals have subclinical infection.Those who do show evidence of the illness usually present with tender swollen parotid gland (the saliva producing gland situated near the angle of the jaw on either side of the face) tenderness (tenderness at the angle of the jaw) accompanying facial swelling.
Usually, one parotid gland enlarges a couple of days prior to the other, but unilateral parotid gland involvement can occur. Difficulty and pain in opening the mouth may result from the parotid gland inflammation. The parotid glands return to normal size within a week. Involvement of other salivary glands in conjunction with the parotids occurs in some of the cases.

Fever and malaise are variable and are often minimal in young children. High fever usually accompanies inflammation of the testes and coverings of the brain. Neck stiffness, headache, and lethargy suggest inflammation of the coverings of the brain. Testicular swelling and tenderness denote its inflammation, which is the most common extra-salivary gland manifestation of mumps in adults, but sterility is rare. Upper abdominal pain, nausea, and vomiting suggest inflammation of the pancreas. Lower abdominal pain and ovarian enlargement suggest inflammation of the ovaries, but the diagnosis may be difficult to make.

Complications:
Other manifestations of the disease are less common than inflammation of the salivary glands. These usually follow the inflammation of the salivary glands, but may precede it or occur without salivary gland involvement and include inflammation of the coverings of the brain, testes, pancreas, ovaries, thyroid gland, liver, kidneys and heart, decreased platelet counts in the blood and joint pains.

How is it diagnosed?
Diagnosis of simple cases is clinical. Blood tests are not routinely required. In complicated cases, investigations help to identify other organs involved.

Treatment:
The patient should be isolated until swelling subsides and kept at bed rest during the febrile period. Treatment of patients with mumps is largely supportive, although anti-inflammatory agents may be useful in cases of severe inflammation of the testes or joints.

Prevention:
Mumps vaccine is safe and highly effective. It is recommended for routine immunization for children over age 1 year, either alone or in combination with other virus vaccines (eg, in MMR vaccine). A second dose is recommended for children prior to starting school. It should not be given to pregnant women or to individuals with decreased immunity.