Mumps is an extremely contagious viral infection that usually affects children.

The condition has a number of symptoms, the most common one being swelling of one or both of the salivary glands on the sides of the face.

These glands are called the parotid glands and when they swell the patient develops a "hamster like" face. Once someone has had mumps, they usually become immune to future infections.

To aid in the battle against the spread of mumps, the MMR vaccine is commonly given at an early age to help the body become immune to the virus. Before the MMR vaccination was brought in, in England and Wales there were 1,200 cases involving hospital admission per year.

According to Medilexicon's medical dictionary mumps is:

"An acute infectious and contagious disease caused by a mumps virus of the genus Rubulavirus and characterized by fever, inflammation and swelling of the parotid gland, and sometimes of other salivary glands, and occasionally by inflammation of the testis, ovary, pancreas, or meninges."

What are the Signs and Symptoms of Mumps? A symptom is something the patient feels or reports, while a sign is something that other people, including the doctor detects. A headache may be an example of a symptom, while a rash may be an example of a sign.

The symptoms of mumps normally appear 2-3 weeks after the patient has been infected, however almost 20% of people with the virus do not suffer any signs or symptoms at all.

The main symptom of mumps is painful and swollen parotid (salivary) glands, which cause the person's cheeks to puff out. Other symptoms can include: Pain in the sides of the face where it is swollen Pain experienced when swallowing Trouble swallowing Feeling tired and weak Fever/high temperature

Headache Nausea Dryness in mouth Pain in joints Reduced appetite What Causes Mumps? A person suffers mumps when infected with the mumps virus. It can be transmitted via respiratory secretions (e.g. saliva) from a person already affected with the condition. When contracting mumps, the virus travels from the respiratory tract to the salivary glands and reproduces, causing the glands to swell. Examples of how it can be spread are: sneezing or coughing using the same cutlery/plates with someone infected sharing food and drink with someone infected kissing someone infected touching their nose or mouth and then passing it onto a surface someone else may touch Someone infected with the mumps virus is contagious for approximately 15 days (six days before the symptoms start to show, up to nine days after they start). The mumps virus is part of the paramyxovirus family, which is a widespread cause of infection, especially in children. How is Mumps Diagnosed? Normally, mumps can be diagnosed by its symptoms alone, especially by examining the facial swelling. In addition to examining this area and taking a note of the symptoms, a doctor may: check inside the mouth to see the position of the tonsils - when infected with mumps, a person's tonsils can get pushed to the side take the patient's temperature take a sample of blood, urine or saliva for testing take a sample of CSF (cerebrospinal fluid) for testing - this is usually in severe cases How is Mumps Treated? As mumps is viral, antibiotics cannot be used to treat it, and at present there are no anti-viral medications able to treat mumps. Treatment can only help relieve the symptoms until the infection has run its course and the body has developed an immunity, much like a cold. In most cases people

recover from mumps within two weeks. Steps that can be taken to help relieve the symptoms of mumps include: Consuming plenty of fluids, ideally water - avoid fruit juices as they stimulate the production of saliva, which is painful for someone with mumps. Putting something cold on the swollen area to alleviate the pain. Eating mushy or liquid food as chewing will also be painful Getting sufficient rest and sleep Gargling warm salt water Taking painkillers such as paracetamol or ibuprofen How can Mumps be Prevented? The mumps vaccine is the general method for preventing mumps; it can come on its own or as part of the MMR vaccine. The MMR vaccine also defends the body from rubella and measles. The MMR vaccine is given to an infant when they are just over one year old and again as a booster just before they start school. Anyone born after the 90s would most probably have been given the MMR vaccine but if unsure it is always advised to check with your doctor. Reference: http://www.medicalnewstoday.com/articles/224382.php

Virus classification Group: Group V ((-)ssRNA) Order: Mononegavirales Family: Paramyxovirus Genus: Rubulavirus

Mumps virus is the causative agent of mumps, a well-known common childhood disease characterised by swelling of the parotid glands, salivary glands and other epithelial tissues, causing high morbidity and in some cases more serious complications such as deafness. Natural infection is currently restricted to humans and the virus is transmitted by direct contact, droplet spread, or contaminated objects.

It is considered a vaccine-preventable disease, although significant outbreaks have occurred in recent years in developed countries such as America, in areas of poor vaccine uptake. These have allowed the further evaluation and ennumeration of its efficacy (~7585% after two doses of MMR).[1]

Mumps virus belongs to the genus Rubulavirus in the family Paramyxovirus and is seen to have a roughly spherical, enveloped morphology of about 200 nm in diameter. It contains a linear, singlestranded molecule of negative-sense RNA 15,384 nucleotides long. Structure

The Mumps virus is a roughly spherical particle made up of concentric layers of fatty lipids, large protein molecules, and nucleic acid. It is dotted with large 'spikes' made up of protein that enable it to gain entry to host cells. Inside lies a core of a single, long molecule of RNA wrapped up in protein that is released into the cell.

Reference: http://en.wikipedia.org/wiki/Mumps_virus

For other uses of the word Mumps or MUMPS, see Mumps (disambiguation).Mumps Classification and external resources

Child with mumps ICD-10 B26 ICD-9 072 8449 001557 emerg/324 emerg/391 ped/1503

DiseasesDB MedlinePlus eMedicine

MeSH D009107

Mumps (epidemic parotitis) is a viral disease of the human species, caused by the mumps virus. Before the development of vaccination and the introduction of a vaccine, it was a common childhood disease worldwide. It is still a significant threat to health in the third world, and outbreaks still occur sporadically in developed countries.[1]

Painful swelling of the salivary glands classically the parotid gland is the most typical presentation.[2] Painful testicular swelling (orchitis) and rash may also occur. The symptoms are generally not severe in children. In teenage males and men, complications such as infertility or subfertility are more common, although still rare in absolute terms.[3][4][5] The disease is generally self-limiting, running its course before receding, with no specific treatment apart from controlling the symptoms with pain medication.

Fever and headache are prodromal symptoms of mumps, together with malaise and anorexia. Other symptoms of mumps can include dry mouth, sore face and/or ears and occasionally in more serious cases, loss of voice. In addition, up to 20% of persons infected with the mumps virus do not show symptoms, so it is possible to be infected and spread the virus without knowing it.[6]

Males past puberty who develop mumps have a 30 percent risk of orchitis,[7] painful inflammation of the testicles.[8]Contents [hide] 1 Cause 2 Diagnosis 3 Prevention 4 Treatment 5 Prognosis 6 Epidemiology 7 References 8 External links

[edit] Cause

Mumps is a contagious disease that is spread from person to person through contact with respiratory secretions, such as saliva from an infected person. When an infected person coughs or

sneezes, the droplets aerosolize and can enter the eyes, nose, or mouth of another person. Mumps can also be spread by sharing food and drinks. The virus can also survive on surfaces and then be spread after contact in a similar manner.

A person infected with mumps is contagious from approximately 6 days before the onset of symptoms until about 9 days after symptoms start.[9][10] The incubation period (time until symptoms begin) can be from 1425 days, but is more typically 1618 days.[11] [edit] Diagnosis

A physical examination confirms the presence of the swollen glands. Usually, the disease is diagnosed on clinical grounds, and no confirmatory laboratory testing is needed. If there is uncertainty about the diagnosis, a test of saliva or blood may be carried out; a newer diagnostic confirmation, using real-time nested polymerase chain reaction (PCR) technology, has also been developed.[12] An estimated 20%-30% of cases are asymptomatic.[13] As with any inflammation of the salivary glands, serum amylase is often elevated.[14][15] [edit] Prevention

The most common preventative measure against mumps is a vaccination with a mumps vaccine, invented by American microbiologist Maurice Hilleman at Merck.[16] The vaccine may be given separately or as part of the MMR immunization vaccine which also protects against measles and rubella. In the US, MMR is now being supplanted by MMRV, which adds protection against chickenpox. The WHO (World Health Organization) recommends the use of mumps vaccines in all countries with well-functioning childhood vaccination programmes. In the United Kingdom it is routinely given to children at age 13 months with a booster at 35 years(preschool) This confers lifelong immunity. The American Academy of Pediatrics recommends the routine administration of MMR vaccine at ages 1215 months and at 46 years.[17] In some locations, the vaccine is given again between 4 to 6 years of age, or between 11 and 12 years of age if not previously given. The efficacy of the vaccine depends on the strain of the vaccine, but is usually around 80%.[18][19] The Jeryl Lynn strain is most commonly used in developed countries but has been shown to have reduced efficacy in epidemic situations. The Leningrad-Zagreb strain commonly used in developing countries appears to have superior efficacy in epidemic situations.[20]

Because of the outbreaks within college and university settings, many governments have established vaccination programs to prevent large-scale outbreaks. In Canada, provincial governments and the

Public Health Agency of Canada have all participated in awareness campaigns to encourage students ranging from grade 1 to college and university to get vaccinated.[21]

Some anti-vaccine activists protest against the administration of a vaccine against mumps, claiming that the attenuated vaccine strain is harmful, and/or that the wild disease is beneficial. There is no evidence whatsoever to support the claim that the wild disease is beneficial, or that the MMR vaccine is harmful. Claims have been made that the MMR vaccine is linked to autism and inflammatory bowel disease, including one study by Andrew Wakefield[22][23] (the paper was discredited and retracted in 2010 and Wakefield was later stripped of his license after his work was found to be an "elaborate fraud" [24]) that indicated a link between gastrointestinal disease, autism, and the MMR vaccine. However, subsequent studies indicate no link between vaccination with the MMR and autism.[25] Since the dangers of the disease are well known, while the dangers of the vaccine are quite minimal, most doctors recommend vaccination.

The WHO, the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, the American Academy of Family Physicians, the British Medical Association and the Royal Pharmaceutical Society of Great Britain currently recommend routine vaccination of children against mumps. The British Medical Association and Royal Pharmaceutical Society of Great Britain had previously recommended against general mumps vaccination, changing that recommendation in 1987. In 1988 it became United Kingdom government policy to introduce mass child mumps vaccination programmes with the MMR vaccine, and MMR vaccine is now routinely administered in the UK.[citation needed]

Before the introduction of the mumps vaccine, the mumps virus was the leading cause of viral meningoencephalitis in the United States. However, encephalitis occurs rarely (less than 2 per 100,000).[26] In one of the largest studies in the literature, the most common symptoms of mumps meningoencephalitis were found to be fever (97%), vomiting (94%) and headache (88.8%).[27] The mumps vaccine was introduced into the United States in December 1967: since its introduction there has been a steady decrease in the incidence of mumps and mumps virus infection. There were 151,209 cases of mumps reported in 1968. Since 2001, the case average was only 265 per year, excluding an outbreak of >6000 cases in 2006 attributed largely to university contagion in young adults.[28][29] [edit] Treatment

There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck/testicular area and by acetaminophen/paracetamol (Tylenol) for pain relief. Aspirin is not used due to a hypothetical link with Reye's syndrome. Warm

salt water gargles, soft foods, and extra fluids may also help relieve symptoms. According to the Department of Health of Minnesota there is no effective post-exposure recommendation to prevent secondary transmission, as well as the post-exposure use of vaccine or immunoglobulin is not effective.[30]

Patients are advised to avoid acidic foods and beverages, since these stimulate the salivary glands, which can be painful.[31] Reference: http://en.wikipedia.org/wiki/Mumps The incubation period is 16 - 18 days but may vary from 14 - 25 days. Parotid swelling develops in 95% of those with clinical illness. The rate of subclinical infection varies with age, but is on average 30%. In a small proportion of patients, the symptoms may resemble mild URTI. Typically, a prodromal illness consisting of headache, malaise, myalgia and low grade fever occurs 1 - 2 days before the onset of parotid enlargement. Patients with classic mumps develop enlargement of one parotid gland, followed 1 - 5 days later by enlargement of the contralateral gland. The patient complains of pain and tenderness in the area of the gland. The submandibular and sublingual glands may occasionally be involved. The parotid swelling starts to subside after 4 to 7 days. Virus shedding into the saliva begins a couple of days before the onset of parotitis and ends 7 to 8 days later.

Complications

All the other manifestations of mumps can be regarded as systemic complications of mumps rather than as true complications. Meningitis ;- Aseptic meningitis occurs in 10% of patients with mumps but as many as 50% show abnormalities in the CSF. Mumps is the most frequent causative agent of aseptic meningitis, in many countries being responsible for 10 - 15% of all cases. Symptoms are indistinguishable from other types of aseptic meningitis and can start one week before parotid swelling before parotid swelling to 3 weeks after it. The CSF reveals a lymphocytosis of usually below 500 lymphocytes/mm3, normal or elevated protein. Virus can be isolated from the CSF during the first 2 to 3 days after onset. Later, specific antibodies can demonstrated in the CSF. Symptoms of meningitis subside 3 to 10 days after onset and recovery is usually complete. A study suggests that the majority of cases of meningitis occur without apparent parotiditis. Encephalitis ;- encephalitis occurs rarely as a complication of mumps, where lesions are found in the brain and spinal cord. The incidence of encephalitis is around 1 in 6000 cases of mumps. Probably both direct viral invasion and allergic inflammatory reactions lie behind the nervous tissue damage. Clinical features suggesting encephalitis are convulsions, focal neurological signs, movement disorder and changes in sensory perception. Sometimes polio-like paralysis ensues and fatalities have been reported.

Hearing Loss ;- before vaccinations, mumps used to be one of the leading causes of hearing loss in children and young adults. In most cases, the hearing loss is transient but permanent dysfunction may occur. Hearing problems did not correlate with meningitis and appears to be due to direct damage tothe cochlea. The incidence of hearing loss is estimated to be in the region of 1 per 15,000 cases. Orchitis and oophoritis ;- orchitis and oophoritis are more likely to occur after puberty where the incidence is 20 - 30%, and in 20 - 40% of cases, there is bilateral involvement. Men are much more likely to be affected than women. Pancreatitis ;- the exact incidence of pancreatitis is hard to determine but is thought to be as high as 5%. Arthralgia ;- arthralgia affecting a large joint may develop 2 weeks after parotitis. They are more frequent in young male adults. Myocarditis ;- this can usually only be found on ECG examination in 10 - 15% of patients. Rarely, congestive heart failure and deaths have been reported. Transient Renal Dysfunction ;- this is a frequent complication of clinical mumps. Cases of symptomatic nephritis following mumps are unusual. Insulin Dependent Diabetes ;- there is some epidemiological evidence to suggest that mumps may be a triggering mechanism for IDDM. It is thought that immunological mechanisms may be involved and certain HLA-D haplotypes are particularly susceptible. Abortion ;- if a pregnant woman contracts mumps during her pregnancy, there is increased risk for abortion. This is thought to be due to hormonal imbalances caused by virus infection. Thyroiditis ;- there is evidence for a role of mumps virus in the causation of subacute thyroditis. However, the evidence is not strong.

C. Pathogenesis Mumps is transmitted by droplet spread or by direct contact. The primary site of viral replication of the epithelium of the upper respiratory or the GI tract or eye. The virus quickly spreads to the local lymphoid tissue and a primary viraemia ensues, whereby the virus spreads to distant sites in the body. The parotid gland is usually involved but so may the CNS, testis or epididymis, pancreas and ovary. A few days after the onset of illness, virus can again be isolated from the blood, indicating that virus multiplication in target organs leads to a secondary viraemia Parotitis is the most frequent presentation, occurring in 95% of those with clinical symptoms. Occasionally, meningitis may precede parotitis by a week. Virus is excreted in the urine in infectious form during the 2 weeks following the onset of clinical illness. It is not known whether virus actually multiplies in renal tissues or whether the virus is of haematogenous origin. Life-long immunity is the rule after natural infection, but reinfections can occur and 1 - 2% of all cases are thought to be reinfections. Reference:

http://virology-online.com/viruses/MUMPS.htm