Mumps (Epidemic Parotitis)

§ overviewOverview

Acute systemic viral infection of paramyxovirus (Rubulavirus) with tropism for glandular and nervous tissues.

§ icdICD Classification

B26

§ etiologyEtiology

• 01Mumps virus (paramyxovirus)

§ epidemiologyEpidemiology

Peak in unvaccinated children 5–15 y; incubation 14–21 d; contagious 1 d before to 5 d after gland swelling.

§ clinicalClinical Features

• 01Prodrome: fever, malaise, myalgia, headache
• 02Painful bilateral parotid swelling (70%) with elevated earlobe
• 03Trismus, pain on chewing acidic foods
• 04Redness around Stensen duct opening without pus
• 05Orchitis, oophoritis, meningo-encephalitis, deafness

§ differentialDifferential Diagnosis

• 01Suppurative parotitis (unilateral, pus at duct)
• 02Sialolithiasis
• 03Sjögren syndrome
• 04HIV parotid disease

§ investigationsInvestigations

• 01Clinical diagnosis
• 02Serology: IgM to mumps virus
• 03RT-PCR of saliva/buccal swab
• 04Serum amylase elevated (salivary isoenzyme)

§ treatmentTreatment

• 01Supportive: hydration, analgesia, antipyretics, bed rest
• 02Isolation for 5 days after swelling onset
• 03No antivirals of proven benefit

§ complicationsComplications

• 01Orchitis (30% post-pubertal males) → rarely infertility
• 02Aseptic meningitis, encephalitis
• 03Sensorineural deafness (unilateral)
• 04Pancreatitis

§ prognosisPrognosis

Self-limiting; resolves in 7–10 days; lifelong immunity.

§ preventionPrevention

• 01MMR vaccine at 12–15 mo and 4–6 y (two doses ≈ 88% effective)

§ examKey Examination Points

• 01Bilateral parotid swelling with elevated earlobe
• 02Absence of pus at Stensen duct

§ revisionQuick Revision Summary

• 01Paramyxovirus · bilateral parotitis · MMR vaccine

§ vivaBDS Viva Questions

• 01Complications of mumps?
• 02How does it differ from suppurative parotitis?
• 03Vaccination schedule?

§ mcqsMCQs — Assessment (3)

§ relatedRelated Diseases

References

1. Hviid A. Lancet 2008