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| Mumps Disease |
Mumps is characterized by painful enlargement of the salivary glands and sometimes involvement of the gonads, meninges, pancreas and other organs. It is caused by a paramyxovirus called mumps virus which may be isolated from saliva, cerebrospinal fluid, blood, urine, brain and other infected tissues of the patient with mumps.
Mumps is more common between the ages of 5-15 years. Since the risk of orchitis is much greater than the risk of oophoritis, it is a serious disease in males.
Epidemiology
It is endemic in most urban populations. The virus spreads from humans by direct contact, droplets, fomites contaminated by infectious saliva and possibly urine. Incubation period ranges from 14-24 days with peak at 17 to 18 days. Patient is infectious 24 hours prior to appearance of swelling and upto 3 days after the swelling has subsided. A lifelong immunity is produced by any type of clinical or subclinical infection. Maternal antibodies are usually protective for the first 6-8 months of the infant.
Clinical Manifestations
- In children prodromal symptoms are rare, but may show as fever, muscular pain especially involving neck, headache and malaise.
- Onset is by pain and swelling in one or both parotid glands. The swelling slowly subsides in 3-7 days or occasionally lasts longer.
- The swelling is bilateral in two third of the cases. Second salivary gland may swell up as the first gland is subsiding. The swollen area is tender, hot, red and painful. The earlobe is pushed forward and upward when parotid gland is involved. Pain is specially elicited by tasting some liquid e.g. lemon juice: a useful diagnostic sign. Child feels difficulty in eating, swallowing and talking. Temperature is variable.
- Redness and swelling are commonly seen around the opening of Stenson's duct (duct of parotid gland). There is oedema of pharynx, soft palate pushin the tonsils medially. Submandibular and sublingual glands may be involved and swollen, with or without parotid swelling.
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