Mumps: Causes, Symptoms, and Prevention

Mumps is a viral infection primarily affecting the salivary glands, particularly the parotid glands, located near the ears. It is caused by the mumps virus, a member of the paramyxovirus family. Before the widespread use of the mumps vaccine, the disease was a common childhood illness, particularly in school-age children. Today, mumps is much less common due to vaccination, though outbreaks can still occur, especially in areas where vaccination rates are low.

What Is Mumps?
Mumps is a contagious viral infection that causes painful swelling of the salivary glands, particularly the parotid glands. The hallmark of mumps is swelling in one or both cheeks, giving the characteristic “puffy cheeks” or swollen jaw appearance.

While mumps is typically mild in children, it can cause complications in older individuals, including adults, and can sometimes lead to more serious issues such as hearing loss, meningitis, and inflammation of the testicles or ovaries.

How Does Mumps Spread?
Mumps is spread from person to person through respiratory droplets or saliva when an infected person coughs, sneezes, or talks. It can also spread through contact with contaminated objects, such as sharing cups or eating utensils. The virus can enter the body through the nose or mouth, where it multiplies before spreading to other parts of the body, including the salivary glands.

An individual with mumps is most contagious a few days before symptoms develop and for several days after the onset of symptoms.

Symptoms of Mumps
Symptoms of mumps typically appear 16-18 days after exposure to the virus, although this incubation period can range from 12 to 25 days. The symptoms often begin with non-specific flu-like signs, followed by the characteristic swelling of the salivary glands.

Common symptoms include:

Swollen Salivary Glands: The most recognizable sign of mumps is painful swelling of the parotid glands located just below the ears, causing one or both cheeks to become puffy and tender.
Fever: A moderate fever, usually around 101°F to 104°F (38.5°C to 40°C), often accompanies the swelling.
Headache: A mild to moderate headache may occur.
Muscle Aches: Muscle pain and body aches are common.
Fatigue and Weakness: Feeling tired or lethargic is typical during the course of the illness.
Loss of Appetite: A reduced desire to eat, often due to pain when chewing or swallowing.
Pain While Eating or Swallowing: Chewing or swallowing can become uncomfortable due to the swelling of the glands.
Some individuals with mumps may have mild or no symptoms, but they can still spread the virus to others.

Complications of Mumps
Though most cases of mumps are mild, especially in children, complications can arise, particularly in adults. These complications can affect different parts of the body, including:

Orchitis: In males, particularly those who have reached puberty, mumps can cause inflammation of the testicles (orchitis). This can result in pain, swelling, and in rare cases, lead to infertility.
Oophoritis: In females, mumps can lead to inflammation of the ovaries (oophoritis), causing lower abdominal pain, though it rarely affects fertility.
Meningitis: In rare cases, the virus can cause inflammation of the membranes surrounding the brain and spinal cord (meningitis). Symptoms include neck stiffness, headache, and sensitivity to light.
Encephalitis: Mumps can also lead to inflammation of the brain (encephalitis), which may cause seizures, confusion, or neurological damage.
Hearing Loss: Mumps can damage the cochlea, a part of the inner ear, leading to partial or permanent hearing loss.
Pancreatitis: In some cases, mumps can cause inflammation of the pancreas, leading to symptoms like nausea, vomiting, and abdominal pain.
Mumps and Pregnancy
Mumps during pregnancy, particularly in the first trimester, has been associated with an increased risk of miscarriage. However, no direct evidence links mumps to congenital birth defects.

Diagnosis of Mumps
A healthcare provider can typically diagnose mumps based on the characteristic swollen salivary glands and other symptoms. In some cases, laboratory tests may be used to confirm the diagnosis. These tests can include:

Blood Tests: To detect antibodies to the mumps virus.
Swab Tests: A sample from the inside of the cheek or throat can be tested for the presence of the mumps virus.
Urine or Saliva Tests: To identify the virus in other body fluids.
Treatment of Mumps
There is no specific antiviral treatment for mumps. Since it is a viral infection, antibiotics are not effective. The goal of treatment is to relieve symptoms and prevent complications.

Home care for mumps typically involves:

Rest: Encourage the patient to rest and avoid strenuous activity.
Hydration: Drinking plenty of fluids helps prevent dehydration.
Pain and Fever Management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help reduce fever and relieve pain.
Cold Compresses: Applying a cold compress to the swollen glands can reduce pain and swelling.
Soft Foods: Eating soft or liquid foods that require minimal chewing can help ease discomfort.
Patients with mumps should stay isolated from others, especially from those who are not vaccinated, for at least five days after the onset of gland swelling to reduce the risk of spreading the virus.

Prevention of Mumps
The most effective way to prevent mumps is through vaccination. The measles, mumps, and rubella (MMR) vaccine provides immunity against all three diseases. The vaccine is typically given in two doses:

First Dose: Between 12-15 months of age.
Second Dose: Between 4-6 years of age, or before starting school.
The MMR vaccine is highly effective at preventing mumps. A single dose is about 78% effective at preventing the disease, and two doses increase effectiveness to about 88%. In some cases, individuals who have been vaccinated can still contract mumps (a "breakthrough" infection), but the symptoms are usually milder and the risk of complications is lower.

Mumps Outbreaks
Despite the widespread use of the MMR vaccine, mumps outbreaks still occur, particularly in areas where vaccination rates are low. Outbreaks have been reported in crowded settings, such as colleges, schools, and camps, where close contact increases the likelihood of transmission. The spread of the disease can be exacerbated by individuals who are infected but have mild or no symptoms.

During an outbreak, public health officials may recommend an additional dose of the MMR vaccine to boost immunity, especially for those at higher risk.

Herd Immunity
Herd immunity plays a significant role in preventing mumps outbreaks. When a large percentage of the population is vaccinated, it creates a protective barrier, reducing the overall spread of the virus. This helps protect those who cannot be vaccinated, such as infants or people with certain medical conditions, and prevents outbreaks from occurring.

Mumps is a contagious viral infection that primarily affects the salivary glands, causing swelling and discomfort. While most cases are mild, complications can arise, particularly in adults and those who are not vaccinated. Vaccination with the MMR vaccine is the most effective way to prevent mumps and its associated complications. Thanks to widespread vaccination, mumps has become much less common, but outbreaks still occur in areas with low vaccine coverage. Awareness, vaccination, and good public health practices are essential in keeping mumps under control and protecting communities from outbreaks.