Mumps

Also from Answers.com... ADHD Learn how to spot the signs.

More about Mumps: Causes and symptoms Diagnosis Treatment Alternative treatment Prognosis Prevention

Definition

Mumps is a relatively mild, short-term viral infection of the salivary glands that usually occurs during childhood. Typically, mumps is characterized by a painful swelling of both cheek areas, although the person could have swelling on one side or no perceivable swelling at all. The salivary glands are also called the parotid glands, therefore, mumps is sometimes referred to as an inflammation of the parotid glands (epidemic parotitis). The word mumps comes from an old English dialect, meaning lumps or bumps within the cheeks.

Description

Mumps is a very contagious infection that spreads easily in highly populated areas, such as schools. Although not as contagious as measles or chickenpox, mumps was once quite common. Prior to the release of a mumps vaccine in the United States in 1967, approximately 92% of all children had been exposed to mumps by the age of 15. In these pre-vaccine years, most children contracted mumps between the ages of four and seven. Mumps epidemics came in two to five year cycles. The greatest mumps epidemic was in 1941 when approximately 250 cases were reported for every 100,000 people. In 1968, the year after the live mumps vaccine was released, only 76 cases were reported for every 100,000 people. By 1985, less than 3,000 cases of mumps were reported throughout the entire United States, which works out to about 1 case per 100,000 people. The reason for the decline in mumps was the increased usage of the mumps vaccine. However, 1987 noted a five-fold increase in the incidence of the disease because of the reluctance of some states to adopt comprehensive school immunization laws. Since then, state-enforced school entry requirements have achieved student immunization rates of nearly 100% in kindergarten and first grade. In 1996, the Centers for Disease Control and Prevention (CDC) reported only 751 cases of mumps nationwide, or, in other words, about one case for every five million people.

— Ron Gasbarro, PharmD

Dictionary: mumps  (mŭmps)

An acute, inflammatory, contagious disease caused by a paramyxovirus and characterized by swelling of the salivary glands, especially the parotids, and sometimes of the pancreas, ovaries, or testes. This disease, mainly affecting children, can be prevented by vaccination.

[Perhaps from pl. of dialectal mump, grimace.]

An acute contagious viral disease, characterized chiefly by enlargement of the parotid glands (parotitis).

Besides fever, the chief signs and symptoms are the direct mechanical effect of swelling on glands or organs where the virus localizes. One or both parotids may swell rapidly, producing severe pain when the mouth is opened. In orchitis, the testicle is inflamed but is enclosed by an inelastic membrane and cannot swell; pressure necrosis produces atrophy, and if both testicles are affected, sterility may result. The ovary may enlarge, without sequelae.

An attenuated live virus vaccine can induce immunity without parotitis. It is recommended particularly for adults exposed to infected children, for students in boarding schools and colleges, and for military troops.

(parotitis), a contagious parotitis caused by the mumps virus (paramyxovirus) and characterized by swelling of the parotid gland and sometimes swelling of the pancreas, ovaries, and testicles. The incubation period is 12 to 20 days; transmission is by droplet spread and direct contact; communicability begins about 2 days before the appearance of symptoms and lasts until swelling of the glands has abated. See also parotitis.

Mumps. (Zitelli/Davis, 2002, courtesy of GDW McKendrick)

Definition

Mumps is a relatively mild short-term viral infection of the salivary glands that usually occurs during childhood. Typically, mumps is characterized by a painful swelling of both cheek areas, although the person could have swelling on one side or no perceivable swelling at all. The salivary glands are also called the parotid glands; therefore, mumps is sometimes referred to as an inflammation of the parotid glands (epidemic parotitis). The word mumps comes from an old English dialect word that means lumps or bumps within the cheeks.

Description

Mumps is a very contagious infection that spreads easily in such highly populated areas as day care centers and schools. Although not as contagious as measles or chickenpox, mumps was once quite common. Prior to the release of a mumps vaccine in the United States in 1967, approximately 92% of all children had been exposed to mumps by the age of 15. In these pre-vaccine years, most children contracted mumps between the ages of four and seven. Mumps epidemics came in two to five year cycles. The greatest mumps epidemic was in 1941 when approximately 250 cases were reported for every 100,000 people. In 1968, the year after the live mumps vaccine was released, only 76 cases were reported for every 100,000 people. By 1985, less than 3,000 cases of mumps were reported throughout the entire United States, which works out to about 1 case per 100,000 people. The reason for the decline in mumps was the increased usage of the mumps vaccine. However, 1987 noted a five-fold increase in the incidence of the disease because of the reluctance of some states to adopt comprehensive school immunization laws. Since then, state-enforced school entry requirements have achieved student immunization rates of nearly 100% in kindergarten and first grade. In 1996, the Centers for disease Control and Prevention (CDC) reported only 751 cases of mumps nationwide, or, in other words, about one case for every five million people.

Causes & Symptoms

The paramyxovirus that causes mumps is harbored in the saliva and is spread through sneezing, coughing, and other direct contact with another person's infected saliva. Once the person is exposed to the virus, symptoms generally become noticeable in 14–24 days. Initial symptoms include chills, headache, loss of appetite, and a lack of energy. However, an infected person may not experience these initial symptoms. Swelling of the salivary glands in the face (parotitis) generally occurs within 12–24 hours of the above symptoms. Accompanying the swollen glands is pain on chewing or swallowing, especially with acidic beverages, such as lemonade. A fever as high as 104°F (40°C) is also common. Swelling of the glands reaches a maximum on about the second day and usually disappears by the seventh day. Once a person has contracted mumps, he or she becomes immune to the disease, despite how mild or severe symptoms may have been.

While the majority of cases of mumps are uncomplicated and pass without incident, some complications can occur. Complications are, however, more noticeable in adults who get the infection. In 15% of cases, the covering of the brain and spinal cord becomes inflamed (meningitis). Symptoms of meningitis usually develop within four or five days after the first signs of mumps. These symptoms include a stiff neck, headache, vomiting, pain with bending or flexing the head, and a lack of energy. Mumps meningitis is usually resolved within seven days, and damage to the brain is exceedingly rare.

Mumps infection can spread into the brain causing inflammation of the brain (encephalitis). Symptoms of mumps encephalitis include the inability to feel pain, seizures, and high fever. Encephalitis can occur during the parotitis stage or one to two weeks later. Recovery from mumps encephalitis is usually complete, although complications, such as seizure disorders, have been noted. Only about 1 in 100 patients with mumps encephalitis dies from the complication.

About one-quarter of all post-pubertal males who contract mumps can develop a swelling of the scrotum (orchitis) about seven days after the parotitis stage. Symptoms include marked swelling of one or both testicles, severe pain, fever, nausea, and headache. Pain and swelling usually subside after 5–7 days, although the testicles can remain tender for weeks.

Girls occasionally suffer an inflammation of the ovaries, or oophoritis, as a complication of mumps, but this condition is far less painful than orchitis in boys.

As of late 2002, some researchers in Europe are studying the possibility that mumps increases a person's risk of developing inflammatory bowel disease (IBD) in later life. This hypothesis will require further research, as present findings are inconclusive.

Diagnosis

When mumps reaches epidemic proportions, diagnosis is relatively easy on the basis of the physical symptoms. The doctor will take the child's temperature, gently palpate (touch) the skin over the parotid glands, and look inside the child's mouth. If the child has mumps, the openings to the ducts inside the mouth will be slightly inflamed and have a "pouty" appearance. With so many people vaccinated today, a case of mumps must be properly diagnosed in the event the salivary glands are swollen for reasons other than viral infection. For example, in persons with poor oral hygiene, the salivary glands can be infected with bacteria. In these cases, antibiotics are necessary. Also in rare cases, the salivary glands can become blocked, develop tumors, or swell due to the use of certain drugs, such as iodine. A test can be performed to determine whether the person with swelling of the salivary glands actually has the mumps virus.

As of late 2002, researchers in London have reported the development of a bioassay for measuring mumps-specific IgG. This test would allow a doctor to check whether an individual patient is immune to mumps, and allow researchers to measure the susceptibility of a local population to mumps in areas with low rates of vaccination.

Treatment

Nutritional Therapy

Nutritional therapy may alleviate pain and aid healing. A nutritionist or naturopath may recommend the following:

• drinking lots of fluids to replace fluid loss
• eating only such easy-to-digest foods as soups, broth or bland foods
• taking multivitamin/mineral supplement to help boost the immune function

Homeopathy

A number of homeopathic remedies can be used in the treatment of mumps. For example, belladonna may be useful for flushing, redness, and swelling. Bryonia (wild hops) may be useful for irritability, lack of energy, or thirst. Phytolacca (poke root) may be prescribed for extremely swollen glands. A homeopathic physician should always be consulted for appropriate doses for children, and remedies that do not work within one day should be stopped. A homeopathic preparation of the mumps virus can also be used prophylactically or as a treatment for the disease.

Herbal Therapy

Several herbal remedies may be useful in helping the body recover from the infection or may help alleviate the discomfort associated with the disease. Echinacea (Echinacea spp.) can be used to boost the immune system and help the body fight the infection. Other herbs taken internally, such as cleavers (Galium aparine), calendula (Calendula officinalis), and phytolacca (poke root), target the lymphatic system and may help to enhance the activity of the body's internal filtration system. Since phytolacca can be toxic, it should only be used by patients under the care of a skilled practitioner. Topical applications are also useful in relieving the discomfort of mumps. A cloth dipped in a heated mixture of vinegar and cayenne (Capsicum frutescens) can be wrapped around the neck several times a day. Cleavers or calendula can also be combined with vinegar, heated, and applied in a similar manner.

Acupressure

Acupressure can be used effectively to relieve pain caused by swollen glands. The patient can, by using the middle fingers, gently press the area between the jawbone and the ear for two minutes while breathing deeply.

Allopathic Treatment

When mumps occurs, the illness is usually allowed to run its course. The symptoms, however, are treatable. Because of difficulty swallowing, the most important challenge is to keep the patient fed and hydrated. The individual should be provided a soft diet, consisting of cooked cereals, mashed potatoes, broth-based soups, prepared baby foods, or foods put through a home food processor. Aspirin, acetaminophen, or ibuprofen can relieve some of the pain due to swelling, headache, and fever. Avoiding fruit juices and other acidic foods or beverages that can irritate the salivary glands is recommended, as is avoiding dairy products that can be hard to digest. In the event of complications, a physician should be contacted at once. For example, if orchitis occurs, a physician should be called. Also, supporting the scrotum in a cotton bed on an adhesive-tape bridge between the thighs can minimize tension. Ice packs are also helpful.

Expected Results

When mumps is uncomplicated, the prognosis for full recovery is excellent. In rare cases, however, a relapse occurs after about two weeks. Complications can also delay complete recovery.

Prevention

A vaccine exists to protect against mumps. The vaccine preparation (MMR) is usually given as part of a combination injection that helps protect against measles, mumps, and rubella. MMR is a live vaccine administered in one dose between the ages of 12-15 months, 4-6 years, or 11-12 years. Persons who are unsure of their mumps history and/or mumps vaccination history should be vaccinated. Susceptible health care workers, especially those who work in hospitals, should be vaccinated. Because mumps is still prevalent throughout the world, susceptible persons over age one who are traveling abroad would benefit from receiving the mumps vaccine.

The mumps vaccine is extremely effective, and virtually everyone should be vaccinated against this disease. There are, however, a few reasons why people should not be vaccinated against mumps:

• Pregnant women who contract mumps during pregnancy have an increased rate of miscarriage, but not birth defects. As a result, pregnant women should not receive the mumps vaccine because of the possibility of damage to the fetus. Women who have had the vaccine should postpone becoming pregnant for three months following vaccination.
• Unvaccinated persons who have been exposed to mumps should not get the vaccine, as it may not provide protection. The person should, however, be vaccinated if no symptoms result from exposure to mumps.
• Persons with minor fever-producing illnesses, such as an upper respiratory infection, should not get the vaccine until the illness has subsided.
• Because mumps vaccine is produced using eggs, individuals who develop hives, swelling of the mouth or throat, dizziness, or breathing difficulties after eating eggs should not receive the mumps vaccine.
• Persons with immune deficiency diseases and/or those whose immunity has been suppressed with anti-cancer drugs, corticosteroids, or radiation should not receive the vaccine. Family members of immunocompromised people, however, should get vaccinated to reduce the risk of mumps.
• The CDC recommends that all children infected with human immunodeficiency disease (HIV) who are asymptomatic should receive an MMR vaccine at 15 months of age.

The mumps vaccine has been controversial in recent years because of concern that its use was linked to a rise in the rate of childhood autism. The negative publicity given to the vaccine in the mass media led some parents to refuse to immunize their children with the MMR vaccine. One result has been an increase in the number of mumps outbreaks in several European countries, including Italy and the United Kingdom.

In the fall of 2002, the New England Journal of Medicine published a major Danish study disproving the hypothesis of a connection between the MMR vaccine and autism. A second study in Finland showed that the vaccine is not associated with aseptic meningitis or encephalitis as well as autism. Since these studies were published, American primary care physicians have once again reminded parents of the importance of immunizing their children against mumps and other childhood diseases.

Resources

Books

"Viral Infections: Mumps." Section 19, Chapter 265 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

Zand, Janet, Allan N. Spreen, and James B. LaValle. "Mumps." Smart Medicine for Healthier Living. Garden City Park, NY: Avery Publishing Group, 1998.

Periodicals

Gabutti, G., M. C. Rota, S. Salmaso, et al. "Epidemiology of Measles, Mumps and Rubella in Italy." Epidemiology and Infection 129 (December 2002): 543–550.

Kimmel, S. R. "Vaccine Adverse Events: Separating Myth From Reality." American Family Physician 66 (December 1, 2002): 2113–2120.

Madsen, K. M., A. Hviid, M. Vestergaard, et al. "A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism." New England Journal of Medicine 347 (November 7, 2002): 1477–1482.

Makela, A., J. P. Nuorti, and H. Peltola. "Neurologic Disorders After Measles-Mumps-Rubella Vaccination." Pediatrics 110 (November 2002): 957–963.

McKie, A., D. Samuel, B. Cohen, and N. A. Saunders. "A Quantitative Immuno-PCR Assay for the Detection of Mumps-Specific IgG." Journal of Immunological Methods 270 (December 1, 2002): 135–141.

Nielsen, S. E., O. H. Nielsen, B. Vainer, and M. H. Claesson. "Inflammatory Bowel Disease—Do Microorganisms Play a Role?" [in Danish] Ugeskrift for laeger 164 (December 9, 2002): 5947–5950.

Pugh, R. N., B. Akinosi, S. Pooransingh, et al. "An Outbreak of Mumps in the Metropolitan Area of Walsall, UK." International Journal of Infectious Diseases 6 (December 2002): 283–287.

Organizations

American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007. (847) 434-4000. .

Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. .

Other

Recommended Childhood Immunization Schedules, United States, 1995. June 16, 1995, Volume 44, RR-5. Can be purchased from Superintendent of Documents, U. S. Government Printing Office, Washington, DC 20402-9325. (202) 783-3238.

Update: Vaccine Side Effects, Adverse Reactions, Contraindications, and Precautions September 6, 1996, Volume 45, RR-12. Can be purchased from Superintendent of Documents, U. S. Government Printing Office, Washington, DC 20402-9325. (202) 783-3238.

[Article by: Mai Tran; Rebecca J. Frey, PhD]

Definition

Mumps is a relatively mild short-term viral infection of the salivary glands that usually occurs during childhood.

Description

Typically, mumps is characterized by a painful swelling of both cheek areas, although the person could have swelling on one side or no perceivable swelling at all. The salivary glands are also called the parotid glands; therefore, mumps is sometimes referred to as an inflammation of the parotid glands (epidemic parotitis). The word mumps comes from an old English dialect, meaning lumps or bumps within the cheeks.

Demographics

Mumps is a very contagious infection that spreads easily in such highly populated environments as daycare centers and schools. Although not as contagious as measles or chickenpox, mumps was once quite common. Prior to the release of a mumps vaccine in the United States in 1967, approximately 92 percent of all children had been exposed to mumps by the age of 15. In the pre-vaccine years, most children contracted mumps between the ages of four and seven. Mumps epidemics came in two to five year cycles. The greatest mumps epidemic was in 1941 when approximately 250 cases were reported for every 100,000 people. In 1968, the year after the live mumps vaccine was released, only 76 cases were reported for every 100,000 people. By 1985, fewer than 3,000 cases of mumps were reported throughout the entire United States, the equivalent of about one case per 100,000 people. The reason for the decline in mumps was the increased usage of the mumps vaccine. However, 1987 noted a five-fold increase in the incidence of the disease because of the reluctance of some states to adopt comprehensive school immunization laws. After that, state-enforced school entry requirements achieved student immunization rates of nearly 100 percent in kindergarten and first grade. In 1996, the Centers for Disease Control and Prevention (CDC) reported only 751 cases of mumps nationwide, that is, about one case for every 5 million people.

Causes and Symptoms

The paramyxovirus that causes mumps is harbored in the saliva and is spread by sneezing, coughing, and other direct contact with another person's infected saliva. Once the person is exposed to the virus, symptoms generally occur in 14 to 24 days. Initial symptoms include chills, headache, loss of appetite, and a lack of energy. However, an infected person may not experience these initial symptoms. Swelling of the salivary glands in the face (parotitis) generally occurs within 12 to 24 hours of the above symptoms. Accompanying the swollen glands is pain on chewing or swallowing, especially with acidic beverages, such as lemonade. A fever as high as 104°F (40°C) is also common. Swelling of the glands reaches a maximum on about the second day and usually disappears by the seventh day. Once individuals have contracted mumps, they become immune to the disease, despite how mild or severe their symptoms may have been.

While the majority of cases of mumps are uncomplicated and pass without incident, some complications can occur. Complications are, however, more noticeable in adults who get the infection. In 15 percent of cases, the covering of the brain and spinal cord becomes inflamed (meningitis). Symptoms of meningitis usually develop within four or five days after the first signs of mumps. These symptoms include a stiff neck, headache, vomiting, and a lack of energy. Mumps meningitis is usually resolved within seven days, and damage to the brain is exceedingly rare.

The mumps infection can spread into the brain causing inflammation of the brain (encephalitis). Symptoms of mumps encephalitis include the inability to feel pain, seizures, and high fever. Encephalitis can occur during the parotitis stage or one to two weeks later. Recovery from mumps encephalitis is usually complete, although complications, such as seizure disorders, have been noted. Only about one person in 100 with mumps encephalitis dies from the complication.

About one-fourth of all post-pubertal males who contract mumps can develop a swelling of the scrotum (orchitis) about seven days after the parotitis stage. Symptoms include marked swelling of one or both testicles, severe pain, fever, nausea, and headache. Pain and swelling usually subside after five to seven days, although the testicles can remain tender for weeks.

Girls occasionally suffer an inflammation of the ovaries (oophoritis) as a complication of mumps, but this condition is far less painful than orchitis in boys.

Diagnosis

When mumps reaches epidemic proportions, diagnosis is relatively easy on the basis of the physical symptoms. The doctor will take the child's temperature, gently palpate (touch) the skin over the parotid glands, and look inside the child's mouth. If the child has mumps, the openings to the ducts inside the mouth will be slightly inflamed and have a "pouty" appearance. With so many people vaccinated as of the early 2000s, a case of mumps must be properly diagnosed in the event the salivary glands are swollen for reasons other than viral infection. For example, in persons with poor oral hygiene, the salivary glands can be infected with bacteria. In these cases, antibiotics are necessary. Also in rare cases, the salivary glands can become blocked, develop tumors, or swell due to the use of certain drugs, such as iodine. A test can be performed to determine whether the person with swelling of the salivary glands actually has the mumps virus.

In late 2002, researchers in London reported the development of a bioassay for measuring mumps-specific IgG. This test would allow a doctor to check whether an individual patient is immune to mumps and allow researchers to measure the susceptibility of a local population to mumps in areas with low rates of vaccination.

Treatment

When mumps does occurs, the illness is usually allowed to run its course. The symptoms, however, are treatable. Because of difficulty swallowing, the most important challenge is to keep the patient fed and hydrated. The individual should be provided a soft diet, consisting of cooked cereals, mashed potatoes, broth-based soups, prepared baby foods, or foods put through a home food processor. Aspirin (only for individuals over the age of 20), acetaminophen, or ibuprofen can relieve some of the pain due to swelling, headache, and fever. Patients should void fruit juices and other acidic foods or beverages that can irritate the salivary glands. They should also avoid dairy products that can be hard to digest. In the event of complications, a physician should be contacted at once. For example, if orchitis occurs, a physician should be called. Also, supporting the scrotum in a cotton bed on an adhesive-tape bridge between the thighs can minimize tension. Ice packs are also helpful.

Prognosis

When mumps is uncomplicated, prognosis is excellent. However, in rare cases, a relapse occurs after about two weeks. Complications can also delay complete recovery.

Prevention

A vaccine exists to protect against mumps. The vaccine preparation (MMR) is usually given as part of a combination injection that helps protect against measles, mumps, and rubella. MMR is a live vaccine administered in one dose between the ages of 12 and 15 months, between four and six years of age, or 11 and 12 years of age. Persons who are unsure of their mumps history and/or mumps vaccination history should be vaccinated. Susceptible healthcare workers, especially those who work in hospitals, should be vaccinated. Because mumps is still prevalent throughout the world, susceptible persons over the age of one year who are traveling abroad would benefit from receiving the mumps vaccine.

The mumps vaccine is extremely effective, and virtually everyone should be vaccinated against this disease. There are, however, a few reasons why people should not be vaccinated against mumps:

• Pregnant women who contract mumps during pregnancy have an increased rate of miscarriage but not birth defects. As a result, pregnant women should not receive the mumps vaccine because of the possibility of damage to the fetus. Women who have had the vaccine should postpone pregnancy for three months after being vaccinated.
• Unvaccinated persons who have been exposed to mumps should not get the vaccine, as it may not provide protection. The persons should, however, be vaccinated if no symptoms result from the exposure to mumps.
• Persons with minor fever-producing illnesses, such as an upper respiratory infection, should not get the vaccine until the illness has subsided.
• Because mumps vaccine is produced using eggs, individuals who develop hives, swelling of the mouth or throat, dizziness, or breathing difficulties after eating eggs should not receive the mumps vaccine.
• Persons with immune deficiency diseases and/or those whose immunity has been suppressed with anti-cancer drugs, corticosteroids, or radiation should not receive the vaccine. Family members of immunocompromised people, however, should get vaccinated to reduce the risk of mumps.
• The CDC recommends that all children infected with human immunodeficiency disease (HIV) who are asymptomatic should receive an the MMR vaccine at 15 months of age.

Parental Concerns

The mumps vaccine has been controversial in the early 2000s because of concern that its use was linked to an increased rate of childhood autism. The negative publicity given to the vaccine in the mass media led some parents to refuse to immunize their children with the MMR vaccine. One result has been an increase in the number of mumps outbreaks in several European countries, including Italy and the United Kingdom.

In the fall of 2002, the New England Journal of Medicine published a major Danish study disproving the hypothesis of a connection between the MMR vaccine and autism. A second study in Finland showed that the vaccine is also not associated with aseptic meningitis or encephalitis. Since these studies were published, U.S. primary care physicians have once again reminded parents of the importance of immunizing their children against mumps and other childhood diseases.

Resources

Books

Gutierrez, Kathleen A. "Mumps Virus." In Principles andPractice of Pediatric Infectious Diseases, 2nd ed. Edited by Sarah S. Long et al. St. Louis, MO: Elsevier, 2003.

Maldonado, Yvonne A. "Mumps." In Nelson Textbook of Pediatrics. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2004.

[Article by: Ron Gasbarro, PharmD Rebecca J. Frey, PhD Rosalyn Carson DeWitt, MD]

Mumps is an acute infectious disease caused by a paramyxovirus. Humans are the only known natural host. Mumps disease is usually mild, characterized by fever and swelling of one or both parotid salivary glands. The parotiditis usually develops an average of sixteen to eighteen days after direct contact, through the nose or mouth, with the saliva of an infected individual. In approximately 20 to 40 percent of cases, however, mumps disease occurs asymptomatically or with an uncharacteristic presentation.

Even though mumps is regarded as a fairly benign disease in the twenty-first century, in the prevaccine era mumps caused much morbidity and mortality in the United States. In 1967, mumps accounted for over one-third of encephalitis cases and one death occurred out of approximately 20,000 mumps cases. Mumps infection during pregnancy is not associated with birth defects, but infection during the first trimester is associated with a greater occurrence of fetal death. Other conditions caused by mumps include meningitis, orchitis, mastitis, pancreatitis, neuritis, arthritis, nephritis, thryroiditis, pericarditis, and deafness.

Mumps parotiditis occurs equally among males and females. Severe mumps disease, however, such as encephalitis, has been observed to occur more frequently among boys than girls. Other gender-specific manifestations are also influenced by age. After puberty, orchitis commonly occurs among males, though sterility rarely results. Among post-pubescent females, mastitis is a common manifestation.

Mumps infection can be confirmed by isolation of the virus from throat swabs, urine, or spinal fluid. Blood tests to detect antibodies to mumps virus can be used to differentiate between a current mumps infection and a previous infection. Skin testing is not reliable.

In countries without mumps vaccination, epidemics occur every two to five years, affecting most frequently those ages five to nine. Mumps disease exhibits seasonally with more cases occurring during the winter and spring. Historically, mumps outbreaks occur in situations where individuals are grouped together, such as military camps, prisons, boarding schools, and aboard ships. In community outbreaks, school-aged children are often infected first and then infect family members at home.

The mumps virus was first identified in 1934. By 1948 a killed virus vaccine was licensed, but it was later discontinued because it did not produce long-lasting immunity. The current mumps vaccine in the United States is a live, attenuated vaccine (the Jeryl-Lynn strain) licensed in December 1967. Since introduction of the Jeryl-Lynn mumps vaccine, the reported number of mumps cases in the United States has decreased dramatically, from over 150,000 in 1968 to 387 cases in 1999.

The availability of this vaccine, the use of the combination measles, mumps, and rubella (MMR) vaccine beginning in 1986, and the two-dose recommendation in 1989 of MMR has immunized many children who would have otherwise have developed mumps disease.

(SEE ALSO: Communicable Disease Control; Immunizations)

Bibliography

American Academy of Pediatrics (2000). "Mumps." In 2000 Red Book: Report of the Committee on Infectious Diseases, 25th edition, ed. L. K. Pickering. Elk Grove Village, IL: American Academy of Pediatrics.

Baum, S. G., and Litman, N. A. (2000). "Mumps Virus." In Principles and Practice of Infectious Diseases, 5th edition, eds. G. L. Mandell, J. E. Bennett, and R. Dolin. Philadelphia: Churchill Livingstone.

Plotkin, S. A., and Wharton, M. (1999). "Mumps Vaccine." In Vaccines, 3rd edition, eds. S. A. Plotkin and W. A. Orenstein. Philadelphia, PA: W. B. Saunders.

— LAURIE KAMIMOTO

For more information on mumps, visit Britannica.com.

An acute and contagious disease marked by fever and inflammation of the salivary glands. Caused by a virus, mumps is normally a childhood disease that passes with no aftereffects.

A communicable paramyxovirus disease of humans that attacks one or both of the parotid salivary glands. Called also epidemic parotitis. There is some evidence that the infection also occurs rarely in dogs and cats.