Mumps
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2008-07-01T02:36:02Z
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/* External links */ [[Category:Microbiology]]
{{Taxobox
| color = lite red
| name = ''Mumps virus''
| image = PHIL_1874.jpg
| image_caption = [[Transmission electron microscopy|TEM]] micrograph of the mumps virus.
| virus_group = V
| ordo = ''[[Mononegavirales]]''
| familia = ''[[Paramyxoviridae]]''
| genus = ''[[Rubulavirus]]''
| type_species = '''''Mumps virus'''''
}}
{{for|other uses of the word Mumps or MUMPS|Mumps (disambiguation)}}
'''Mumps''' or '''epidemic [[parotitis]]''' is a [[viral disease]] of the [[human]] species. The word "mumps" originally meant "to mumble", and came to be applied to the disease because of the side effects it causes. Prior to the development of [[vaccination]] and the introduction of a [[mumps vaccine|vaccine]], it was a common [[childhood disease]] worldwide, and is still a significant threat to health in the [[third world]].<ref name=Harrison>{{cite book | author = Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, Isselbacher KJ, Eds. | title = Harrison's Principles of Internal Medicine | edition = 16th | publisher = McGraw-Hill Professional | year = 2004 | id = ISBN 0-07-140235-7 }}</ref>
Painful swelling of the [[salivary gland]]s (classically the [[parotid gland]]) is the most typical presentation.<ref name=Hviid/> Painful [[testicle|testicular swelling]] and [[rash]] may also occur. While symptoms are generally not severe in children, the symptoms in teenagers and adults can be more severe and complications such as [[infertility]] or [[subfertility]] are relatively common, although still rare in absolute terms.<ref>{{cite journal | author=Preveden T, Jovanovic J, Ristic D | title=[Fertility in men after mumps infection without manifestations of orchitis] | journal=Med Pregl | year=1996 | pages=99–102 | volume=49 | issue=3-4 | pmid=8692089 }}</ref><sup>,</sup><ref>{{cite journal | author=Shakhov EV, Krupin VN | title=[The clinico-statistical characteristics of the testicular generative function in male subfertility following mumps] | journal=Urol Nefrol (Mosk) | year=1990 | pages=46–50 | volume= | issue=2 | pmid=2368216 }}</ref><sup>,</sup><ref>{{cite journal | author=Tsvetkov D | title=[Spermatological disorders in patients with postmumps orchitis] | journal=Akush Ginekol (Sofiia) | year=1990 | pages=46–9 | volume=29 | issue=6 | pmid=2100952 }}</ref> The disease is generally self-limited, running its course before receding, with no specific treatment apart from controlling the symptoms with [[painkiller]]s.{{TOCleft}}
{{DiseaseDisorder infobox |
Name = Mumps |
ICD10 = {{ICD10|B|26||b|25}} |
ICD9 = {{ICD9|072}} |
ICDO = |
Image = |
Caption = |
OMIM = |
MedlinePlus = 001557 |
eMedicineSubj = emerg |
eMedicineTopic = 324 |
eMedicine_mult = {{eMedicine2|emerg|391}} {{eMedicine2|ped|1503}} |
DiseasesDB = 8449 |
}}
<br style="clear:both" />
==Symptoms==
[[Image:Mumps comparison.jpg|thumb|Comparison of a person before and after contracting the mumps]]
The more common symptoms of mumps are:
* [[Parotid gland|Parotid]] [[inflammation]] (or [[parotitis]]) in 60–70% of infections and 95% of patients with symptoms.<ref name=Hviid>{{cite journal |journal=Lancet |date=2008 |volume=371 |issue=9616 |pages=932–44 |title=Mumps |author= Hviid A, Rubin S, Mühlemann K |doi=10.1016/S0140-6736(08)60419-5 |pmid=18342688}}</ref> [[Parotitis]] causes swelling and local pain, particularly when chewing. It can occur on one side (unilateral) or both sides (bilateral).
* [[Fever]]
* [[Headache]]
* [[Orchitis]], referring to painful inflammation of the testicle.<ref>{{cite journal | author=Manson AL | title=Mumps orchitis | journal=Urology | year=1990 | pages=355–8 | volume=36 | issue=4 | pmid=2219620 | doi = 10.1016/0090-4295(90)80248-L}}</ref> Males past puberty who develop mumps have a 30 percent risk of orchitis.<ref>[http://www.uchc.edu/ocomm/features/stories/stories06/feature_mumps.html]{{Dead link|date=March 2008}}</ref>
Other symptoms of mumps can include sore face and/or ears and occasionally in more serious cases, loss of voice.
===Prodrome===
Fever and headache can occur already as [[prodromal symptoms]] of mumps, together with [[malaise]] and [[anorexia (symptom)|anorexia]].
==Signs and tests==
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 [[serology|blood]] may be carried out; a newer diagnostic confirmation, using real-time nested polymerase chain reaction (PCR) technology, has also been developed <ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16971175 Real-time PCR for mumps diagnosis on clinical spec...[J Clin Virol. 2006] – PubMed Result<!-- Bot generated title -->]</ref>. An estimated 20%-30% of cases are asymptomatic.<ref>http://jama.ama-assn.org/cgi/reprint/295/20/2348.pdf#search=%22orchitis%20iowa%20health%2030%2020%22</ref>
==Treatment==
There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck area and by [[Acetaminophen]]/Paracetamol (Tylenol) for pain relief. [[Aspirin]] use is discouraged in young children because of studies showing an increased risk of [[Reye's syndrome]].<ref>The significance of these studies has been questioned.</ref> Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.
Patients are advised to avoid fruit juice or any acidic foods, since these stimulate the salivary glands, which can be painful.
==Prognosis==
Death is very unusual. The disease is self-limiting, and general outcome is good, even if other organs are involved. Mumps viral infections in adult males carries a 25% risk that the testes may become infected leading to sterility. After the illness, life-long [[immunity (medical)|immunity]] to mumps generally occurs.
==Complications==
Known complications of mumps include:
*Infection of other organ systems
*Sterility in men (this is quite rare, and mostly occurs in older men)
*Mild forms of [[meningitis]] (rare, 40% of cases occur without parotid swelling)
*[[Encephalitis]] (very rare, rarely fatal)
*Profound (91 dB or more) but rare sensorineural [[hearing loss]], uni- or bilateral
*Pancreatitis manifesting as pain abdomen and vomiting
*Oophoritis (inflammation of ovaries) but fertility is rarely affected.
==Prevention==
The most common preventative measure against mumps is immunization with a [[mumps vaccine]]. The vaccine may be given separately or as part of the [[MMR vaccine|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 [[World Health Organization|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 15 months. The [[American Academy of Pediatrics]] recommends the routine administration of MMR vaccine at ages 12-15 months and at 4-6 years.<ref>{{PDFlink|[http://www.cispimmunize.org/IZSchedule.pdf]}}</ref> 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. [[Vaccine#Efficacy|Efficacy of the vaccine]] depends on the strain of the vaccine, but is usually around 80%.<ref>{{cite journal
|author=Schlegel M, Osterwalder JJ, Galeazzi RL, Vernazza PL
|title=Comparative efficacy of three mumps vaccines during disease outbreak in Eastern Switzerland: cohort study
|journal=BMJ
|year=1999
|pages=352
|volume=319
|issue=7206
|pmid=10435956}}</ref><sup>,</sup><ref>{{cite web | title=Summary | work=WHO: Mumps vaccine | url=http://www.who.int/vaccines/en/mumps.shtml#summary] | accessdate=2006-04-18}}</ref> 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 is commonly used in developing countries, but appears to have superior efficacy in epidemic situations.<ref>{{cite journal|journal=Clin Infect Dis
|year=2007
|volume=45
|pages=459–66
|title=Mumps outbreaks in Canada and the United States: Time for new thinking on mumps vaccines
|author=Peltola H, Kulkarni PS, Kapre SV, Paunio M, Jadhav SS, Dhere RM
|url=http://www.journals.uchicago.edu/CID/journal/issues/v45n4/50311/50311.html | doi = 10.1086/520028
|format={{dead link|date=June 2008}} – <sup>[http://scholar.google.co.uk/scholar?hl=en&lr=&q=intitle%3AMumps+outbreaks+in+Canada+and+the+United+States%3A+Time+for+new+thinking+on+mumps+vaccines&as_publication=Clin+Infect+Dis&as_ylo=2007&as_yhi=2007&btnG=Search Scholar search]</sup>
}}</ref>
Some [[anti-vaccinationists|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. Disagreeing, 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.
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).<ref name=PinkBook_2006>{{cite book | author = Atkinson W, Humiston S, Wolfe C, Nelson R (Editors). | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | edition = 9th | publisher = Centers for Disease Control and prevention | year = 2006 | id = [http://www.cdc.gov/nip/publications/pink/def_pink_full.htm Fulltext] }}</ref> 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%).<ref>{{cite journal | author=Kanra G, Isik P, Kara A, Cengiz AB, Secmeer G, Ceyhan M | title=Complementary findings in clinical and epidemiologic features of mumps and mumps meningoencephalitis in children without mumps vaccination | journal=Pediatr Int | year=2004 | pages=663–8 | volume=46 | issue=6 | pmid=15660864 | doi = 10.1111/j.1442-200x.2004.01968.x}}</ref> 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.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5553a1.htm Summary of Notifiable Diseases - United States, 2006<!-- Bot generated title -->]</ref><ref>[http://www.latimes.com/features/health/la-he-mumps14apr14,1,547450.story 2006 mumps outbreak occurred despite high vaccination rate - Los Angeles Times<!-- Bot generated title -->]</ref>
==See also==
* [[List of modern mumps outbreaks]]
==References==
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==External links==
{{commonscat|Mumps}}
* ''Original version based on the [[National Library of Medicine]]'s [http://www.nlm.nih.gov/medlineplus/ency/article/001557.htm Medline Plus] website. Update Date: 08/15/01. Update date included for cross-reference against newer versions.''
*{{cite journal | author=Schlegel M, Osterwalder JJ, Galeazzi RL, Vernazza PL | title=Comparative efficacy of three mumps vaccines during disease outbreak in Eastern Switzerland: cohort study | journal=BMJ | year=1999 | pages=352 | volume=319 | issue=7206 | pmid=10435956 [http://bmj.bmjjournals.com/cgi/content/full/319/7206/352 fulltext @ BMJJournals.com]}}
* [http://www.nhsdirect.nhs.uk/he.asp?ArticleID=255 NHS.uk] – Encyclopedia – 'NHS Direct Online Health Encyclopaedia: Mumps', [[National Health Service]] (UK)
* [http://www.who.int/immunization/topics/mumps/en/index.html WHO.int] – "Immunization, Vaccines and Biologicals: Mumps vaccine", [[World Health Organisation]]
* [http://www.microbiologybytes.com/virology/Paramyxoviruses.html MicrobiologyBytes: Paramyxoviruses]"
* [http://www.ncbi.nlm.nih.gov/entrez/viewer.fcgi?db=Nucleotide&dopt=GenBank&val=7592770 nih.gov] – "NIH database entry: complete genome of Miyahara strain of Mumps"
* [http://www.cdc.gov/vaccines/vpd-vac/mumps/default.htm cdc.gov] – Collection of information from the [[Centers for Disease Control and Prevention|CDC]] concerning mumps
{{Viral diseases}}
{{Oral pathology}}
[[Category:Viral diseases]]
[[Category:Pediatrics]]
[[Category:Oral pathology]]
[[Category:Mononegavirales]]
[[Category:Microbiology]]
[[ar:نكاف]]
[[cs:Příušnice]]
[[de:Mumps]]
[[es:Parotiditis]]
[[fr:Oreillons]]
[[id:Beguk]]
[[it:Parotite epidemica]]
[[he:חזרת (מחלה)]]
[[la:Parotitis epidemica]]
[[lb:Mumps]]
[[nl:Bof]]
[[ja:流行性耳下腺炎]]
[[no:Kusma]]
[[pl:Nagminne zapalenie przyusznic]]
[[pt:Parotidite infecciosa]]
[[ro:Parotidită epidemică]]
[[ru:Эпидемический паротит]]
[[sl:Mumps]]
[[fi:Sikotauti]]
[[sv:Påssjuka]]
[[tl:Beke]]
[[tr:Kabakulak]]
[[zh:腮腺炎]]