Mumps is a contagious viral disease that causes swelling of the salivary glands. It is caused by the mumps virus and primarily affects children aged 5-10 years. The virus spreads through direct contact with infected saliva or respiratory droplets. Common symptoms include fever, headache and swelling of the parotid salivary glands. Complications can include orchitis in males and pancreatitis, though most cases resolve without issues. Treatment focuses on relief of symptoms and prevention is through vaccination with the MMR vaccine.

3. MUMPS
BY: DR.SAFEER MUKHTAR
PAEDIATRICS DEPT. SMCH
EMAIL: MR.SAFEER157624@GMAIL.COM
CONTACT: 03353478880

4. What is Mumps?
DEFINITION:
“It is an acute self-limiting contagious viral disease, characterized by
fever, bilateral or unilateral parotid swelling or tenderness.”

5. Etiology
 Mumps is caused by MUMPS virus.
 RNA virus
 Family: Paramyxovirus
 Genus: Rubula virus

6. Epidemiology
 Usual Age: 5-10 years age group.
 Transmission:
1. Direct contact
2. Droplet infection
3. Fomites contaminated by saliva
 Incubation period:
12-25 days
 Common in unvaccinated children.
 Usually occurs in winter and spring months.

7. Pathogenesis
The virus targets the salivary glands,CNS,Pancreas,Testes and to
lesser extent thyroid,ovaries,heart,liver and joint synovia.
After transmission  Entry into respiratory tract 
Replication/multiplication occurs in respiratory epithelium 
Entry into the blood (viremia)  Spread into target tissues 
salivary glands are selectively affected  Edema & infiltration
with lymphocytes in the affected gland.

8. Clinical Features
Prodromal Phase:
Lasting for 1-2 days.
 Fever
 Headache
 Vomiting
 Achiness
THEN....
 Parotitis appears (unilateral initially then becomes bilateral in 70% cases)
 Tender parotid gland
 Ipsilateral ear pain +/-
 Ingestion of sour or acidic food or liquids enhance pain in parotid area.

9. Cont....
 As the swelling progresses, the angle of jaw is obscured and the ear lobe may be lifted
upward and outward.
 The opening of Stensen’s Duct may be red & edematous
 The parotid swelling peaks approximately at 3rd day and gradually subsides over 7
days.
 Fever and other systemic symptoms resolves in 3-5 days.
 A morbilliform rash is rarely seen.
 Most commonly it involves parotid gland.
 Submandibular or submental glands may also be involved without swelling of parotid
gland
 Edema over sternum due to lymphatic obstruction may occur.

12. Diagnosis
 Diagnosis is generally clinical.
 CBC: Leukopenia with a relative lymphocytosis –
 Serum Amylase: Level increases with increase in swelling and becomes normal
within 2 weeks.
 Culture: By isolating the virus in saliva, csf , blood or urine.
 Enzyme Immunoassays: IgG & IgM.

13. Differential Diagnosis
 Cervical Lymphadenitis:
Lymph nodes has a well defined discrete border, oval shaped,
firm & tender. Multiple lymph nodes may be enlarged.
 Bacterial Parotitis:
1. Main organism; Staph. aureus
2. Usually unilateral.
3. Gland surface; Red, Warm & Tender.
4. Pus can be expressed from Stensen’s duct.
5. CBC; Raised WBCs.

14.  Recurrent Parotitis:
1. Recurrent swelling of parotid gland.
2. As a consequence of drugs eg. Iodides and Phenothiazines or by Idiopathic cause.
3. Parotid gland is not tender
 Tumors:
1. Rare in children and cause confusion in early stages of malignancy.

15. Complications
 Epididymo-Orchitis:
1. Usually unilateral.
2. Occurs in first week of parotitis.
3. Fever,Nausea,Vomiting and Abdominal pain are followed by swollen and tender testis.
 Pancreatitis:
1. Uncommon
2. Epigastric tenderness, fever and chills.
3. Raised amylase and lipase.
4. ☆Epidemiologic studies have suggested that mumps may be associated with the subsequent
development of Diabetes Mellitus but a casual link has not been established.

16. Cont...
 Meningoencephalomyelitis:
1. Only in 10% cases
2. Follows parotits by 3-10 days.
3. CSF Pleocytosis may be present in 60% of the cases in patients with mumps parotitis.
4. Clinical features of headache and raised ICP may be present.

17. Cont...
 Deafness:
Neuritis of the auditory nerve.
 Miscellaneous: (Rare...)
1. Oophoritis
2. Myocarditis
3. Thyroiditis
4. Arthritis etc...

18. Management
 Education about the disease and its spread.
 Isolation (American Academy of Paediatrics recommend an isolation period of 5 days after
the onset of parotitis for patients)
 Treatment is generally supportive.
 There is no specific antiviral treatment available.
 Adequate hydration.
 Cold or hot compression over parotid to relieve pain.
 If fever, give paracetamol or ibuprofen.
 Semi-solid or liquid diet is given to avoid pain on chewing.
 Best rest if orchitis
 Local support if orchitis.

19. Prognosis
 The outcome of mumps is nearly always excellent, even when the disease is
complicated by encephalitis.

20. Prevention
 Immunization with Mumps Vaccine is the primary mode of prevention.
 It is given as a part of MMR vaccine.
 CDC recommends 2 doses.
 1St dose at 12-15 months age.
 2nd dose at 4-6 years of age. The second dose should be given before the child
enters the puberty.
 MMR is a live virus vaccine and should not be administered to pregnant women or
to immunodeficient children.