Mumps. In: International Child Health Care: A practical manual for hospitals worldwide. Child advocacy International

ABSTRACT

Mumps is caused by a virus of the paramyxovirus family (also measles and prainfluenza). the virus is spread by airborne droplets through the respiratory tract; mouth; and possibly conjunctivae and urine; and is present in saliva; CSF; blood and urine. Clinical presentation- . Incubation period is 14-24 days. Onset is with painful swelling of paroid glands; fever; general malaise; and occuasionally headache. Parotid swelling may be unilateral at first; followed a couple of days later by swelling of the opposite paratoid gland; with pain on opening the dry mouth. Mild meningoencephalitis is common; there may be nausea and vomiting; and abdominal pain. Orchitis presents with fever and tender oedematous swelling of the testis. In 10-20of cases the second testicle may be affected. However; infertility is rare. Differential diagnosis of parotitis includes cervical adenitis; pyogenic parotitis; recurrent parotitis; tumours of the parotid and tooth infections. Mumps orchitis can mimic hernias; tumours; haematomas; epididymo-orchitis and testicular torsion. Complications- Complications include oophoritis; mastitits; pancreatitis; nephritis; myocarditis; thyroiditis; labyrinthine disturbance; painful swelling of the lacrimal glands; optic neuritis; uveeokeratitis; rapid loss of vision; arthritis; jaundice; pneumonia and thrombocytopenia. Transient or permanent unilateral nerve deafness has been reported. Infection during pregnancy very rarely causes disease of the fetus; for example aqueductal stenosis and hydrocephalus. Management symptomatic treatment includes analgesics; fluids and scrotal support for orchitis. Value of corticosteroids for orchitis is not established. Prevention- Measles; mumps; rubella (MMR) immunisation is routine in rich countries and has reduced mumps by over 90