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Mumps.

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VOL: 101, ISSUE: 24, PAGE NO: 28

- Mumps is an acute virus infection that causes enlargement of the parotid glands (salivary glands in the cheeks a...

What is it?
- Mumps is an acute virus infection that causes enlargement of the parotid glands (salivary glands in the cheeks at the angle of the jaw).

- It has been a notifiable disease in the UK since October 1988.

Causes
- Mumps is caused by a virus from the myxovirus group.

- It is transmitted by droplet infection, mainly from infected saliva but also through urine.

- Incubation period is 14-21 days.

- It is contagious from several days before the parotid swelling to several days after it appears.

- It is similarly contagious to influenza and rubella.

- Exposed individuals should be considered infectious from 12-25 days after exposure.

Symptoms
- Dry mouth, fever with headache and difficulty swallowing.

- Unilateral or bilateral swelling of the parotid glands.

- At least 30 per cent of cases in children have no symptoms.

- Following puberty, mumps can cause swollen, tender, inflamed testicles.

Treatment
- Treatment is based on alleviating symptoms.

- Paracetamol is used to reduce pain and fever. Regular rinsing of the mouth and a good fluid intake are also helpful.

- In cases of orchitis cool compresses can be helpful.

Prevention
- The introduction of MMR vaccine in 1988 halted the three-yearly cycle of mumps epidemics.

- The routine schedule for immunisation consists of two MMR vaccinations.

- There is no single antigen mumps vaccine licensed in the UK.

Complications
- Aseptic meningitis occurs in 15 per cent of cases (usually without further complications).

- Orchitis (usually unilateral) occurs in up to 20 per cent of post-pubertal males. Sterility is rare.

- Oophritis occurs in five per cent of postpubertal female sufferers. Sterility is rare.

- Profound deafness in one ear occurs in 1:15,000 cases.

- Encephalitis occurs in 1:400 to 1:6000 cases. The case fatality rate for mumps encephalitis is 1.4 per cent.

- Pancreatitis.

- Neuritis.

- Arthritis.

- Mastitis.

- Nephritis.

- Thyroiditis.

- Pericarditis.

- Mumps in the first trimester of pregnancy may increase the rate of spontaneous abortion.

Epidemiology
- Mumps incidence peaks in winter and spring but has been reported throughout the year.

- It caused about 1,200 hospital admissions annually in England and Wales before MMR.

- The number of notified cases was stable from 1995-1999, with fewer than 2,000 notifications recorded annually. It rose from 1,691 in 1999 to 2,162 in 2000.

- A resurgence of mumps occurred in 1999 and 2000 with outbreaks predominantly affecting secondary school children in the north of England.

- Most cases occurred in those who had either never received a mumps-containing vaccine, as they were too old, or had received only one dose of MMR.

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