The mumps

An outbreak of mumps on the Ohio State University campus has brought the mumps back into the news again.  Forty cases of the disease have been confirmed in students and some individuals associated with the university.   

Mumps is a viral infection that primarily affects the parotid glands.  The disease was very common in the United States until vaccination for mumps was instituted in 1967.  Before the vaccine, up to 200,000 cases of mumps occurred each year.  Now it’s less than 500 cases per year.

The virus that causes mumps is called a paramyxovirus.  It is spread by infected individuals through direct contact, airborne droplets (coughing and sneezing) and saliva.  The time that an infected person can transmit mumps to a non-infected person is from three days before symptoms appear to about nine days after the symptoms appear.  Incubation takes about two to four weeks.  The mumps is about as contagious as the flu.

In many cases the infection is asymptomatic.  For the others there are the typical signs and symptoms of a virus: fever, tiredness, headache, and loss of appetite.  Swelling of the parotid glands occurs in most cases of mumps.  The parotids are salivary glands located in the cheeks, just in front of the ears.  In 70 percent of cases, the glands are swollen on both sides.  The term “mumps” is an old expression for lumps or bumps within the cheeks.

Symptoms last one to two weeks and there is usually no permanent damage to the parotid glands.  Complications of mumps are rare and include inflammation of the brain (encephalitis), the spinal cord (meningitis), the testicles (orchitis), the ovaries (oophoritis) and the pancreas (pancreatitis).  It can also cause permanent deafness in one or both ears. 

Finally, infection in susceptible women can lead to spontaneous abortion during pregnancy.

Since the general symptoms of mumps may be similar to other common infections, it may be difficult to diagnose initially.  The characteristic swelling in the parotid glands and cheeks make the disease easier to spot.  However, other infections, such as strep and mono, can cause gland swelling.  A blood test can be done to determine antibodies status for mumps.  

The disease is a viral infection, so antibiotics are not effective in treatment.  It will run its course as the body’s immune system fights it off.  Once an individual has had the disease, he/she is considered immune for life.

The vaccination for mumps (MMR- measles, mumps, and rubella) also confers lifelong immunity.  It’s the reason we don’t see a lot of this disease.  Two shots have been recommended since the late 1980s to early 1990s, one at age 12 to 15 months and the second at age four to six years.  Individuals who have not received two MMR shots are urged to get a booster.       

A final note about the vaccine: some have raised concerns about a possible connection between the MMR vaccine and autism.   The American Academy of Pediatrics, the Institute of Medicine, and the Centers for Disease Control and Prevention concluded that there’s no scientifically proven link between the MMR vaccine and autism.  

These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which happens to be about the time children are given their first MMR vaccine.  This coincidence in timing shouldn’t be mistaken for a cause-and-effect relationship.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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