MumpsMumps is caused by a virus which spreads by droplet infection and affects
mainly children of school age and young adults. The infectivity rate is not high and there is serological evidence that 30-40% of infections are clinically inapparent. Most cases occur in the spring. The incubation period is about 18 days. A quarantine period is not necessary: contacts should be watched for the first sign of disease from the 12th to the 28thday after exposure.
Clinical Features.(Mumps)Malaise, fever and some pain near the angle of the jaw is soon followed by tender swelling alone is often the first feature. The submandibular salivary glands may also be involved. The swollen glands subside in a few days, and may be succeeded by swelling of a previously unaffected gland. Orchitis occurs in about one in four males who develop mumps after puberty; it is usually on one side only, but if it is bilateral, sterility may be a sequel. Obscure abdominal pain may be due to pancreatitis or oöphoritis. Acute lymphocytic meningitis is another mode of presentation. Encephalomyelitis is rare. If such conditions are due to mumps, they are accompanied by a lymphocytosis. It is also of great diagnostic value in such obscure cases to know that mumps is epidemic in the district at the time.
Diagnosis.(Mumps)Most cases of mumps can be diagnosed on clinical grounds alone. But the diagnosis can be confirmed in doubtful cases by the demonstration of specific antibodies, or the virus may be cultured from the saliva, or from the cerebrospinal fluid in meningitis. Suppurative parotitis is distinguished by the circumstances of onset in an old, frail, ill, febrile or dehydrated patient in whom oral hygiene is poor, and confirmed by obtaining pus from the parotid duct. Calculous obstruction of the parotid duct is rare; it is relatively common in the submandibular duct where the stone can often be felt. Sarcoidosis may cause enlargement of the parotid glands and is usually painless and accompanied by other signs especially uveitis.
Treatment. Oral hygiene is important when the mouth is very dry due to lack of saliva. Difficulty in opening the mouth may necessitate feeding through a straw. Apart from the relief of symptoms as they appear, no other treatment is necessary. Orchitis can be relieved by the administration of prednisolone for a few days without apparent danger of dissemination of infection. Cases of mumps should be isolated until the gland last affected has subsided.