MUMPS
DEFINITION
Mumps is a relatively mild viral infection of the salivary glands that usually occurs during childhood. Typically, mumps is characterized by a painful swelling of both cheeks. In some cases, the swelling may occur in only one cheek, or there may be no swelling at all. The word "mumps" comes from an old English word meaning lumps or bumps in the cheeks.
DESCRIPTION
Mumps is a very contagious (catching) infection. It spreads easily in densely populated areas, such as schools. At one time, mumps was very common in the United States. Prior to 1967, about 92 percent of all children had been exposed to mumps by the age of fifteen. Most children developed the disease between the ages of four and seven. Mumps epidemics reappeared in two- to five-year cycles. The greatest mumps epidemic in modern times occurred in 1941. There were about 250 cases of the disease for every 100,000 Americans.
This pattern began to change in 1968, when a mumps vaccine was released. The vaccine proved very effective in preventing the disease. By 1985, less than 3,000 cases of mumps were reported in the entire United States. That works out to less than 1 case per 100,000 people.
Mumps: Words to Know
- Encephalitis:
- Inflammation of the brain.
- Meningitis:
- Inflammation of the tissue surrounding the brain and spinal cord.
Only two years later, the news about mumps in the United States had taken a turn for the worse. The rate of infections had increased five times. The reason given for this increase was the failure to have all young children vaccinated against the disease. Many states became concerned about this trend. They passed laws requiring all children in kindergarten and first grade to have vaccinations against mumps. The success of these efforts became apparent in 1996. In that year, only 751 cases of mumps were reported nationwide, or about 1 case for every 5 million people.
CAUSES
The virus that causes mumps lives in a person's saliva. It is spread by coughing, sneezing, or other direct contact between people.
SYMPTOMS
Once a person is exposed to the virus, symptoms occur in fourteen to twenty-four days. Initial symptoms include chills, headache, loss of appetite, and a lack of energy. Less than twenty-four hours later, the salivary glands in the face begin to swell. The patient finds it painful to chew or swallow, especially acidic beverages like orange juice and lemonade. A fever as high as 104°F is also common.
The swelling reaches a maximum on about the second day. It usually disappears completely by the seventh day. Once a person has had mumps, he or she can never have the disease again.
The majority of cases of mumps disappear without complications. Complications are more likely to occur with adults who get the infection. In 15 percent of all cases, the mumps virus spreads to the brain. There, it causes an inflammation of brain tissue known as meningitis (pronounced meh-nen-JI-tiss; see meningitis entry). Symptoms of meningitis usually develop within four or five days after the first signs of mumps. These symptoms include a stiff neck, headache, vomiting, and a lack of energy. Meningitis is a very serious condition and must be treated very quickly.
The mumps virus can cause another disease of the brain known as encephalitis ("brain fever"; see encephalitis entry). The symptoms of mumps encephalitis include the inability to feel pain, seizures, and a high fever. Most patients recover from mumps encephalitis without complications. In about 1 percent of all cases, a person dies from mumps encephalitis. Those who survive may develop seizure disorders that can stay with a person throughout his or her life.
About a quarter of all adolescent boys who develop mumps also experience swelling of the scrotum (the sac that contains the testicles). This swelling is accompanied by severe pain, fever, nausea, and headache. These symptoms tend to disappear after five to seven days, although the testicles may remain tender for weeks.
DIAGNOSIS
Before the mumps vaccine was developed, diagnosing mumps was easy. Most doctors had seen many cases of mumps and recognized the characteristic swollen salivary glands as a sign of the disease. Today, the disease is so rare that it can easily be missed. A doctor may attribute the swelling to some other condition, such as a bacterial infection. To diagnose mumps, then, the doctor's primary goal is to rule out other possible explanations for swollen salivary glands. A simple test is available that tells whether the swelling is caused by mumps or by some other condition, such as poor oral (tooth-care) hygiene.
TREATMENT
There is no treatment for mumps. All that can be done is to allow the disease to run its course. However, steps can be taken to make the patient more comfortable. For example, acetaminophen (pronounced uh-see-tuh-MIN-uh-fuhn,
trade name Tylenol), or ibuprofen (pronounced i-byoo-PRO-fuhn, trade name Advil) can help relieve the pain due to swelling, headache, and fever. Aspirin should never be given to children who have mumps. Aspirin has been found to cause Reye's syndrome (see Reye's syndrome entry), a potentially fatal disease.
Because of difficulty swallowing, the most important challenge is to keep the patient fed and hydrated (given liquids). He or she should be provided with a soft diet, consisting of cooked cereals, mashed potatoes, broth-based soups, prepared baby foods, or foods put through a home food processor. Fruit juices should be avoided because they can irritate the salivary glands. Patients also should not be given dairy products because they may be difficult to digest.
In the event of complications, a doctor should be contacted at once. For example, there are treatments that can relieve the discomfort of swelling of the scrotum.
Alternative Treatment
Some patients find that acupressure (a Chinese therapy that involves applying pressure to certain points in the body) can help relieve the pain of swollen glands. They use their middle fingers to press gently on the area between the jawbone and the ear for two minutes while breathing deeply.
GROWING VIRUSES
Until the 1940s, research on viruses progressed very slowly. A major problem was that no one knew how to grow viruses in the laboratory. By contrast, bacteria were easy to grow. Sometimes, all that was needed was to keep food open to the air. Bacteria grew quickly on the food.
An important breakthrough came when scientists discovered that viruses will grow in live chick embryos. Live chick embryos are easy to find—just crack open a fertilized egg! The problem was that bacteria also like to grow in chick embryos. By the 1940s, that problem could be solved as well. Simply adding an antibiotic to the chick embryo killed the bacteria, but had no effect on the viruses.
Much of the work done on growing viruses was conducted by American bacteriologist John F. Enders (1897–1985) and his colleagues at Children's Hospital in Boston. With the technique they developed, Enders and his colleagues were able to grow the viruses that cause mumps, measles, poliomyelitis, chickenpox, and other diseases. They eventually developed vaccines for mumps and measles. Other researchers later used the same techniques to develop a vaccine for poliomyelitis.
A number of homeopathic remedies have been recommended for various symptoms of mumps. These include belladonna for swelling and redness; wild hops for lack of energy, irritability, and thirst; and poke root for swollen glands. Homeopathic remedies that do not have an effect on the patient should not be continued.
Several herbal remedies may be useful in helping the body recover from a mumps infection or helping to relieve the discomfort of the disease. These herbs include echinacea (pronounced ek-i-NAY-see-uh), cleavers, calendula (pronounced KUH-len-juh-luh), and poke root. Poke root can be toxic, so it should be used only under the close supervision of a trained practitioner.
Some herbal remedies are applied as packs placed directly on the swollen glands. These packs may be dipped in a solution of vinegar and cayenne or a solution made from cleavers or calendula mixed with vinegar and heated.
PROGNOSIS
The prognosis for mumps is usually excellent. Most patients recover completely from the disease with no aftereffects. In rare cases, a relapse (return of the disease) may occur after about two weeks. Complications occur rarely.
PREVENTION
Today, mumps is a preventable disease. A vaccine against the disease is usually given in combination with vaccines for measles (see measles entry) and rubella (see rubella entry). The vaccine is called the MMR vaccine. It is usually given in a single dose between the ages of twelve and fifteen months, four and six years, or eleven and twelve years. Anyone who is not certain whether he or she has had a vaccination should be vaccinated.
Vaccinations are also recommended for certain groups of people. For example, health-care workers should be vaccinated to protect them from infection by clients. People who travel to other parts of the world should consider a mumps vaccination. Although the disease has largely disappeared in the United States, it is still common in many other parts of the world.
On the other hand, there are some people who should not be vaccinated against mumps. For these people, the vaccine can be more dangerous than the disease it is intended to prevent. Among those who should not be vaccinated are the following:
- pregnant women
- anyone with an illness accompanied by a mild fever
- people who are allergic to eggs and/or egg products
- persons with conditions that have damaged their immune systems, such as those who are HIV-positive
FOR MORE INFORMATION
Books
Stoffman, Phyllis. The Family Guide to Preventing and Treating 100 Infectious Diseases. New York: John Wiley & Sons, 1995.