Mumps

Page last reviewed: 13/07/2011

Mumps is a highly contagious viral infection that usually affects children. The most common symptom of mumps is a swelling of the parotid glands. Swelling and pain of the testicles is common in men and boys after puberty.

The parotid glands are located on one side, or both sides, of the face. The swelling gives a person a distinctive 'hamster face' appearance.

Once a person has had mumps, they usually develop immunity against further infections.

How common are mumps?

Before the introduction of the measles, mumps and rubella (MMR) vaccine in 1988, mumps was a common childhood infection that was responsible for many hospital admissions a year.

After the MMR vaccine was introduced as part of the routine childhood vaccination programme, the number of mumps cases fell sharply.

However, in recent years, there has been a rise in the incidence of mumps, particularly among teenagers and young adults. In 2009 more than 3600 cases were reported, most 15-34 years of age.

The recent mumps epidemics mainly affected people who were never vaccinated with MMR vaccine or may have only received one dose of the MMR vaccine..

How is the mumps spread?

The mumps virus is spread in the same way as the common cold and flu viruses. The mumps virus is airborne, which means that it can survive briefly in the outside environment. Therefore, mumps can be spread through:

  • direct contact - for example, if you sneeze or cough, tiny droplets of fluid containing the mumps virus are launched into the air and can be breathed by others
  • indirect contact - for example, if infected droplets are transferred to an object, such as a door handle, and someone else touches it, they may catch the mumps if they then touch their mouth or nose.

The most effective way to prevent catching mumps is to have the MMR vaccine, which is thought to be 95% effective in protecting against the mumps.

Mumps is a highly contagious infection. People who are infected are most contagious for 1-2 days before the onset of symptoms, and for five days afterwards.

During this time, it is important to prevent spreading the infection to others, particularly those at high risk of developing complications. For example:

  • teenagers and young adults who have not been vaccinated
  • pregnant women.

Outlook

The outlook for young children with mumps is generally good because the symptoms should pass within two weeks without causing any long-term problems.

The outlook for teenagers and adults with mumps is slightly less positive because they have a higher risk of developing complications, some of which can be serious.

Complications of mumps include:

  • painful swelling of the testicles (in boys and men)
  • encephailitis (swelling of the brain) or viral meningitis
  • deafness
  • mumps can also rarely cause inferitility in men

As there is currently no cure for mumps, treatment is aimed at relieving the symptoms and preventing the further spread of infection. 

Contagious
Contagious is when a disease or infection can be easily passed from one person to another.
MMR
MMR stands for measles, mumps and rubella. It is a vaccine that prevents measles, mumps and rubella by making the body produce antibodies to fight off the viruses.

Page last reviewed: 13/07/2011

The symptoms of mumps usually develop 14-25 days after being infected with the mumps virus (the incubation period). The average incubation period is around 17 days.

Swelling of the parotid glands is the most common symptom of mumps. The parotid glands are a pair of glands that are responsible for producing saliva. They are located on either side of your face, just below your ears.

Both glands are usually affected by the swelling, although in a minority of cases, only one gland is affected.

The swelling causes additional symptoms, including:

  • pain and tenderness in the swollen glands
  • pain on swallowing and/or difficulty swallowing.

Other symptoms of the mumps include:

  • headache
  • joint pain
  • nausea
  • dry mouth
  • mild abdominal pain
  • fatigue
  • loss of appetite
  • inflammation of ovaries, testicles, deafness
  • high temperature (fever) of 38ºC (100.4ºF), or above.

When to seek medical advice

Contact your GP if you suspect that you or your child have mumps. While the infection is not usually serious, mumps share symptoms with other, more serious types of infection, such as glandular fever and tonsillitis. It is always best to visit your GP so that they can confirm (or rule out) a diagnosis of mumps.

Page last reviewed: 13/07/2011

Mumps is caused by the mumps virus, which belongs to a family of viruses that are known as paramyxoviruses. Paramyxoviruses are a common source of infection, particularly in children.

When you get mumps, the virus moves from your respiratory tract (your nose, mouth and throat) into your parotid glands, where it begins to reproduce. This causes inflammation and swelling of the glands.

Viral cells can also enter your cerebrospinal fluid (CSF), which is the fluid that surrounds and protects your brain and spine. Once the virus has entered the CSF, it can spread to other parts of your body, such as your brain, pancreas, testicles (in boys and men), and ovaries (in girls and women).

How mumps is spread

Mumps is an airborne virus and can be spread by:

  • an infected person coughing or sneezing and releasing tiny droplets of contaminated saliva, which can then be breathed in by another person
  • an infected person touching their nose or mouth, then transferring the virus onto an object, such as a door handle, or work surface; if someone else then touches the object shortly afterwards, they can transfer the virus into their respiratory tract
  • sharing utensils, such as cups, cutlery or plates with an infected person
Immune
The immune system is the body's defence system, which helps protect it from disease, bacteria and viruses.
Sneezes
Sneezing is an involuntary expulsion of air and bacteria from the nose and mouth.
Swelling
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Page last reviewed: 13/07/2011

Mumps is usually diagnosed from the symptoms, in particular from the swelling around your parotid glands.

If you have mumps, your GP can see and feel the swelling. By looking inside your mouth, they may be able to see that your tonsils have been pushed out of their usual position.

If you have mumps you may also have a raised temperature, approximately between 37.5 and 39.5ºC (100 to 103ºF).

To confirm the diagnosis, particularly in a case where symptoms are severe or there are complications, a blood, urine or cerebrospinal fluid (CSF) test can be used. The CSF test or spinal tap involves taking a sample of the fluid that runs through your spine.

If you think that you or your child has mumps, you should visit your GP so that a diagnosis can be confirmed.

Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Spine
The spine supports the skeleton, and surrounds and protects the delicate spinal cord and nerves. It is made up of 33 bones called the vertebrae.
Swelling
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Page last reviewed: 13/07/2011

There are currently no anti-viral medications that can be used to treat mumps. Treatment is focused on relieving symptoms until your body's immune system manages to fight off the infection.

The self-care techniques listed below should help.

  • Get plenty of bed rest until your symptoms have passed.
  • Over-the-counter (OTC) painkillers, such as ibuprofen or paracetamol, can reduce symptoms of pain. Children who are 16 years old or under should not be given aspirin.
  • Drink plenty of fluids, but avoid drinks that are known to stimulate saliva production, such as fruit juice, because excess saliva can cause pain. Water is usually the best fluid to drink.
  • Applying a cold compress to your swollen glands should help to reduce the pain.
  • Eat foods that do not require a lot of chewing, such as soup, mashed potatoes and scrambled eggs.

Preventing the spread of infection

In people with mumps, preventing the spread of infection is also important. The advice below explains the best way to do this.

  • Stay away from school, college or work until five days after the onset of your symptoms.
  • Wash your hands regularly, using soap and water.
  • Always use a tissue to cover your mouth and nose when you cough and sneeze. Throw the tissue in a bin immediately afterwards.
Fever
A high temperature, also known as a fever, is when someone's body temperature goes above the normal 37°C (98.6°F).
Immunity
The immune system is the body's defence system, which helps protect it from disease, bacteria and viruses.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Testes
Testicles are the two oval-shaped reproductive organs that make up part of the male genitals. They produce sperm and sex hormones.

Page last reviewed: 13/07/2011

MMR Vaccine

The best way to prevent catching mumps is to be immunised with the measles, mumps and rubella (MMR) vaccine.

Advice for children

The MMR vaccine is part of the routine childhood immunisation programme. One dose is given to a child at 12 months of age. A second dose is given in junior infants of primary school at four to five years of age (except in Sligo Leitrim and Donegal where it is given by the GP).

Contact your local public nurse or GP if you are uncertain about whether your child's vaccinations are up-to-date.

Advice for adults

The MMR vaccine can be given at any age, so there may be circumstances where you are advised to have the MMR vaccine.

For example, if you were born between 1980-1990, you may not be protected against mumps. It is unlikely that you will have been previously exposed to a mumps infection, so vaccination may be recommended.

If you were born before 1978, it is unlikely that you have been vaccinated against mumps. While it is likely that you will have been previously exposed to mumps, vaccination may be recommended if you have a high risk of exposure to mumps.

All students starting third level college, particularly those aged 17-24 years, are recommended   two doses of MMR vaccine if they have not previously received the vaccine. Vaccination for older students is not usually needed.

Factors that can increase your risk of exposure to mumps include:

  • living or working in environments that contain a high number of young people living in close contact, such as a college, university or army base
  • being a healthcare worker

You also have a higher risk of exposure if you are travelling to a part of the world that does not offer routine vaccination against mumps, such as:

  • most of Africa, except Egypt and Libya
  • Pakistan
  • India
  • Japan
  • South East Asia
DoseDose is a measured quantity of a medicine to be taken at any one time, such as a specified amount of medication.ImmunisationVaccination or immunisation is usually given by an injection that makes the body's immune system produce antibodies that will fight off a virus.MMRMMR stands for measles, mumps and rubella. It is a vaccine that prevents measles, mumps and rubella by making the body produce antibodies that will fight off the viruses.SneezesSneezing is an involuntary expulsion of air and bacteria from the nose and mouth.

Page last reviewed: 13/07/2011

Common complications

Common complications of mumps include:

  • pain and swelling of the testicles (orchitis) - which affects 20% of all males who get mumps after puberty
  • pain and swelling of the ovaries (oophoritis) - which affects 5% of all females who get mumps after puberty
  • inflammation of the pancreas (pancreatitis) - which occurs in 5% of cases
  • viral meningitis - which occurs in an estimated 1-10% of all cases.

Orchitis, oophoritis, viral meningitis and pancreatitis are explained in more detail below.

Orchitis

The most common symptom of orchitis is the painful swelling of the testicles. The pain can range from mild to severe. The testicles usually begin to swell 4-8 days after the onset of mumps symptoms.

Other symptoms of orchitis include:

  • high temperature (fever) of 38ºC (100ºF) or above
  • vomiting
  • headache
  • a general feeling of being unwell

The swelling should resolve within a week, although your testicles may feel tender for several weeks.

Symptoms of pain can be eased using over-the-counter (OTC) painkillers, such as paracetamol or ibuprofen. If the pain is particularly severe, contact your GP who may prescribe a stronger painkiller for you.

Applying cold compresses to your testicles, and wearing supportive athletic underwear, may also reduce any pain.

An estimated 50% of men who get mumps will notice some shrinkage of their testicles. An estimated 7-13% of men will experience a drop in their sperm count (the amount of healthy sperm that their body can produce). However, this is rarely large enough to cause infertility.

Oophoritis

Oophoritis is the inflammation (swelling) of your ovaries, which can cause symptoms of:

  • lower-abdominal pain
  • high temperature (fever) of 38ºC (100ºF) or above
  • vomiting

The symptoms of oophoritis usually pass once the body has fought off the underlying mumps infection.

There have been a number of cases where oophoritis has triggered an early menopause and caused infertility. But this is thought to be rare.

Pancreatitis

The most common symptom of pancreatitis is the sudden onset of pain in the centre of your upper abdomen. Other symptoms of acute pancreatitis can include:

  • nausea
  • vomiting
  • diarrhoea
  • loss of appetite
  • high temperature (fever) of 38ºC (100ºF) or above
  • tenderness of the abdomen and, less commonly, yellowing of the skin and the whites of the eyes (jaundice)

Although the pancreatitis associated with mumps is usually mild, admission to hospital may be recommended so that your body functions can be supported until your pancreas recovers.

Viral meningitis

Viral meningitis is a viral infection of the outer membranes (meninges) of your brain and spinal cord.

Unlike bacterial meningitis, which is regarded as a potentially life-threatening medical emergency, viral meningitis causes much milder, flu-like symptoms, and the risk of serious complications are low.

Symptoms of viral meningitis include:

  • high temperature (fever) of 38ºC (100ºF) or above
  • sensitivity to light (photophobia)
  • headache
  • nausea
  • vomiting

The symptoms of viral meningitis usually pass within 14 days.

Mumps and pregnancy

Women who develop a mumps infection during the first 12-16 week of pregnancy have a slightly higher risk of miscarriage. There is no evidence that mumps causes birth defects.

Rare complications of mumps

Rare but potentially serious complications of mumps include:

  • a serious brain infection (encephalitis), which occurs once in every 6,000 cases
  • permanent hearing loss, which occurs once in every 15,000 cases.

Encephalitis requires emergency admission to an intensive care unit (ICU). Unfortunately, there is currently no treatment to reverse hearing loss.

Brain
The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Ovaries
Ovaries are the pair of reproductive organs that produce eggs and sex hormones in females.
Testes
Testicles are the two oval-shaped reproductive organs that make up part of the male genitals. They produce sperm and sex hormones.
Thyroid
The thyroid is a jointed piece or cartilage that enclosed the vocal cords and forms the 'Adam's apple' in men.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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