MUMPS

XIE QIFENG

Dept. of Infectious Disease

Introduction

Mumps is an acute respiratory tract

infectious disease caused by mumps virus,
it occurs primarily in school-aged children
and adolescents.The most prominent
manifestation is nonsuppurative swelling
and tenderness of the salivary glands with
one or both parotid glands involved in most
cases.
Introduction

Meningitis, meningoencephalitis,
epididymo-orchitis, oophoritis and
pancreatitis are the common
extrasalivary gland manefestations of
mumps.
Etiology
Mumps virus (Paramyxovirus parotitis)
belongs to Paramyxoviridae family. RNA
virus.

6 major proteins. nucleocapsid associated

(S antigen) for diagnosis. Hemagglutinin-

neuraminidase(V antigen) for protection.
Etiology
Sensitive to ether,ultraviolet and
high temperature

Humans are the only natural host

 Epidemiology
Sources of infection:
Patients in early course of the disease, hosts
under covert infection.
The period of peak contagion before or at the
onset of parotitis.

Route of transmission :
Via droplet nuclei or direct contact,fomites
 Epidemic features:
Endemic throughout the world.
The peak incidence in winter and
spring.
School-aged children at high risk.
Post-infection immunity is stable and
long-lasting.
Pathogenesis and Pathology

The virus usually infecting glandular

tissue such as parotid, orchis or oophoron.
The main pathologic findings are
nonsuppurative inflammatory reactions.
The meningoencephalitis may involve
the Fusion protein.
Clinical Manifestations
Incubation period: averages 16 to 18 days
with a range of 2 to 4 weeks.

Prodromal symptoms include low- grade fever,

anorexia,malaise and headache.

Parotid tenderness and ipsilateral earache

within 1 or 2 days after the illness onset,then
parotid is visibly enlarged and go to maximum
size over next 2 to 3 days accompanied severe
pain and normal or high temperature. One
parotid enlarges after the other. The orifice of
Stensens duct is edematous and erythematous.
Parotid returns to normal size within a week.
Patients with parotitis have difficulty with
pronunciation and mastication. Citrus fruits and
juices exacerbates the pain.
Other salivary glands involved include
submandibular adenitis and sublingual
adenitis.
 Clinical meningitis occurs in 15% of patients
with mumps. Its onset averages 4-5 days after
parotitis but may before, after or in the
absence of parotitis. Clinical features are
headache, vomiting, fever and nuchal rigidity.
CSF pleocytosis. Prognosis is benign.

The onset of orchitis is abrupt with high

temperature, chills , testicular pain and
swelling. Impaired fertility is rare.
 Oophoritis develops in 5% postpubertal
women with mumps. Impaired fertility is
rare.

Pancreatitis is manifested by severe epigastric

pain and tenderness,fever,nausea,and
vomiting.
Diagnosis
In most instances, the diagnosis of mumps is
made on the basis of a exposure history and of
parotid swelling and tenderness accompanied
other symptoms.

Laboratory confirmation is unnecessary in

typical cases, exception the absence or
recurrence of parotitis and extrasalivary glands
involved. Serologic tests,viral isolation.
Amylase and lipase.
Differential Diagnosis

Suppurative parotitis

Other viral parotitis: caused by parainfluenza

virus, coxsackievirus and influenza A virus.
---serologic tests or viral culture

Parotid enlargement caused by other reasons

Prognosis

Benign and self-limited

Major death causes are severe mumps
encephalitis
Treatment
Supportive and symptomatic treatment

Anti-viral therapy: ribavirin and interferon

Dexamethason for meningoencephalitis

Diethylstilbestrol for orchitis

Prenvention
Patients should be isolated.
Attenuated mumps virus vaccine has been
available. More than 90% vaccine recipients
produced protective antibody.
Aseptic meningitis associated with
vaccine virus occurred in 0.025% recipients.
Mumps vaccine should not be
administered to pregnant women or persons
with immunodeficiencies.
Thanks!