Mumps
Mumps is a viral infection of the parotid salivary glands. These glands are located just below and in front of the ears. They produce saliva, which drains into the mouth and helps to break up and digest food.Mumps is caused by a contagious virus, which is transmitted through airborne droplets from the coughs and sneezes of infected people. It takes between 14-21 days for the symptoms of mumps to develop, after coming into contact with someone who has the virus. Mumps is normally a mild illness, but in a minority of cases, there can be severe complications, such as deafness and meningitis. This is why children are vaccinated against mumps.
Since 1988, when the childhood measles, mumps and rubella (MMR) immunisation was introduced, mumps has become less common in the UK. However, in recent years, there has been an increase in cases of mumps because some parents have chosen not to let their child have the MMR vaccine.
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Symptoms
In mumps, one or both of the salivary glands swell up and become painful. This creates the characteristic 'hamster' appearance of a swollen face, particularly just below, and in front of, the ear. The swelling of the glands increases over two to three days and gradually decreases as the high temperature falls. It is not unusual for swelling to last for around eight days.
The incubation period for mumps (the time that the viral infection is in your system before the symptoms begin to show) is between 14-21 days. However, a person who has the mumps infection is contagious from about six days before their glands swell, until about five days after they swell. You can only pass on mumps if you currently have the infection.
Other symptoms of mumps may include:
 pain when chewing and swallowing,
sore throat,
fever,
feeling tired,
loss of appetite,
mild abdominal (tummy) pain,
dry mouth, and
headache.
There may be swelling around the ovaries (in girls) or testes (in boys after puberty).
Around a third of people with the mumps virus develop no symptoms and, in most other people, the symptoms are fairly mild.
Causes
The mumps virus is spread in saliva and in minute airborne droplets from the coughs and sneezes of infected people.
The virus that most commonly causes mumps is a paramyxovirus. On rare occasions your parotid glands may swell due to the influenza virus or Coxsackie virus. These conditions may also be responsible for mumps returning.
Lack of immunisation is the main factor that puts people at risk of having mumps. Some adults may not be immune. If you were not given a vaccination as a child, or have a weakened immune system, you may also be at risk.
Diagnosis
Mumps is usually diagnosed from the symptoms, in particular, from the swelling around your parotid glands.
If you have mumps, your GP will be able to see and feel the swelling, and by looking inside your mouth he or she 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 37.5-39.5C (100 to 103F).
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.
Treatment
There is no cure for mumps, so treatment deals solely with the symptoms. Your body heals itself by producing antibodies to the virus, which provides immunity for the rest of your life. Repeat infection is very rare, although no immunisation is 100% effective. However, all the vaccines in the UK immunisation programme offer substantial protection.
If you have mumps, you should drink plenty of cool fluids, especially water, but you should avoid drinking fruit juice because it stimulates saliva production, which can be painful.
A mild painkiller, such as ibuprofen, or paracetamol, will help to reduce your pain and ease a mild fever. However, children 16 years of age, or younger, should not be given aspirin.It may also be soothing to hold a warm flannel against your swollen glands.
Adolescent boys and men who have severe inflammation of the testes (orchitis) may be prescribed a stronger painkiller, or steroid drugs called corticosteroids.
Prevention
The measles, mumps and rubella vaccine (MMR) is given in two doses as part of the national immunisation programme. The first dose should be given at around 13 months of age and the second just before the child starts school (between 3-5 years of age). Where required (for example, if your child has missed out on the vaccination programme), the two doses of the immunisation can be given at any age, as long as each dose is separated by an interval of at least one month. However, it is recommended that children receive their second dose before starting school.
Children who have not been vaccinated and who develop mumps should be kept away from school and from as many people as possible for several days from the onset of swelling glands. This is because mumps is very contagious and is spread through coughs and sneezes.
Complications
Most cases of mumps are mild, but when complications occur they can be serious.
One in four men who catch mumps over the age of 12 may develop inflammation of one or both testicles (orchitis). This can be very painful, especially if it affects both testes. There is also evidence that suggests that this could lower fertility but only in extremely rare cases will it lead to sterility. On rare occasions, females with mumps may experience swelling of their ovaries (oophritis).
Brain inflammation (encephalitis) and inflammation of the meninges (meningitis) occasionally occurs. Other parts of your body, such as your pancreas, and thyroid gland, may also be inflamed, which can be painful. Another rare complication of mumps is deafness in one ear, but this happens very occasionally.
Pregnant women who develop mumps during the first 12-16 weeks of pregnancy (the first trimester) have a slightly higher risk of miscarriage, but there is no evidence that mumps can cause deformities in your unborn child.
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