Mumps

Overview – Mumps

Mumps is an acute viral illness caused by the mumps virus, a paramyxovirus, primarily affecting the salivary glands, especially the parotid glands. It spreads via respiratory droplets and is known for its classic presentation of painful parotitis. While usually self-limiting, it can lead to significant complications such as orchitis, meningitis, and rarely, infertility. Widespread vaccination with the MMR vaccine has dramatically reduced incidence in many regions, but sporadic outbreaks still occur, particularly in under-vaccinated populations.

Definition

Mumps is a contagious viral infection characterised by inflammation of the parotid glands, often accompanied by systemic symptoms such as fever, malaise, and myalgia.

Aetiology

• Mumps virus (Genus: Rubulavirus, Family: Paramyxoviridae)

Pathogenesis

• Transmission: Aerosolised respiratory droplets, saliva, or direct contact
• Initial infection in upper respiratory tract
• Spreads via lymphatics and bloodstream (viraemia) to:
  • Salivary glands (especially parotid)
  • Pancreas
  • CNS
  • Testes/ovaries

Clinical Features of Mumps

Prodromal Phase

• Fever
• Malaise
• Headache
• Myalgia
• Anorexia

Glandular Involvement

• Parotitis:
  • Painful, tender swelling of one or both parotid glands
  • Often worse with chewing or sour foods
  • May lead to facial swelling and trismus
• Other Glandular Involvement:
  • Orchitis (in ~20–30% of postpubertal males)
    • Usually unilateral
    • Can cause testicular atrophy or infertility (rare)
  • Oophoritis, mastitis (less common)

Diagnosis

• Clinical diagnosis (based on characteristic parotitis)
• Laboratory confirmation:
  • PCR from saliva, throat swab, or urine
  • Serology:
    • Positive IgM antibodies or rising IgG titres

Management

Supportive Care

• Rest
• Hydration
• Analgesia / antipyretics (e.g. paracetamol)
• Cold compresses for glandular pain
• Saline gargles

Note: No antiviral therapy is currently available

Prevention

• MMR vaccine (Measles, Mumps, Rubella):
  • Two doses given in childhood
  • Booster doses may be required during outbreaks or in at-risk groups
• Highly effective, though immunity may wane over time

Complications

• Orchitis (may → testicular atrophy, infertility)
• Aseptic meningitis (generally self-limiting)
• Encephalitis (rare)
• Pancreatitis
• Hearing loss (sensorineural, usually unilateral and rare)
• Oophoritis or mastitis

Differential Diagnosis

• Bacterial parotitis (e.g. Staphylococcus aureus)
• Other viral causes of parotitis (e.g. influenza, EBV)
• Dental infections
• Salivary gland tumours or stones

Summary – Mumps

Mumps is a viral illness that commonly presents with fever and parotid gland swelling, and may lead to complications such as orchitis or meningitis. Diagnosis is largely clinical but can be confirmed with PCR or serology. Management is supportive, and prevention is primarily through routine MMR vaccination. For broader context, visit our Respiratory Overview page.