Mumps (epidemic parotid) – symptoms, complications and prevention

Mumps (epidemic parotid) is an infectious, contagious disease, produced by the howler virus, developed by people not previously immunized through disease or vaccination. The source of infection is exclusively human, represented by the mumps patient with the symptomatic or asymptomatic form, writes Dr. Stefan Gilinger, Infectious Diseases specialist in a press release from Victor Babes Timisoara Hospital.

How it is transmitted

According to the doctor, there are no healthy carriers of the howling virus. The virus can be contracted through the respiratory tract through Flugge’s droplets, saliva or through contaminated objects (napkins, handkerchiefs), and the disease (mumps) will be developed by all people not previously immunized by disease or vaccination in a variable period between 2 and 4 weeks after contact.

Signs and symptoms

The onset of the disease is sudden and is characterized by fever, chills, headache, odynophagia (sore throat), generalized muscle pain followed by physical fatigue.

The constant symptom of mumps is parotiditis (inflammation of the parotid gland), which can be accompanied by the involvement of the other salivary glands in 10% of cases (submandibular and sublingual).

Complications

Inconstantly and rarely, secondary manifestations may appear through testicular inflammation (orchitis), pancreatic inflammation (pancreatitis), damage to the central nervous system or other manifestations, these being preceded by a febrile croup.

Parotiditis is characterized by initially unilateral, later bilateral inflammation of the parotid with filling of the retromandibular groove, and “dressing” of the angle of the mandible with the impossibility of identifying the angle of the mandible on palpation, accompanied by trismus. Parotid inflammation is not accompanied locally by Celsius signs (pain, warmth, redness).

Pancreatitis, in the context of mumps, is frequent, but with mild forms of the disease (approximately 80% of cases), often asymptomatic, remaining undiagnosed. In cases with present symptoms, this is manifested by abdominal pain “in the bar”, in the upper abdominal floor, which is associated with nausea and vomiting.

Orchitis urliana appears in male patients after the age of puberty, usually unilateral, as a secondary manifestation. The symptomatology of Urlian orchitis includes a new febrile croup followed by testicular swelling, painful, erythematous scrotal skin, with erasure of the scrotal skin folds. A rare complication of urlian orchitis is male sterility (1-2%).

Affecting the central nervous system in the case of mumps is represented by Urlian meningitis and Urlian encephalitis.

Urlian meningitis, more common in men, has a favorable, self-limiting evolution, and heals without neurological sequelae. Urlian encephalitis can appear early (simultaneously with parotiditis) or late and is caused by viral invasion of the central nervous system. It is manifested by hearing disorders, balance disorders and convulsions, with the possibility of long-term neurological sequelae.

In the case of mumps in pregnant women, the virus can cross the placenta and cause spontaneous abortion, intrauterine death or defects in the formation of fetal organs in 20% of this category of patients.

Other manifestations caused by the howling virus can be: optic neuritis, deafness, cerebellar ataxia, facial paresis, oophoritis (ovarian damage), mastitis, thyroiditis, myocarditis, arthritis, thrombocytopenic purpura, which are often asymptomatic, remaining undiagnosed.

diagnosis

According to the infectious disease doctor, Stefan Gilinger, the diagnosis is confirmed clinically or with the help of laboratory analyses, by the presence of IgM antibodies against the howling virus 2 weeks after the onset of symptoms. The presence of anti-urlian virus IgG antibodies (protectors) can be increased, either by previous vaccination or by passing through the disease.

Treatment

Until now, no effective antiviral has been discovered to neutralize the howling virus, thus, the treatment of epidemic parotitis is non-specific and is characterized by non-steroidal and symptomatic anti-inflammatory drugs (antipyretic and analgesic), generally having a favorable evolution, both in the short term , as well as in the long term.

The treatment of orchitis also requires strict bed rest and local applications of an ice pack wrapped in a towel. The treatment of Urlian meningitis/encephalitis is strictly intra-hospital.

Prevention

Mumps prophylaxis is carried out through active immunization (vaccination) in the form of a triple vaccine (measles-mumps-rubella-MMR, MMR) containing a live attenuated mumps virus that was introduced in Romania in the National Vaccination Program in 2004.

Vaccination consists of 2 doses, initially administered at the age of 1 year, later at 6-7 years (prior to entering the community). Infants up to the age of one year are protected against infection by the antibodies “inherited” from the previously immunized mother (through vaccination or disease). The mumps vaccine, having in its component a live attenuated, conditioned virus, is contraindicated in pregnant women and immunosuppressed patients (eg: HIV infection, neoplasms).

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