MUMPS

Acute infectious disease

RNA virus, genus Rubulavirus, family
paramyxoviridae
Caused by RNA virus of genus Rubalavirus of the
family paramyxoviridae
Prediliction for glandular and nervous tissue
Annual incidence of mumps in the absence of
immunisation is 100-1000 cases / 100000 population
Epidemic peak every 2-5 years
Natural infection confers life long protection
non suppurative enlargement or tenderness of one or
both glands
 AGENT FACTORS
Agent: Myxovirus parotiditis
Grows in chick embryo or tissue culture
Only one antigenic type

Source of infection: Clinical and subclinical cases

subclinical cases accounts for 30-40% maintains the
cycle of infection, the virus can be islated from saliva or
from swabs taken from stensons duct. virus also found
in blood, urine, human milk and saliva
 PerioPeriod of communicability: 4-6 days
before the onset of symptoms and a week or
more thereafter

The period of maximum infectivity is just

before or at the onset of parotitis

Once the swelling is subsided the case is no

longer infectitious

Secondary attack rate: 86%

 HOST FACTORS
Age:

Most common in children 5-9 years of age

The avg age of incidence is higher in mumps is

higher than in measles or chickenpox

More severe in adults than in children

No age is exempt if there is no previous immunity

IMMUNITY:

Natural infection confers lifelong immunity

There is onlynone antigenic type of mumps virus and

it does not exhibit significant antigenic variation

Children < 6 months of age are immune because of

maternal antibodantibodies
ENVIRONMENTAL FACTORS

Endemic disease, cases occur throughout the year

Peak incidence is in winter
Epidemics assossiated with overcrowding

MODE OF TRANSMISSION
Droplet infection

INCUBATION
14 - 18 days
CLINICAL FEATURES

generalised viral infection

30 -40% clinically non apparent

Pain and swelling in either one or both parotid glands

may also involve sublingual and mandibular glands

Ear ache on affected side prior to onset of swelling

 Pain and stiffness on opening the mouth brfore the
swelling is evident

Also affects testes

pancreas
cns
ovaries
prostate etc

Fever, headache in severe cases for about 3-5 days

swelling subsides in 1-2 weeks

 COMPLICATIONS
Orchitis
unilateral -75%
most common extra salivary gland manifestatio in
adults
testicular swelling and tenderness
high fever 7-10 days after the onset of parotitis in 25-
40% 0f post pubertal men
bilateral is rare
assoss with sterility - ill founded
Pancreatitis:

upper abdominal pain

nausea
vomitting
mumps- leading cause of pancreatitis in children
4% of patients

Oophoritis:

lower abdominal pain

ovarian enlargement
unilateral
5%
Others:
diabetes
nerve deafnes in 5 per 100,000 mumps cases
poly arthritis
hydrocephalus
meningitis 15%
encephalitis 0.02-0.03%
cerebellar ataxia
transverse myelitis
1st trimester infection- spontaneous abortion - 25%,
congenital malformations
VACCINATION:

Live attenuated vaccine

Strains- Jeryl Lynn, RIT 4385, Leningrad3, L-Zagreb,
Urabe,Hosino, Torii
WHO recommends not to use rubini strains bcoz of
low effectiveness
0.5 ml i.m after 1year of age either alone or as MMR.
Second dose given at 4-6 years of age
produces detectabl antibodies in 95% of vaccinees
Jeryl Lynn strain has the lowest assossiated incidence
of post vaccine aseptic meningitis ( 1 in 50,000 to 1
in1.8 million)
 no cases of long term sequelae assossiated with
mumps vaccination

mumps elimination strategies include

1. high covrage with first dose

2. ensuring second opportunity for vaccination

3. catch up immunization for ssceptible cohorts

Mumps vaccine not administered to

pregnant women
ppl recieving immunosuppressive therapy
those severely ill
 MUMPS SURVEILLANCE
Clinical mumps: accute onset of u/l or b/l tender ,self
limiting parotid swelling- 2 daysor more and without
other apparent cause
Laboratory confirmed:
1. +ve Ig M ab( without immunization in prev 6
weeks),
2. isolation of virus from saliva, urine or CSF
3. Seroconvertion 4 fold increase in Ig G
Epidemiologically confirmed: a patient with clinical
mumps epidemiologically linked to a lab confirmed
mumps case
CONTROLS:

Control is difficult because

the disease is infectious before the diagnosis is made
Long and variable incubation period
ocurance o sub clinical cases
cases shud be isolated till clinical manifestation
subside
disinfect articles used by patient
contacts kept under surveillance
THANK YOU