Mumps

Infectious Agent

An enveloped, negative-strand RNA virus (a paramyxovirus) of the genus Rubulavirus .

Transmission

By respiratory droplets, saliva, or contact with contaminated fomites.

Epidemiology

Endemic in many countries throughout the world. In 2014, mumps-containing vaccine was routinely used in 121 countries worldwide. The risk of exposure among travelers is high in many countries, including industrialized countries.

Clinical Presentation

Incubation period is 16–18 days (range, 12–25 days). Mumps is an acute systemic illness which classically presents with unilateral or bilateral swelling of the parotid glands. Onset of illness is usually nonspecific, with symptoms of fever, headache, malaise, myalgia, and anorexia; however, infections may be asymptomatic. Complications may occur such as orchitis, hearing loss, aseptic meningitis, encephalitis, and pancreatitis.

Diagnosis

Usually clinical, defined as illness with acute onset of unilateral or bilateral tender, self-limited swelling of the parotid glands, other salivary glands, or both, lasting ≥2 days, and without other apparent cause. Laboratory confirmation of mumps involves detection of nucleic acid by RT-PCR or virus isolation by culture. For further information on laboratory testing, see www.cdc.gov/mumps/lab/index.html. Mumps is a nationally notifiable disease.

Treatment

Supportive care is the mainstay of treatment.

Prevention

Before departure from the United States, travelers aged ≥12 months who do not have acceptable evidence of mumps immunity (as documented by 2 doses of live mumps virus vaccine, laboratory evidence of immunity, laboratory confirmation of disease, or birth before 1957) should be vaccinated with 2 doses of measles-mumps-rubella (MMR) vaccine ≥28 days apart. There is no recommendation for vaccination against mumps for infants aged <12 months before international travel; however, infants aged 6–11 months should receive 1 dose of MMR vaccine before departure to protect against measles.

CDC website: www.cdc.gov/mumps

Bibliography

  1. CDC. Manual for the surveillance of vaccine-preventable diseases. Atlanta: CDC; 2012 [cited 2016 Sep. 25]. Available from: http://www.cdc.gov/vaccines/pubs/surv-manual/index.html.
  2. CDC. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2013 Jun 14;62(RR-04):1–34.
  3. CDC. Update: mumps outbreak—New York and New Jersey, June 2009–January 2010. MMWR Morb Mortal Wkly Rep. 2010 Feb 12;59(5):125–9.  [PMID:20150887]
  4. Dayan GH, Quinlisk MP, Parker AA, Barskey AE, Harris ML, Schwartz JM, et al. Recent resurgence of mumps in the United States. N Engl J Med. 2008 Apr 10;358(15):1580–9.  [PMID:18403766]
  5. World Health Organization. Immunization, vaccines and biologicals: mumps. 2015 [updated 5 Aug 2015; cited 2016 Sep. 25]. Available from: http://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveil....

Authors

Cristina V. Cardemil, Nakia S. Clemmons