Mumps

Mumps is a contagious viral infection that causes painful swelling of the salivary glands, making the cheeks and jaw puff up. While most people recover completely within two weeks, the disease can spread easily and sometimes leads to serious complications.

Table of contents

• What is mumps
• Signs and symptoms
• How mumps spreads
• Who is at risk
• Complications
• Diagnosis
• Treatment
• Prevention and vaccination
• When to stay home

What is mumps

Mumps is a contagious disease caused by the mumps virus, which belongs to a group of viruses known as paramyxoviruses (a family of viruses that cause various infections in humans)^[1]. The infection mainly affects the salivary glands (glands that produce saliva), especially the parotid glands located between the ear and the jaw^[2].

• Salivary glands (parotid, sublingual, submandibular)
• Brain and spinal cord (in complications)
• Pancreas (in complications)
• Testicles (in complications)
• Ovaries (in complications)

Mumps used to be a very common childhood disease before vaccination became available. After the mumps vaccine was introduced in 1967 in the United States, the number of cases dropped by more than 99 percent^[1]. Despite this dramatic decrease, outbreaks still occur, especially among people who live in close contact with each other, such as on college campuses or in other crowded settings^[3].

Signs and symptoms

Many people infected with mumps have no symptoms at all and don’t know they’re infected. Others may experience only mild symptoms that feel like a cold^[3]. When symptoms do appear, they typically show up 16 to 18 days after exposure to the virus, though this period can range from 7 to 25 days^[1].

The first symptoms are usually mild and non-specific. These early signs may include fever, headache, muscle aches, tiredness, and loss of appetite^[2]. Some people also experience a stiff neck during this early stage^[4].

Within a few days, the most recognizable symptom of mumps appears: painful swelling of the salivary glands. This swelling typically affects the parotid glands, causing puffy cheeks and a tender, swollen jaw^[1]. The swelling usually starts on one side of the face first before appearing on both sides, though sometimes only one side becomes swollen^[5]. This characteristic appearance is sometimes described as looking like “chipmunk cheeks”^[3].

The swelling makes it harder to chew, swallow, or speak, and may cause earache^[5]. The pain typically gets worse when the person swallows, talks, chews, or drinks acidic juices like orange juice^[2]. More than 70 percent of mumps cases involve this swelling, known as parotitis (inflammation of the parotid glands)^[3].

It’s important to remember that many different viruses and bacteria can cause swelling of the salivary glands, so this symptom doesn’t always mean mumps infection^[3].

How mumps spreads

Mumps is highly contagious and spreads easily through direct contact with saliva or respiratory droplets from an infected person’s nose, mouth, or throat^[1]. You can catch mumps when an infected person coughs, sneezes, or talks near you^[4].

The virus also spreads by sharing items that may have saliva on them, such as water bottles, cups, eating utensils, or toys^[1]. Participating in close-contact activities like playing sports, dancing, or kissing can also transmit the infection^[1]. If someone with mumps touches surfaces with unwashed hands, the virus can spread to others who touch those same surfaces^[3].

A person infected with mumps can spread the virus before they even know they’re sick. The contagious period (the time when someone can spread the disease) begins a few days before the salivary glands start to swell and continues until up to five days after swelling begins^[1]. People are most contagious from two days before symptoms appear through about five days after^[4].

Who is at risk

Anyone who is not protected against mumps through vaccination or previous infection is at risk of getting the disease^[1]. Mumps most commonly affects children between the ages of 2 to 12 who haven’t received the mumps vaccine^[3]. However, adolescents and adults can also get mumps, even if they have been vaccinated, because immunity from the vaccine can weaken over several years^[3].

Certain groups of people have a higher likelihood of getting mumps because they are in close contact with others for extended periods. These include school-aged children, students at colleges and universities, and healthcare workers^[1]. People traveling internationally to areas where mumps is still common are also at increased risk^[1].

People with weakened immune systems and those who aren’t vaccinated against the virus face higher risk^[3]. People living in close quarters, such as on college campuses or in dormitories, are more likely to be exposed during outbreaks^[3].

Complications

Most people with mumps recover completely within about 10 days to two weeks without any lasting problems^[5]. However, mumps can sometimes cause serious complications, especially in adolescents and adults^[2].

Common complications include swelling of the testicles in males, called orchitis (inflammation of the testicles), which occurs in about 10 percent of male cases after puberty^[4]. This can cause testicular pain and tenderness. In females, mumps can cause swelling of the ovaries, known as oophoritis (inflammation of the ovaries), though this is less common^[4]. Neither of these complications has been shown to lead to infertility^[12].

Other complications include inflammation of the pancreas, called pancreatitis (inflammation of the pancreas), which causes stomach pain^[2]. Mumps can also affect the brain and nervous system, causing meningitis (inflammation of the membranes covering the brain and spinal cord) or encephalitis (inflammation of the brain)^[4]. Viral meningitis can occur in about one-quarter of people with mumps^[6].

Temporary hearing loss in one ear can occur, and rarely, mumps can cause permanent deafness^[5]. Other rare complications include kidney inflammation or heart muscle inflammation^[4].

People who have been vaccinated against mumps are less likely to develop complications than unvaccinated people^[4]. Vaccinated people who do get mumps usually have milder symptoms and complications are less frequent^[1].

Diagnosis

A doctor may diagnose mumps based on the typical symptoms and whether the person has been exposed to someone with mumps^[2]. In places where mumps is less common, laboratory testing is often needed to confirm the diagnosis^[6].

If you think you or your child may have mumps, it’s important to call your doctor’s office before going in. The office may give you special instructions to protect other patients from the virus, or they may suggest talking over the phone first^[1].

Several tests can be used to diagnose mumps. A sample from the mouth or throat can be tested using a method called real-time reverse transcription polymerase chain reaction (rRT-PCR) (a laboratory technique that detects genetic material from the virus), which is the preferred diagnostic method^[8]. Doctors may also collect samples of saliva, urine, or blood to test for the virus^[4].

A blood test can show an immune system reaction to the virus by detecting antibodies^[2]. Viral culture, which grows the virus in a laboratory, is another option^[4].

It’s important to note that negative laboratory results among vaccinated people don’t necessarily rule out mumps, especially during an outbreak^[8]. Other conditions can cause similar symptoms, so proper testing is important to confirm the diagnosis^[2].

Treatment

There is no specific medicine to treat mumps. The virus must run its course, and treatment focuses on relieving symptoms and helping the person feel more comfortable^[1]. Most people recover completely within three to ten days^[10].

To help ease symptoms at home, get plenty of rest and drink lots of fluids to stay hydrated^[1]. Drinking plenty of water is especially important to avoid dehydration (loss of too much body fluid)^[5].

Pain relievers that you can buy without a prescription, such as acetaminophen or ibuprofen, can help reduce fever and relieve pain from swollen glands^[10]. However, never give aspirin to anyone younger than 18 because of the risk of a serious condition called Reye syndrome^[4].

Applying a warm or cold cloth to the swollen cheeks and neck can help with pain and discomfort^[10]. For males with swollen testicles, applying ice packs can help^[10].

Eating soft foods that don’t require much chewing makes eating easier when the jaw is swollen and painful^[1]. Avoid acidic foods and drinks like orange juice, grapefruit juice, or lemonade, as these can make the pain in the swollen glands worse^[2].

In complicated cases where serious problems develop, a hospital stay may be required^[9]. Patients with meningitis, encephalitis, heart muscle inflammation, kidney inflammation, or severe pancreatitis need more intensive medical care^[8].

Prevention and vaccination

Getting vaccinated is the best way to protect against mumps^[1]. The mumps vaccine is usually given as part of a combination vaccine called MMR (measles, mumps, and rubella vaccine), which protects against three diseases at once^[1]. There is also an MMRV vaccine that includes protection against chickenpox^[1].

Children should receive two doses of the MMR vaccine. The first dose is given at 12 through 15 months of age, as soon as possible within this time period. The second dose may be given as early as one month after the first dose, but it is usually given between 4 and 6 years of age^[7].

One dose of mumps vaccine is about 80 percent effective in preventing the disease, but two doses are approximately 90 percent effective^[4]. This means it is still possible for someone who has received two doses of MMR to get mumps, but their symptoms are usually milder^[4].

After the U.S. mumps vaccination program started in 1967, there has been a more than 99 percent decrease in mumps cases in the United States^[1].

Certain groups of people at high risk should make sure they have received two doses of MMR vaccine. These include college students, healthcare workers, international travelers, and people living in communities with a mumps outbreak^[7]. The two doses should be given at least 28 days apart^[7].

People born before 1957 are generally considered immune to mumps because they likely were exposed to the virus before vaccines were available^[7]. If you’re not sure whether you’ve been vaccinated, check with your doctor. They can provide the vaccine if needed^[5].

When to stay home

If you or your child has mumps, it’s very important to stay away from others to prevent spreading the virus. Anyone with mumps should stay home from school, work, daycare, and avoid social events^[1].

The isolation period should last for at least five days after the swelling of the salivary glands begins^[1]. During this time, limit contact with others as much as possible. Even within the household, try to minimize close contact, though by the time mumps is diagnosed, most household members have usually already been exposed^[9].

Good hygiene practices can help reduce the spread of infection. Wash your hands well and often with soap and water^[1]. Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue away and wash your hands^[1]. Don’t share eating utensils, cups, water bottles, towels, bedding, or clothes with others^[5].

If you think you or your child has been exposed to mumps, contact your local health department, doctor, or clinic for advice right away^[4]. If you never had mumps or were never vaccinated against it, you may need to stay home from work or school for a while^[7].