The Generalist: Mumps
Chris Drumm MD, Heidi James MD, and Vanessa Cardy MD
- Paramyxovirus with incubation period of 16-18 days
- Highly contagious; spreads via respiratory droplets
- Outbreaks usually occur late winter to spring
- School age or college age
- 99% reduction in cases post vaccination
- In the U.S., first vaccine is usually given between 12 and 15 months of age with the second dose between 4 and 6 years old (varies by jurisdiction)
- Fever, headache, myalgias, and anorexia, followed by parotitis
- Parotid swelling unilateral initially, sometimes progressing to bilateral
- Parotid swelling can last up to 10 days
- Decreased white blood cell (WBC) count and increased amylase
- Virus RNA detected by PCR on buccal or oral swab
- Positive serum IgM (may not be detectable until 5 days after symptom onset)
- 15%-30% of males
- Frequently occurs 5-10 days after parotitis
- Can cause severe testicular pain
- 5%-10% of post-pubertal females
- Often present with pelvic pain, fever, and vomiting
- Used to be the leading cause of viral meningitis before vaccination
- Influenza, parainfluenza, Epstein-Barr virus (EBV), coxsackie, adenovirus
- Consider Staphylococcus aureus if patient has severe parotid tenderness, high fever, and chills and appears toxic
- Salivary stones
- Sjogren’s syndrome
Ian L. - February 2, 2020 2:46 PM
The vaccine is live attenuated so does this pose are risk those older and the immunosuppressed .
What about mumps immunoglobulin then for close contacts ?
Heidi J., MD - February 4, 2020 11:10 AM
Hi Ian - Here's a reply from Chris Drumm:
It is sad to say but the immune globulin has not been shown to lessen disease severity. The MMRI vaccine is contraindicated if someone has and immunodeficiency (including HIV with low CD4 counts, leukemia/lymphoma, those on systemic immunosuppressive therapy). It does not pose a risk to patients that are older though.
But the immune globulin has been shown to be helpful in the case of measles.