Mumps
What is Mumps
Mumps is a viral illness caused unsurprisingly the "Mumps Virus" ( must have taken ages to come up with such a name !!). The Mumps Virus causes a painful swelling and inglammation of one or more of the salivary glands around the mouth. Typically the "Parotid" gland is involved giving a painful swelling under and in front of the ear. The submandibular glands may be involver, or as well as the parotid. The submandibular glands are under the jaw bone on each side giving a swelling below and inside of the Jaw Bone.
In adults with Mumps, as well as the Salivary glands, other bits of the body can get swollen, painful and inflamed too. In adult men the testicles can be involved, in women the ovaries and in both sexes the pancreas. In children viral meningitis can occur. Prior to mass mumps vaccination Mumps meningitis was by far the commonest form of viral meningitis. Fortunately full recovery was the usual outcome, however some were not so lucky.
How do you catch it ?
Mumps is spread from person to person by droplets on coughing and sneezing, or by close physical contact.
The course of the disease.
Between 14 and 21 days after contact the infected child will start to feel generally unwell with a temperature and all that goes with it. After 2-3 days the swelling of one or more of the salivary glands starts. This happens quite quickly, frequently the child may go to bed with little the matter, but wake the next morning looking like a chipmonk !!
The swelling of the glands is painful, the swelling is very tender to touch. Also anything in the mouth that would normally stimulate the flow of saliva, causes pain. Something sour tasting like citrus fruit will cause excruciating pain. People will normally only try this once !!
The swelling persists for 2-5 days and then gradually resolves. Sometimes as one gland is resolving another will start up giving a more prolonged illness. As the swelling of the glands subsides, so does the swelling of any other bits.
How is mumps treated ?
In the majority of cases no treatment helps or is needed. This is just as well as there is no specific treatment. Mumps just gets better irrespective of what is taken. Useful measures are paracetamol or Ibuprofen to reduce the fever and to help to relieve the pain. This should be given in full dose, 2 * 500mg paracetamol tablets four times per day, and / or Ibuprofen 600mg three times per day. An ice pack may help to relieve the pain.
Prevention
Fortunately Mumps is very easily prevented by vaccination. Mumps vaccine is cheap, safe and effective, always a good combination for treatment. Otherwise there is little that can be done to prevent spread of an outbreak. Excluding an infected child from school for weeks after the illness has passed may be the traditional preventative measure. However this is rather pointless as the child will have maximally infectious for the 2-3 days before the swelling happens. So the child will have already infected the rest of the class before anyone knows that he has got mumps. In view of this there is nothing to be gained by stopping a child returning to school as soon as he is well, even though he will still be infectious to some extent. Scools do not alwaus see things quite this way !!
Vaccination
Since 1984 all children have been offered Mumps vaccination as part of the standard Measles, Mumps and Rubella vaccine or MMR. Until two years ago uptake of the MMR was very high so that Mumps became an unusual thing to see. The only children of school age are those whose parents refused to permit their child being vaccinated for whatever reason they may have. The pros and cons of the MMR are discussed seperately. As the uptake of Mumps vaccination has fallen there is a group of non-immune children that will shortly be starting school. We have already seen a rise in the numbers of cases of Mumps in this age group, however when they start school, there will be enough non immune kids for Mumps to be passed on from one non immune kid to the next. This will result in the unavoidable fact that the non immune children will get infected from somewhere. They will take their incubating Mumps to school and give it to the other non immune kids. There is no reason to believe that these children will escape Mumps as there is nothing to prevent it. It would be expected that all of the non immune kids will get clinical mumps shortly after starting school.
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