mumps

Quick Overview

• What is Mumps? An acute, contagious viral infection that is colloquially called “goat peter” or “booby.” Mumps is one of the teething troubles, although it increasingly affects adolescents and adults.
• Infection: The mumps virus is usually infected by droplet infection or direct salivary contact (kissing). Rare is an indirect transmission by sharing of cutlery, glasses, etc. A contagion with mumps is possible all year round.
• symptoms: Initially nonspecific symptoms such as drowsiness, lack of appetite, head and body aches and fever. Then painful swelling of the parotid gland laterally on the head / neck (one-sided or bilateral).
• Possible complications: et al Meningitis (meningitis), brain inflammation (encephalitis), ear otitis or inflammation of the auditory nerve (possibly with permanent deafness), orchitis or epididymitis (epididymitis), ovarian inflammation (oophoritis), breast inflammation (mastitis), pancreatitis (pancreatitis), Myocarditis, nephritis, arthritis, anemia
• Treatment: Relief of symptoms (symptomatic therapy) with analgesics, antipyretic drugs, etc.
• Forecast: In about 40 percent of all mumps infections show no or very slight symptoms. Especially mumps in children is usually harmless. The older the patient, the more likely it will be complications. Lingering sequelae such as deafness or infertility are rare.

Mumps: symptoms

Mumps does not trigger symptoms in all infected people: a maximum of six out of ten people develop significant symptoms.

First mumps symptoms are nonspecific. There are, for example Loss of appetite, fever such as Headache and body aches on. Many patients also complain general malaise and feel flabby and unwell.

Because the mumps virus enters the salivary glands, also can dry feeling in the mouth and difficulties swallowing to adjust.

Especially in children under five, Mumps often resembles a common cold (flu) with symptoms such as runny nose, headache, body aches and mild fever. In children under two years, the infection very often runs without any apparent symptoms.

One to two days after the onset of the disease, the typical begins inflammatory swelling of the parotid glands (parotitis), The paired parotid gland (Glandula parotis) lies on both sides of the face and extends from the zygomatic arch at the level of the ear to the jaw angle. In mumps usually both parotid glands swell (sometimes a little earlier than the second). Rarely, only one of the two glands swollen. The swelling in the cheek and neck leads to the typical “Hamster cheeks” (especially in children). It usually stops within a week.

With the gland swelling are often Pain Connected: Pressure on the ear canal causes earache. Also the chewing and wide opening of the mouth can be painful. In severe cases, patients may only eat soft or liquid foods such as mashed potatoes, soups or porridge.

In some patients, in addition to the parotid glands, the paired ones also swell Salivary glands in the lower jaw or under the tongue at. Also adjacent lymph node can increase.

Mumps: complications

Mumps in children rarely causes complications. In contrast, mumps is much more problematic in adults. Generally, the risk of complications of mumps infection increases with the age of the patient. Such complications arise when the mumps viruses spread in the body and infect other organs.

So one counts Involvement of the central nervous system (CNS) the most common complications of mumps. Men are more affected than women. For example, CNS involvement can be manifested as meningitis (meningitis) or encephalitis (encephalitis):

• In one to ten percent of cases develop a symptomatic meningitis. An indication of this is when patients with mumps show signs of stiff neck, nausea and vomiting, as well as apathy and even loss of consciousness. Lingering sequelae or deaths from mumps meningitis are unknown.
• Less than one percent of mumps patients develop encephalitis. However, this mumps encephalitis can lead to death in individual cases.

A CNS involvement in mumps is usually noticeable four to five days after the parotitis. It can also occur before swelling of the salivary glands or even be the only symptom of mumps infection.

The mumps viruses can also have a Inner ear inflammation (Labyrinthitis) or one Inflammation of the auditory nerve (Acoustic Neuritis). In rare cases, those affected have a permanent hearing loss (Sensorineural hearing loss) from that.

A more common mumps complication in men is one Hodenentzündung, This mumps orchitis develops in 15 to 30 percent of adult mumps patients. Mostly it affects only one testicle, but sometimes both. Afterwards, fertility may be limited. Only seldom does the testicle inflammation lead to complete infertility. A Epididymitis (Epididymitis) is also a potential consequence of mumps infection.

Mumps in women leads to one in three out of ten cases mastitis (Mastitis). Much rarer is one Ovarian inflammation (Oophoritis): Up to five percent of adult mumps suffer from it.

Sometimes mumps viruses call one pancreatitis (Pancreatitis). This develops in about four percent of patients with mumps. Symptoms such as severe abdominal pain, nausea and vomiting indicate pancreatitis.

Other possible complications with mumps are arthritis (Arthritis), nephritis (Nephritis), anemia (Anemia) as well Myocarditis (Myocarditis).

Tip: If symptoms occur in patients with mumps that are not traditionally associated with the condition, be sure to call a physician. You could point to a serious complication. The sooner the right therapy is started, the better and faster the recovery will be.

Mumps: Pregnancy

Many women fear that infection with the mumps virus can spread to the unborn baby during pregnancy. However, a mumps infection during pregnancy does not increase the risk of childhood malformations or miscarriage. The unborn baby is so not endangered.

Mumps: contagion

The mumps virus (paromyxovirus parotitis) belongs to the group of the so-called paramyxoviruses, which include, for example, measles viruses. The infection is mainly about droplet infection: Infected people when they cough, sneeze or talk, distribute the smallest saliva droplets in the ambient air containing the mumps virus. Other people can become infected by inhaling these saliva droplets.

Also possible is an infection with mumps over direct saliva contactSo when kissing.

Rarely does it come to one indirect virus transmissionthat is, objects that are contaminated with infectious saliva. This can happen, for example, when a healthy person uses the same cutlery or glass as the infected person.

Anyone who has ever had mumps usually never gets sick again. Infection with the virus generally results in lifelong immunity.

How long is Mumps contagious?

Two days before to four days after the onset of the disease, patients are the most infectious. In total, infected persons can pass on the mumps virus to other people seven days before and up to nine days after the typical swelling of the parotid glands.

Infected people who do not show disease symptoms themselves can also transfer the mumps virus to other people!

Mumps: incubation period

If you become infected with the mumps virus, it will take some time for the first symptoms to appear (if any). This so-called incubation period can in principle be 12 to 25 days. Usually, however, 16 to 18 days pass between contagion and outbreak.

Mumps: examinations and diagnosis

In most cases, it can be easily identified by the symptoms of goat peter disease – especially the typical inflammatory swelling of the salivary glands. Because the disease has become rare in the meantime, the doctor should for safety, too laboratory tests carry out. This is especially true if the patient is actually vaccinated against mumps (the vaccine protection may decrease over time).

In the blood of mumps-infected ones can be specific antibodies to prove against the mumps virus. In acute infections, specific IgM antibodies are usually found. They are detectable already in the first days of the disease. Your mirror will stay elevated for a few weeks.

However, patients with mumps despite vaccination often do not produce IgM antibodies to the pathogen. Instead, an increase in IgG antibodies to mumps viruses can sometimes be detected. But that’s not always the case. In vaccinated with a (suspected) measles disease is therefore always a direct virus detection Recommended: For this, one can examine the urine, a throat swab or the fluid in the mouth pockets on the genome of mumps viruses.

Such a direct pathogen detection is necessary even in severe or complicated disease processes. If there is a suspicion of involvement of the central nervous system, the doctor can take a sample of the cerebral and spinal fluid (CSF). The lab is looking for genome snippets of mumps viruses. Also, suspected mumps complications can still further investigations become necessary. In the case of pancreatitis or testicular inflammation, this can be, for example, an ultrasound examination (sonography).

Since 2013 Mumps is notifiable in Germany. Doctors must report the suspected disease, proven illnesses and deaths by mumps, stating the name of the patient to the responsible health authority. Also, the direction of a public Eirichtung must inform the health department when mumps occurs in the institution.

Mumps: treatment

There is no causal (antiviral) therapy against mumps. You can treat the disease symptomatically. That means there are measures to alleviate the symptoms. For example, help against the painfully swollen parotid glands envelopes, Most patients find cool envelopes pleasant. Some also prefer warm envelopes. That should be tried out on an individual basis. With strong ears, the doctor can be a suitable Painkiller recommend.

When swallowing and pain while chewing, patients should only light, creamy or liquid foods like mashed potatoes, milk porridge or soups. Sour foods and juices are unsuitable during the illness. They stimulate the salivary glands to release secretions. This can increase the symptoms.

When fever is bed rest and adequate hydration advisable. You can fight strong fever cold calf wrap make and eventually antipyretic drugs take (after consultation with the doctor).

is Mumps with complications connected, these are also treated. For example, at a Hodenentzündung Strict bed rest recommended. In addition, you should store the testicles and cool. In severe cases, the doctor prescribes an anti-inflammatory drug. At a pancreatitis the patient must be treated in the hospital. He is often artificially fed temporarily and receives medication for the inflammation. Also at Brain and meningitis appropriate treatment in the hospital is necessary.

Mumps patients should not visit community facilities (school, kindergarten, university, etc.) until the symptoms have resolved, but at the earliest five days after the onset of illness.

Mumps: disease course and prognosis

Normally the prognosis for mumps is good. In most cases, the patients recover completely within two to three weeks, without any consequential damage remaining. Especially in adult patients, however, mumps can cause complications, possibly with long-term consequences:

For example, a mumps-related orchitis can permanently limit fertility. In rare cases, men are subsequently completely infertile (sterility). Meningitis can rarely cause nerve damage or facial numbness. About one in every 20,000 mumps diseases causes lifelong deafness in one ear. Mumps-related brain inflammation rarely ends in death: About 1.5 percent of patients with mumps encephalitis die.

Mumps: vaccination

With a vaccine you can prevent mumps. The Standing Vaccination Commission (STIKO) at the Robert Koch Institute recommends the mumps vaccine for all children. It reduces the number of diseases in two ways: Firstly, the vaccinated person is protected himself. On the other hand, she can no longer infect other people with mumps.

Who should be vaccinated against mumps?

According to the current STIKO recommendation, everyone should children receive the first dose of the mumps vaccine between the ages of 11 and 14 months of age. The second vaccine dose should be given at the earliest four weeks thereafter at the age of 15 to 23 months of life. Its purpose is to ensure that all children are protected against mumps viruses until adulthood.

The mumps vaccine is usually given in combination with the measles and rubella vaccines (called MMR vaccine).

at unvaccinated children and adolescents the mumps vaccination should be made up as soon as possible.

adultswho are born after 1970 and who have not received a mumps vaccine (or only one dose), a single dose of vaccine is recommended in certain cases – namely when they work in the health service in direct patient care, community facilities or adult education facilities ,

How is vaccinated?

The vaccine against mumps contains attenuated, live pathogens (live vaccine). They cause no or at most mild symptoms, but still stimulate the immune system to produce specific antibodies against the mumps virus.

The vaccine is injected into the muscle (intramuscular, i.m.). It can be injected laterally into the butt, upper arm or thigh muscle.

possible side effects

The vaccine against mumps is usually well tolerated. Side effects are rare. For example, local reactions such as mild redness, swelling and pain may develop at the injection site. Sometimes, general symptoms such as fever and fatigue are added. All these imfreactions will fade away after a few days. Heavier side effects of mumps vaccination are very rare.

A few years ago, a British study of 12 participants unsettled the population. Therein a possible connection between the MMR vaccination and autism supposed. Meanwhile, it has been found that deliberately false and invented results have been published – the prosecutor brought the responsible physician and researcher to court in the UK. The study was withdrawn by the journal The Lancet in February 2010 and removed from the list of publications. In addition, subsequent high-quality studies have shown that there is no association between MMR vaccination and the occurrence of autistic disorders.

Mumps despite vaccination

The vaccine against mumps offers a very high, but no 100% protection before an infection. Therefore, it may happen that someone suffers despite the two vaccines mumps. The disease is then usually easier than unvaccinated.

But there are other reasons why mumps can occur despite vaccination. In some people, the immune system does not (sufficiently) respond to the vaccine: There are no or too few antibodies produced against the mumps virus (primary vaccine failure).

In other cases, the vaccine is satisfactory (sufficient antibody production). However, it can happen that the protective effect wears off over time and is not reinforced by the contact with wild viruses (because thanks to rising vaccination rates, only a little “wild” mumpsCirculating viruses in the population). Then one speaks of one secondary vaccine failure.

Additional information

guidelines:

• RKI guidebook “Mumps” of the Robert Koch Institute (2013)