Mumps

Organism Mumps virus is a member of the Paramyxoviridae family of viruses.

Clinical features Mumps is not a true skin infection, but is included here as it shares common means of control with measles and rubella. It is an infection of the salivary glands producing enlargement and pain in the parotid gland, but can lead to orchitis, mastitis, meningitis, pancreatitis and acute respiratory symptoms (see Section 13.1). Commonly an infection of children 2-5 years of age, the more serious manifestations are more likely in adults, especially males.

Diagnosis is made on clinical grounds, but serological confirmation can be made with mumps-specific IgM, a rise in IgG or culture of saliva or urine.

Transmission The virus is transmitted via direct contact or by droplets spread by the airborne route. Any contact of saliva, such as sharing of cutlery, wiping the mouth with a common cloth, or kissing, can result in transmission.

Incubation period 14-24 days.

Period of communicability 6 days before to 6 days after the start of parotitis.

Occurrence and distribution Mumps is probably more common than assumed to be with up to 85% of the population found to have been infected in adult life, although few would have manifested the disease. With such a high proportion of the population meeting the virus, there is a relatively high risk of complications and cost-benefit studies have shown that vaccination produces substantial economic savings.

Control and prevention The reason for including mumps in the routine childhood vaccination programme is similar to that for rubella (Section 12.3). Where there is an efficient programme with the majority of children being vaccinated, it is advantageous to include it with measles and rubella as the MMR vaccine. However, if less than 75% of children are vaccinated, then this could result in an epidemiological shift to older age groups, increasing the likelihood of complications. If mumps vaccination is included, then a second opportunity, either by the routine programme or by catch-up campaigns, should be given unless coverage is over 90%.

Surveillance Comparing the number of children born with those who complete their childhood vaccinations or are vaccinated against measles will give an estimate of the efficiency of the vaccination programme and whether mumps vaccination should be added.

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