Epidemiology of Infectious Diseases: Mumps
Mumps virus - paramyxovirus.
Common clinical features
- Acute viral illness characterized by fever, headache, tenderness and swelling in one or both parotid salivary glands.
- Swelling commonly peaks between 1-3 days following infection.
- In 25% of cases swelling occurs only on one side.
- 30% of cases in children are asymptomatic.
- Complications are rare but can include, aseptic meningitis, orchitis (occurs in about 25% of adolescent and adult males and is rare in prepubescent males), oophoritis (occurs in 5% of post pubertal females, mastitis may also occur. Less common complications include pancreatitis, myocarditis, arthritis, thyroiditis, deafness and spontaneous abortion1,2.
- In the UK infections with mumps peaks during the winter and spring.
- Prior to the introduction of vaccination in 1988 mumps caused epidemics every 3 years with the highest attack rates occurring among children aged 5-9 years1.
- The HPA has reported a large increase in both notifications and laboratory confirmed cases since 2003, suggesting a marked increase in true infection.
- In 2004 90% of confirmed cases of mumps occurred among children and young adults over 15 years (an age-group who did not receive the MMR).
Mode of transmission
Person to person via airborne transmission or droplet spread. Also direct contact with the saliva of an infected person.
16-18 days - range 14-25 days.
Period of Communicability
- Identified in saliva - 7 days before to 9 days after the onset of parotid swelling. Maximum infectiousness occurs 2 days before to 4 days after the onset of illness.
- Subclinical infections can be communicable.
Serology. The mumps virus can be isolated from saliva, blood, urine and CSF in acute phase.
Prevention and control
- Routine MMR vaccination, 2 doses at 12-15 months and at 4 years of age. There is no upper age limit and where required, two doses can be given separated by at least a one month interval (HPA).
- Exclusion from school for 5 days from onset of parotid swelling and arrange for laboratory confirmation2.
- There is no single antigen mumps vaccine licensed in the UK (HPA).
- Laboratory diagnosis by oral fluid testing is offered by the Health Protection Agency.
- Heymann D L, editor, Control of Communicable Disease Manual. 18th ed. American Public Health Association; 2004.
- Hawker J, Begg N, Blair I, Reintjes R, Weinberg J. Communicable Disease Control Handbook, Blackwell, 2005.
© CM Kirwan 2006