Mumps natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]; Nate Michalak, B.A.

Overview

The average incubation period for mumps virus is 16-18 days. Nonspecific prodromal symptoms develop and last 3-4 days. Several days after onset of prodrome, one or both of the parotid salivary glands begin to swell (parotitis). One parotid may swell before the other, and in 25% of patients, only one side swells. Other salivary glands (submandibular and sublingual) under the floor of the mouth also may swell but do so less frequently (10%). Parotitis, lasts at least 2 days, but may persist longer than 10 days. Complications include: orchitis in post-pubertal males, Oophoritis and/or mastitis in post-pubertal females, transient sensorineural hearing loss, Meningitis, Encephalitis, Pancreatitis, and Spontaneous abortion during the first trimester of pregnancy. Mumps is self-limiting and prognosis is excellent for uncomplicated mumps. Adolescents and adults are more likely than children to develop complications but these are rare, and prognosis is still favorable.

Natural History

  • The average incubation period for mumps virus is 16-18 days a range of 12-25 days.
  • Nonspecific prodromal symptoms develop including low-grade fever which may last 3 to 4 days, myalgia, anorexia, malaise, and headache.
  • Several days after onset of prodrome, one or both of the parotid salivary glands begin to swell (parotitis).
  • Swelling is first visible in front of the lower part of the ear. It then extends downward and forward as fluid builds up in the skin and soft tissue of the face and neck.
  • Inflammation usually peaks in 1 to 3 days and then subsides during the next week.
  • Swollen tissue pushes the angle of the ear up and out. As swelling worsens, the angle of the jawbone below the ear is no longer visible.
  • One parotid may swell before the other, and in 25% of patients, only one side swells.
  • Other salivary glands (submandibular and sublingual) under the floor of the mouth also may swell but do so less frequently (10%).
  • Parotitis, lasts at least 2 days, but may persist longer than 10 days.
  • Mumps infection may present only with nonspecific or primarily respiratory symptoms, or may be asymptomatic.[1]

Complications

  • Symptoms in teenagers and adults may be more severe.
  • Complications are relatively rare but may occur in asymptomatic patients and are more common in people who have reached puberty.
  • The most common complication is orchitis in post-pubertal males.[1]
  • Other complications of mumps include:[5][6]

Prognosis

The disease is self-limiting, and the prognosis is generally good, even if other organs are involved. After the illness, life-long immunity to mumps generally occurs. Sterility in men secondary to testicular involvement and death are very rare occurrences.

Resources

CDC: Mumps Complications

References

  1. 1.0 1.1 Mumps. Centers for Disease Control and Prevention (May 29, 2015). http://www.cdc.gov/mumps/index.html Accessed March 09, 2016.
  2. Preveden T, Jovanovic J, Ristic D (1996). "Fertility in men after mumps infection without manifestations of orchitis". Med Pregl. 49 (3–4): 99–102. PMID 8692089.
  3. Shakhov EV, Krupin VN (1990). "The clinico-statistical characteristics of the testicular generative function in male subfertility following mumps". Urol Nefrol (Mosk) (2): 46–50. PMID 2368216.
  4. Tsvetkov D (1990). "Spermatological disorders in patients with postmumps orchitis". Akush Ginekol (Sofiia). 29 (6): 46–9. PMID 2100952.
  5. Galazka AM, Robertson SE, Kraigher A (1999). "Mumps and mumps vaccine: a global review". Bull World Health Organ. 77 (1): 3–14. PMC 2557572. PMID 10063655.
  6. Gupta, R. K (2005). "Mumps and the UK epidemic 2005". BMJ. 330 (7500): 1132–1135. doi:10.1136/bmj.330.7500.1132. ISSN 0959-8138.
  7. Hashimoto H, Fujioka M, Kinumaki H, Kinki Ambulatory Pediatrics Study Group (2009). "An office-based prospective study of deafness in mumps". Pediatr Infect Dis J. 28 (3): 173–5. doi:10.1097/INF.0b013e31818a8ca8. PMID 19209100.
  8. Nussinovitch M, Volovitz B, Varsano I (1995). "Complications of mumps requiring hospitalization in children". Eur J Pediatr. 154 (9): 732–4. PMID 8582424.

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