Mumps Overview and Learning Objectives

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Questions and Answers

What is the typical cause of parotitis in children aged 5-9 years?

Mumps caused by Myxovirus parotiditis (correct)

Bacterial infection from Streptococcus pneumoniae

Viral infection from the influenza virus

Allergic reaction to food

Which of the following is true regarding the secondary attack rate of mumps?

It varies significantly with age.

It is very high, estimated to be about 86 percent. (correct)

It is low, typically around 30 percent.

It is similar to that of measles.

What are common sources of infection for mumps?

Only subclinical cases of mumps

Both clinical and subclinical cases (correct)

Infected food and water

Only clinical cases of mumps

What is a significant characteristic of the Myxovirus parotiditis regarding immunity?

Lifelong immunity is induced after one attack. Signup and view all the answers

During which time frame is a person with mumps most infectious?

At the onset of parotitis and immediately before Signup and view all the answers

What is the incidence rate of spontaneous abortion associated with mumps infection in the first trimester of pregnancy?

25% Signup and view all the answers

What is the recommended age for routine immunization with the mumps vaccine?

Over 1 year Signup and view all the answers

Which of the following individuals should NOT receive the MMR vaccine?

A pregnant woman Signup and view all the answers

Which vaccine is commonly combined with the mumps vaccine for immunization?

Varicella vaccine Signup and view all the answers

What is the expected immune response in individuals receiving the mumps vaccine?

Antibody production in 95% Signup and view all the answers

Which of the following describes a common side effect of the MMR vaccine?

Mild rash or fever Signup and view all the answers

What is a significant hurdle in controlling the spread of mumps?

Long incubation period and pre-symptomatic transmission Signup and view all the answers

What is the typical full range of the incubation period for mumps?

2 to 4 weeks Signup and view all the answers

Which of the following complications is most common in adults with mumps?

Orchitis Signup and view all the answers

What percentage of post-pubertal men typically experience orchitis 7-10 days after parotitis onset?

25-40% Signup and view all the answers

Which of the following is NOT considered a common complication of mumps?

Cardiomyopathy Signup and view all the answers

Which symptom is often reported by children prior to the swelling of the parotid glands in mumps?

Ear ache Signup and view all the answers

What is the rate of pancreatitis occurrence in mumps patients?

4% Signup and view all the answers

Which statement about mumps orchitis leading to sterility is correct?

The assumption of it leading to sterility is ill-founded. Signup and view all the answers

What percentage of mumps patients may develop meningitis?

15% Signup and view all the answers

Study Notes

Mumps Overview

Mumps is an acute infectious disease caused by an RNA virus from the paramyxoviridae family
The virus has a predilection for glandular and nervous tissue
Clinically recognized by non-suppurative enlargement and tenderness of one or both parotid glands
Other organs may be affected
Symptoms vary, some cases may appear without noticeable symptoms
Mortality rate is negligible, but morbidity rate is high
Worldwide occurrence with peaks in epidemics every 2-5 years, typically during winter and spring
Natural infection confers lifelong protection
Incidence (without immunization) is 100-1000 cases per 100,000 population

Learning Objectives

Identify the causative agent of mumps
Understand the clinical presentation and complications of mumps
Recognize available treatments and preventive measures for mumps

Agents Factor

Agent: Myxovirus parotiditis — an RNA virus in the myxovirus family. Only one serotype exists.
Source of Infection: Both clinical and subclinical cases contribute. Subclinical cases (accounting for 30-40% of all cases) are considered crucial for maintaining the infection cycle. The virus can be detected in saliva, surfaces of Stenson's duct, blood, urine, human milk, and occasionally cerebrospinal fluid (CSF).

Communicability Period

Infectious period: 4-6 days before symptom onset and a week or more afterward
Peak infectivity: Just before and at the onset of parotitis
Non-infectious: Once swelling has subsided

Secondary Attack Rate

Estimated at approximately 86%

Host Factors

Age and Sex: Most common in children (5-9 years). Higher incidence than measles, chickenpox, or whooping cough. Adults experience a more severe disease than children if no prior immunity.
Immunity: A single attack, either clinical or subclinical, typically induces lifelong immunity. There is only one antigenic type, and no significant antigenic variations. Infants under 6 months are usually immune due to maternal antibodies.

Mode of Transmission

Primarily through droplet infection and direct contact with an infected person
Often associated with overcrowding

Incubation Period

Typically 14-18 days, varying from 2 to 4 weeks.

Clinical Features

Generalized virus infection; 30-40% of cases are clinically non-apparent
In apparent cases, characterized by pain and swelling in one or both parotid glands.
May also involve sublingual and submandibular glands
Often, initial complaint from child is "earache" on the affected side prior to swelling
Pain and stiffness in the jaw may be experienced before swelling is noticeable
Other symptoms may include fever, headache, muscle pain, pain when eating, loss of appetite

Complications

Though frequent, complications are generally not serious
Examples include orchitis, pancreatitis, meningoencephalitis, thyroiditis, neuritis, hepatitis, and myocarditis.
Orchitis (most frequent in adults): Testicular swelling and tenderness, usually unilateral. High fever often accompanies this complication, appearing 7-10 days after parotitis in about 25-40% of post-pubertal males.
Bilateral orchitis is rare; assumption that mumps orchitis causes sterility is unsubstantiated
Pancreatitis: Upper abdominal pain, nausea, and vomiting suggest pancreatitis. Significantly impacted adults are likely post-pubertal
Oophoritis: Lower abdominal pain and ovarian enlargement
Rarer complications: nerve deafness, polyarthritis, hydrocephalus, encephalitis, cerebellar ataxia, facial palsy, and transverse myelitis
Encephalitis leads to serious neurologic issues, cerebral edema, possible death
Meningitis can develop as a complication in some cases.
Infection in pregnancy's first trimester may increase the risk of spontaneous abortion, although congenital malformations are rarely linked.

Prevention

Vaccination: MMR (Measles, Mumps, Rubella) vaccine is highly effective and is now widely available.
- A single intramuscular dose (0.5 mL) leads to detectable antibodies in 95% of recipients.
- Long-term immunity duration is yet unknown
- Recommended for children over one year of age, either alone or with other virus vaccines.

Control

Mumps control is challenging due to infectivity before diagnosis and a variable incubation period, along with subclinical cases.
Isolated patients until symptoms subside, and disinfect used materials
Monitoring of close contacts is important.
Countries should set disease control targets and implement a strategic mumps immunization program accordingly

Mumps Surveillance

WHO case definitions: Three categories to monitor: clinical mumps, laboratory-confirmed mumps, epidemiologically-confirmed mumps
WHO defines appropriate methods for identifying and tracking mumps cases.

MMR Vaccine Contraindications

Two or more doses of MMR after 12 months old
Life-threatening allergic reactions to neomycin or other components
Pregnant women or women planning pregnancy within 4 weeks
Severely compromised immune systems

Vaccine Side Effects

MMR vaccine is safe and effective
Most people experience no side effects
Some might experience mild fever, rash, or achy joints for a limited time
Seizures caused by fever are possible but not associated with long-term issues.

Additional information

Mumps is usually a self-limiting illness, resolving within a few weeks without specific treatment.

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Description

This quiz provides a comprehensive overview of mumps, including its causative agent, clinical presentation, and complications. Participants will learn about the treatment options and preventive measures available for this infectious disease. Test your knowledge on the epidemiology and characteristics of mumps.