COMMENTARY

Would You Recognize Mumps?

Cristina Cardemil, MD, MPH

Disclosures

May 02, 2016

Editorial Collaboration

Medscape &

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Hello. I'm Dr Cristina Cardemil, a medical epidemiologist at the Centers for Disease Control and Prevention. I'm speaking with you as part of the CDC's Expert Video Commentary series on Medscape.

Mumps cases and outbreaks continue to occur every year in the United States. From year to year, mumps cases can range from roughly a couple of hundred to a couple of thousand. In 2016 to date, 467 mumps cases have been reported from 31 states.[1] Mumps outbreaks have been reported in groups with high vaccine coverage in settings where there was close, prolonged contact with infected people, such as schools, colleges, and prisons.

Healthcare providers play a critical role in recognizing mumps in their patients and preventing and controlling outbreaks. In this commentary, I will review the signs and symptoms of mumps and the steps you should take if you suspect that a patient has mumps. Misdiagnosis can lead to delays in implementing critical measures needed to stop mumps from spreading.

The telltale symptom of mumps is swollen cheeks and jaw. You should check for pain, tenderness, and swelling in the patient's parotid salivary glands on one or both sides. 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. Swelling usually peaks in 1-3 days and then subsides during the next week.[2,3,4]

Figure. Child with mumps. Note the characteristic swollen neck region due to an enlargement of the boy's salivary gland.
Source: Courtesy of Centers for Disease Control and Prevention

Patients may also experience nonspecific symptoms several days before they have parotitis, including low-grade fever which may last 3-4 days, myalgia, anorexia, malaise, and headache. However, mumps infection may present only with nonspecific or primarily respiratory symptoms or may be asymptomatic. These patients may still be able to transmit the virus to others.[2,3,4]

If you suspect that a patient has mumps, collect a buccal or oral swab specimen and a blood specimen for lab testing. Specimens are obtained by massaging the parotid gland for at least 30 seconds before swabbing the area around Stensen's duct. It's important to note that negative lab results among people suspected to have mumps, even if they are vaccinated, do not necessarily rule out the diagnosis. You should also obtain an accurate, complete immunization history, ask about contact with recent mumps cases, and quickly report the case to the health department.[3]

Mumps is spread through respiratory droplets and direct contact with others who have the infection. People with mumps are usually considered most infectious for several days before and after onset of parotitis.[3] Patients with mumps should avoid contact with other people from the time of diagnosis until at least 5 days after the onset of parotitis by staying home from work or school and staying in a separate room if possible.[3] Others who are potentially exposed to mumps should make sure that they are up-to-date with the vaccine that protects against mumps. In addition to staying away from others, patients with mumps can help prevent the virus from spreading by:

  • Covering their mouth and nose with a tissue when they cough or sneeze;

  • Washing hands often with soap and water;

  • Avoiding sharing drinks or eating utensils; and

  • Disinfecting frequently touched surfaces, such as toys, doorknobs, tables, and counters.

For more clinical information about mumps, prevention and control of outbreaks, and recommendations for measles-mumps-rubella (MMR) vaccination, see the CDC mumps website.

Thank you for watching.

Web Resources

CDC Mumps

Photos of Mumps Virus and People Affected by Mumps

Mumps Cases and Outbreaks

For Healthcare Providers

Mumps Surveillance Guidance

Information for Travelers

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