A disease like mumps can be dangerous for children. It often occurs without noticeable symptoms, but it can cause severe complications. It is not easy to protect a child from contracting this infection, since in a children's team it is not always possible to distinguish a sick baby from a healthy one. Manifestations usually occur only a few days after the disease has already begun, and the person has become infectious to others. Parents need to be aware of the serious consequences of getting mumps and the importance of getting vaccinated against it.
The causative agent is a virus of the paramyxovirus family (measles and parainfluenza viruses belong to the same family). The causative agent of mumps develops only in the human body, in its various glands. It primarily affects the salivary glands (parotid and submandibular). But it can also multiply in all other glands of the body (genital, pancreas, thyroid).
Most often, mumps occurs between the ages of 3 and 7 years, but adolescents under 15 years of age can also get sick. Newborns do not have mumps, since their blood levels of antigens to this virus are very high. A person who has been ill develops lifelong persistent immunity, so they do not get sick again with mumps.
It has been noticed that mumps occurs in boys more often than in girls. Moreover, the defeat of the testes in adolescents leads to subsequent infertility. However, the defeat of the gonads occurs only in 20% of cases with a complicated form of mumps.
Types and forms of the disease
The severity of the course of the mumps depends on the number of viruses that have entered the body, their activity, as well as the age and physical form of the child, the state of his immune system.
There are 2 types of disease:
- manifest (manifested by symptoms of varying severity);
- inapparent (asymptomatic mumps).
Manifestant mumps
It is divided into uncomplicated (one or more salivary glands are affected, other organs are not affected) and complicated (the spread of the virus to other organs is observed). The complicated form of mumps is very dangerous, since inflammatory processes affect vital organs: the brain, kidneys, genitals and mammary glands, heart, joints, nervous system. With this form, the mumps can, meningitis, nephritis, mastitis, arthritis, myocarditis, orchitis, pancreatitis. In extremely rare cases, deafness occurs.
This type of mumps proceeds in a mild form, as well as with manifestations of moderate severity and in severe form.
Easy(atypical, with erased symptoms) form of mumps. There is a slight malaise, which quickly disappears without leading to any consequences.
Medium severity the disease is manifested by pronounced signs of damage to the salivary glands and general intoxication of the body with substances that the virus secretes.
Heavy the form. The characteristic signs of damage to the salivary glands are sharply expressed, complications arise.
Inapparent mumps
A feature of this disease is the complete absence of symptoms in a sick child. In this case, it is difficult to suspect the presence of a dangerous infection in his body. The insidiousness lies in the fact that the baby is a distributor of a dangerous infection, although he himself feels as usual.
Causes of disease in children with mumps
The mumps virus is spread only by airborne droplets when a person coughs or sneezes. So the likelihood of the virus getting into the surrounding air increases if the child has a cold.
The incubation period is 12 to 21 days. About a week before the onset of symptoms, the patient becomes contagious to others and continues to remain so until complete recovery, which is diagnosed based on test results.
The virus, together with the air, enters the mucous membrane of the nose and upper respiratory tract, from where it spreads further - to the salivary and other glands of the body. Most often, the disease is manifested by inflammation and enlargement of the salivary glands.
The disease is facilitated by a decrease in the child's immunity due to frequent colds, poor nutrition, and lag in physical development. The susceptibility to the virus in unvaccinated children is very high. In childcare facilities, outbreaks of mumps can be observed if they are visited by children whose disease is latent. In the event of a disease in several babies at the same time, the institution is closed for a 3-week quarantine. The mumps virus dies at a temperature of 20 ° after 4-6 days. It is unstable to the action of ultraviolet rays and disinfectants (lysol, formalin, bleach).
Outbreaks of the disease are especially possible in the autumn-winter period.
Signs of mumps disease
The disease proceeds in several stages.
Incubation period(duration 12-21 days). The following processes take place:
- viruses penetrate the mucous membrane of the upper respiratory tract;
- get into the blood;
- are carried throughout the body, accumulate in the glandular tissue;
- re-enter the bloodstream. At this time, they can already be detected by laboratory diagnostic methods.
The period of clinical manifestations. In the normal course of the disease, there are signs of intoxication of the body and inflammation of the glands in the jaw and ears. This period lasts 3-4 days if there are no complications.
Recovery. At this time, the symptoms of the child's disease with mumps gradually disappear. This period lasts up to 7 days. Until about 9 days after the onset of symptoms, the baby can infect others.
First signs
The first signs of malaise occur in children a day before the appearance of facial swelling. These include lack of appetite, weakness, chills, fever up to 38 ° -39 °, body aches, headache. All these are the consequences of poisoning the body with the products of the vital activity of microorganisms.
The child wants to sleep all the time, but cannot sleep. Small children are naughty. Perhaps an increase in the patient's pulse, a decrease in blood pressure. With a severe form of the disease, the temperature can reach 40 °.
Main manifestations
Children have pain in the earlobes, swelling of the glands. It is difficult to swallow, chew, talk, the pain radiates to the ears. Increased salivation may occur.
The salivary glands are most often swollen on both sides, although a unilateral form of the disease is also possible. Not only the parotid, but also the sublingual and submandibular salivary glands swell. Therefore, inflammation of the salivary glands leads to severe swelling of the cheeks, parotid region and neck.
The skin over the edema near the ears turns red, begins to shine. An increase in swelling is observed within 3 days, after which there is a reverse process of a gradual slow decrease in the size of the tumor. In adults and adolescents, the swelling may not subside for 2 weeks; in young children, it decreases much faster. The older the child is, the more severely he suffers from the disease.
Features of the development of mumps in boys and girls
With mumps in boys, in about 20% of cases, a viral lesion of the epithelium of the testicles (orchitis) occurs. If this occurs during puberty, then the consequence of a complicated disease can be infertility.
Signs of this condition are alternate swelling and redness of the testicles, pain in them, and fever. Inflammation of the prostate gland (prostatitis) can also occur, the manifestations of which are pain in the groin area, frequent painful urination.
In girls, a complication of mumps can be inflammation of the ovaries (oophoritis). At the same time, nausea, abdominal pain occur, adolescent girls have abundant yellow discharge, and a delay in sexual development may occur.
Signs of damage to the nervous system
In rare cases, the virus infects not only the glandular tissues, but also the central nervous system. This leads to meningitis (inflammation of the lining of the brain and spinal cord). This is a disease that can be life-threatening for children. Its manifestations are very characteristic (tension of the muscles of the back and neck, which forces the child to take a special position), vomiting, which does not bring relief, high fever.
A warning: A sign of complications is a sharp increase in temperature after a noticeable improvement in the patient's condition, when the temperature has already dropped to normal. Even if a child with mumps feels completely satisfactory, he should be under the supervision of a doctor until he fully recovers.
Video: Signs and symptoms of mumps, consequences of the disease
Diagnosis for mumps
As a rule, the characteristic course of the disease makes it possible to establish a diagnosis even without additional examination.
In addition to mumps, there are other causes of enlargement of the salivary glands, in which similar manifestations occur. This can happen due to the penetration of bacteria (streptococci, staphylococci) into them, dehydration, dental diseases, HIV infection.
However, in these cases, the appearance of swelling of the cheeks is preceded by any other characteristic manifestations (for example, teeth hurt, there is an injury, after which bacteria could be introduced into the salivary glands).
In order to finally make sure of the presence of an infectious infection, it is necessary to carry out laboratory diagnostics: a blood test for antibodies to the mumps virus, a microscopic examination of saliva and swabs from the pharynx. If there is a suspicion of damage to the nervous system, a puncture of the spinal cord is performed.
Treatment for mumps
As a rule, treatment is carried out at home. Children are hospitalized only when complications arise.
With an uncomplicated course of the disease, children are not given any special drugs. Only the relief of their condition is carried out. It is necessary to often gargle with a soda solution (1 tsp for 1 glass of warm water). If the baby does not know how to gargle, then he is allowed to drink warm chamomile tea.
A warm scarf is wrapped around the neck, a warming compress is made (a gauze napkin is moistened with slightly warmed vegetable oil and placed on a sore spot). This will help relieve pain. Antipyretic and pain relievers are prescribed.
Physiotherapeutic heating using methods such as UHF irradiation, diathermy helps to relieve inflammation of the salivary glands. Sick children should be kept in bed. It is desirable to feed them with semi-liquid or soft food.
Video: Signs of mumps in children, patient care
Prophylaxis
Vaccination is the only effective measure to prevent mumps disease. Vaccination is done 2 times, since immunity after it lasts 5-6 years. The first vaccination is given at 1 year old (together with measles and rubella), and the second at 6 years old.
Children who have been vaccinated against mumps are completely protected from this disease and its dangerous complications. The vaccine is completely safe, even for allergy sufferers.
If there is a sick child in the house, antiviral drugs may be prescribed to other children and adults for prophylaxis.
Video: Consequences of mumps, the importance of vaccination
Content:
Can mumps (mumps) cause infertility in boys or men?
We have already said above that mumps can really disrupt a man's ability to conceive a child (that is, it can cause male infertility), however, this happens quite rarely.
Mumps can only interfere with a man's ability to conceive if it causes inflammation in both testicles. This complication of mumps is observed only in 10% of boys and men (especially between the ages of 15 and 29) who contract the disease and is much less common in boys under 10 years of age.
How can mumps be dangerous during pregnancy?
A number of scientific studies have found that women who contract and develop mumps during the first trimester of pregnancy, the risk increases .
Infection with mumps later in pregnancy is not dangerous.
Observations of the health status of children born to women who have had mumps during pregnancy have shown that this infection does not increase the risk of developing malformations.
Is mumps contagious? Where does this disease come from? How can a person get infected with it?
Mumps (mumps) is a contagious disease. Healthy children or adults can only get mumps from other people who have recently acquired the infection themselves from other people.
The virus, the causative agent of mumps (Rubulavirus), is found in particles of saliva and mucus from the nose and throat of people infected with it. In this regard, it can be transmitted from one person to another when using shared utensils, when kissing, when coughing, sneezing, or under other circumstances that make it possible for an infected person's saliva to enter the mouth or nose of a healthy person.
Can there be mumps in children and adults who have received the vaccine?
Mumps vaccine(CCP) protects most people who get it from contracting the disease. However, in some cases, people who have received both doses of MMR vaccinations, provided for in the vaccination calendar, become infected and get sick with mumps.
When does a person with mumps become contagious themselves and how long can they remain contagious?
In the course of epidemiological studies, it was found that people infected with mumps can become infectious in 7 days. before inflammation of the salivary glands(or 1-2 weeks after they become infected) and remain infectious for another 8 days after the first symptoms of the disease appear.
The maximum infectiousness is observed on days when a person with mumps has an inflammation of the salivary glands.
Is it necessary to isolate a person who has mumps, and if so, how long (how long does the quarantine last)?
Specialists in the field of infectious diseases recommend isolating adults and children with mumps for 5 days (after the onset of inflammation of the salivary glands).
If you must care for a child or adult who has mumps:
- Wash your hands thoroughly with soap and water every time you touch the patient and the things they used
- Insist that the sick person wash their hands more often
- Make sure that during the entire period of illness, the sick person uses separate dishes and a towel.
- It is extremely important not to allow a person with mumps to come into contact with other people (especially adults) who have not been vaccinated against this disease. In this case, isolation must last for at least 26 days.
How long is the incubation period for mumps in children and adults?
Incubation period Incubation period- this is the period of time between the moment the infection enters the human body and the moment the first symptoms of the disease appear.
For many viral infections of the respiratory tract, such as influenza, the incubation period is 1-3 days (that is, the first symptoms of the disease appear 1-3 days after infection with the virus). In the case of other infections, the incubation period can range from a few days (less often hours) to several weeks, months, or years. with mumps (mumps) lasts from 12 to 25 days.
What are the symptoms and signs of mumps in children and adults?
The first signs of mumps in a child or an adult may resemble a common cold: fever up to 38-39 C, chills, pain in muscles and joints. A few days after the onset of these symptoms, inflammation of the salivary glands, located on the neck under the mandible, usually begins.
The inflamed salivary glands greatly increase in size, become painful and visible under the skin.
Quite often, at first the salivary gland on one side becomes inflamed and begins to increase, and after a while the salivary gland on the other side.
The enlarged size of the salivary glands in mumps can persist for 10 days.
The temperature can be maintained for 7 days.
Some people with mumps may develop a rash in the form of thick red patches covering the face, torso, arms and legs.
About 30% of boys and men (and much less often boys under the age of 10) who develop mumps develop inflammation of the testicles (orchitis). Inflammation of the testicles can occur concurrently with inflammation of the salivary glands, or it can begin 1-2 weeks after that.
Symptoms of testicular inflammation (orchitis) associated with mumps may include:
- Temperature rise to 39-40C
- The appearance of severe pain in the scrotum
- Redness and inflammation of the scrotum
Can mumps not cause any symptoms?
In about 20-30% of people who contract mumps, the disease proceeds without noticeable symptoms or causes only symptoms that resemble a mild cold.
With this course of the disease, the development of any complications or consequences is unlikely.
Due to the swollen face in the area of the ears and neck, which becomes similar to the head of a pig, this disease has received the apt name among the people - mumps. Official medicine calls it mumps, from the Latin words "par" - "near, about" and "otis" - "ear". The ending "-it" indicates the inflammatory nature of the disease. The name suggests that mumps is an inflammation of the parotid salivary glands. What kind of disease is this and why do pediatricians especially warn those mothers whose child is a boy?
Mumps is considered a childhood disease, although adults who have not been ill in childhood can also become infected with it.
This is the similarity of mumps with rubella or chickenpox, measles and many diseases, as a result of which persistent lifelong immunity arises in those who underwent them in childhood. An infected adult usually suffers such diseases much more severely than a child, and is more likely to develop complications.
How can you get mumps?
The causative agent of mumps is a paramyxovirus. It is unstable to external influences and quickly dies from ultraviolet radiation and disinfecting chemicals when heated. Therefore, the main route of infection is airborne or contact through saliva and objects contaminated with it (dishes, toys, etc.). This explains why mumps is transmitted so quickly in children's groups (kindergartens, etc.). But this also serves as a risk factor for those who have not yet had mumps: you can get infected anywhere, if there is a carrier of the virus nearby.
It enhances the possibility of infection with the virus and its contagiousness from 1-2 days after infection and before the first symptoms of mumps appear, that is, an outwardly healthy person or child may already be dangerous to others. The greatest infectiousness of the virus is observed 3-5 days after the pronounced symptoms of the disease are noticeable. A person who has recovered remains dangerous until 10-11 days from the onset of the stage of acute illness.
Due to the resistance of the virus to cold, the maximum incidence rates are observed in early spring, and the risk of infection is significantly reduced by autumn. After infection, viruses enter with the blood to different parts of the body, accumulating and multiplying in the glandular tissues of various organs (salivary, pancreas, sex glands). Sometimes (most often in children) mumps, the symptoms of which are usually very noticeable externally, does not manifest itself in any way. In this case, the patient is able to infect a large number of people in contact with him and, without receiving adequate treatment, earn severe complications of mumps (deafness, infertility, etc.)
Symptoms and treatment of mumps
The incubation period (the time from infection with the virus until signs of illness appear) is 11-23 days. Sometimes, on the eve of the disease, there are:
- Chills.
- Muscle and joint pain.
- Headache.
- Feeling of dry mouth and discomfort near the ears, under the lower jaw.
- Lack of saliva leads to dyspepsia and stomatitis.
- 1. At the onset of the disease, mumps is manifested by an increase in temperature up to 38.5 ° C and above, fever, headache and insomnia. An important diagnostic sign even before the mumps manifests itself in the form of severe symptoms, pain when pressing on the area behind the earlobes.
- 2. Inflammation in the parotid salivary glands leads to swelling and severe pain. At the same time, sometimes the patient is deprived of the opportunity to chew, and the pressure of the tumor on the Eustachian tubes leads to the appearance of tinnitus. This description makes it possible to understand what a mumps looks like: a swollen face with a predominant tumor localization in the region of the lower jaw and neck. With unilateral mumps, the tumor is asymmetrical and the face is distorted. The pain "radiates" to the ears or neck.
- 3. After a few days, usually 3-4 days, pains in the affected glands subside, completely disappearing by 7-8 days. The swelling of the face in the projections of the glands also disappears.
The differences in symptoms for children and adults are insignificant:
- Children are more characterized by a sharp development of the disease, without a previous period. The parotid glands are more often affected, the rise in temperature may be insignificant.
- In adults, the prodromal period with severe symptoms is more common. Not only the parotid glands are affected, but also the submandibular glands.
How is mumps treated?
Uncomplicated mumps can be treated at home. Patients are usually hospitalized if a concomitant disease occurs, the treatment of which requires hospital conditions (acute pancreatitis, meningitis) or mumps is severe.
Among the therapeutic measures are prescribed:
- Bed rest for the entire period of pronounced symptoms - 10-11 days.
- A dairy-plant diet is recommended to prevent the development of inflammation of the pancreas and the intake of pureed food in order to facilitate chewing.
- Warm drink in large volumes (weak tea, fruit drink).
- Drug therapy implies symptomatic treatment, anti-inflammatory drugs (ibuprofen, paracetamol, etc.), antihistamines and multivitamins are prescribed.
- In severe cases, with intoxication of the body in a hospital, detoxification treatment is carried out.
The main tasks that the treatment of a disease such as mumps solves is the prevention of complications in the form of inflammation of the gonads, pancreatitis and inflammation of the central nervous system.
In cases where the symptoms were insufficiently expressed and the treatment was carried out with impairments or the person suffered this disease "on his feet", the mumps can lead to serious complications in the form of severe diseases of various glands and damage to the central nervous system:
- In children, mumps often turns into serous meningitis. This disease is characterized by an acute onset, high temperature readings, fever, severe headaches and vomiting that occur after severe symptoms of the underlying ailment appear. In some cases, a complication towards the central nervous system manifests itself in the form of encephalomyelitis or meningoencephalitis with impaired consciousness, drowsiness and paresis of the facial nerve.
- Among the complications that are especially dangerous for men's health, one can note diseases such as orchitis (inflammation of the testicles) characteristic of moderate and severe forms.
Orchitis in severe and moderate forms in about 50% of cases. Symptoms appear on the 5-7th day from the onset of the disease and are expressed at first by a sharp rise in temperature to 39-40 ° C, the appearance of sharp pain in the scrotum and its spread to the lower abdomen. The testicle becomes inflamed and reaches the size of a goose egg. This condition lasts 3-8 days, after which the inflammatory phenomena begin to subside, but in half of the cases, those who have undergone such a complication develop organ atrophy (within 1-2 months).
- On the 4th-7th day of the disease with mumps, sharp pains in the stomach, nausea and vomiting may appear. This is how a complication of the pancreas manifests itself - pancreatitis.
- With complications in the ears, complete deafness or hearing loss from the inflamed gland may develop due to the effect of the virus on the auditory nerve. Hearing usually does not recover after recovery.
- Sometimes, in 0.5% of cases, large joints can be affected by the virus. There is pain and swelling of the joint, and a serous effusion appears inside them. Arthritic phenomena last from 1-2 weeks to 3 months.
Prevention of mumps
Mumps is common all over the world. Measures to prevent the disease currently consist in two-fold vaccination with the associated MMR vaccine at the age of 1 year and 6 years. Immunity in this case is acquired for life, as after the postponed mumps.
If there is a sick person in the house, and the presence of immunity in some family members is in doubt, then the prevention of the disease is reduced to the patient's personal hygiene, the allocation of separate dishes, linen, towels, etc., which are treated with boiling or disinfectants. At the same time, contact of the patient with a person who has not been ill or who has not been vaccinated is unacceptable.
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Mumps, mumps, mumps - an acute infectious disease, accompanied by inflammation of the salivary (mainly parotid) glands, general intoxication, possible damage to other organs and the central nervous system.
Transmission path.
The causative agent of mumps- a filtering virus, belong to paramyxoviruses.Source of infection only man is.
Mumps is transmitted from a patient to a healthy airborne droplet when talking, sneezing, coughing. Outside the human body, the mumps virus quickly dies, therefore, mumps are usually not transmitted through the people around the sick person, through things. However, infection, apparently, can occur through various objects salivated by the sick (dishes, toys), if they pass to a healthy child within a very short time and come into contact with his mouth.
Mumps most often affects children aged 5 to 15 years. Adults can also get sick, but mostly young (from 18 to 30 years old).
Incubation period- 11-30 days (usually 15-19 days).
Symptoms
The disease usually begins with general malaise, headache, fever up to 38-39C.
Sometimes nosebleeds are observed, in severe cases - vomiting and convulsions. After 2-3 days, the parotid gland begins to swell, often on one side, and after 1-2 days on the other. The patient's face at the same time acquires a characteristic appearance (which is why the name "Pig" came about). Sometimes the disease covers other salivary glands, submandibular and sublingual. Mumps is characterized by pain when chewing and opening the mouth. The greatest pain is observed with pressure behind the earlobe. The disease usually lasts 8-10 days. If other salivary glands are affected, or if complications occur, the mumps may heal.
Complications.
Complications (more often in older children) are observed:
- Testicular inflammation in boys ,
- Ovarian inflammation girls ,
- Defeats pancreas, thyroid, thymus glands,
- Inflammation lymph nodes in the neck,
- Serous meningitis and meningoencephalitis.
Boys Testicular inflammation
occurs more often than inflammation of the ovaries in girls.
Usually, first one, and then the second testicle is affected. The area of the inflamed testicle swells, the skin turns red and shiny, the child is in pain. Parents should definitely examine the testicles of the child, as the child may not always be shy and not talk about it.
Treatment should be started immediately, otherwise it can lead to testicular atrophy, and later to infertility. You cannot heal on your own. Only as directed by a doctor. Before the doctor's prescriptions, you can give your child pain relievers from non-steroidal anti-inflammatory drugs: ibuprofen, paracetamol.
Warming compresses, ointments are prohibited. You can apply a bubble of cold water, but not for very long.
With acute pancreatitis there are girdle pains in the abdomen, nausea, vomiting, stool disorders (constipation, sometimes diarrhea). The stool contains the remains of undigested food. The tongue is coated with a whitish bloom. In case of delayed treatment, this can lead in the future to juvenile diabetes mellitus.
The most dangerous complication is Meningoencephalitis
- inflammation of the membranes of the brain and spinal cord.
Symptoms are manifested by a sharp violation of the condition, headaches, stiff neck muscles, dizziness, nausea, vomiting, hearing and vision impairment. There may be loss of consciousness, convulsions. Emergency medical attention is required. The child is transferred to a hospital where meningitis is treated.
PIG TREATMENT.
Diet.
Exclude: white bread, pasta, fried and fatty, sour fruits and vegetables.
It is necessary to drink plenty of drinks in the form of compotes, juices, tea.
The food is preferably dairy-vegetable - dairy products, cereals, mashed soups, vegetable purees, etc.
Treatment is carried out under the supervision and prescription of a doctor:
- Bed rest,
- Diet (liquid and semi-liquid food),
- Vitamins,
- Oral cavity care - rinsing with boric acid solution, rivanol solution 1: 1000, etc.,
- Heat to the affected glands (heating pads, dry heat, compresses, blue light, etc.).
Treatment for complications carried out according to the given disease (meningitis, etc.).
- With orchitis appoint: anti-inflammatory drugs, prednisone or other corticosteroids.
- With meningitis spend dehydration therapy (diuretics), corticosteroids, effective spinal puncture.
- With pancreatitis appoint papaverine, no-shpa, to reduce edema - mannitol, sodium thiosulfate, antienzyme drugs - counterbalance, gordox and etc.
At the end of the disease, special disinfection is not required, it is only necessary to thoroughly ventilate the room, carry out wet cleaning, and clean the furniture.
Contagious period.
The patient is contagious from the last days of the incubation period until the end of the disease. A sick child is usually not admitted to a child care institution within 21 days from the day of illness. After recovering from mumps, a persistent immunity remains - immunity.
Children under 12 years old who have not had mumps and who have had contact with a sick person are prohibited from visiting child care facilities from the 11th to the 25th day from the moment of contact. If there are several cases of mumps in an institution (nursery, kindergarten), patients should be treated in the institution itself, and the children's institution is considered infected (new children are not accepted, children are not allowed to go home, etc.) until the epidemic outbreak ends, that is until new diseases of the mumps appear within 3 weeks. For children who have had mumps, as well as for children over 12 years of age and adults who have had contact with the sick, dissociation does not apply.
Prevention.
Mass immunization of children is carried out. The mumps vaccine is given once to a child aged 12-18 months.
At the same time, stable immunity develops.
Parotitis ( piggy) Is a respiratory viral infection that poses a serious epidemiological hazard due to its high infectivity. The disease most often occurs in children ( more often at the age of 5 - 8 years). In children under 3 years of age, infection is extremely rare. The increased risk of infection remains up to 15 - 16 years. Adults are less susceptible to mumps, but the possibility of infection remains.
Mumps does not pose a serious threat to the patient's life, however, the treatment of the disease is given great attention due to the high risk of complications. In recent decades, severe disease is rare. Also, thanks to mass vaccinations in most countries, the incidence of mumps in general has dropped.
Interesting Facts
- Mumps is often called mumps or mumps because of the characteristic swelling of the upper cheeks in front of the ears.
- The first description of a classic mumps patient was made by Hippocrates 2400 years ago.
- Military doctors made great progress in the diagnosis and treatment of mumps in the 17th - 19th centuries. During this period, mumps was often observed among soldiers due to the large crowding of people in the barracks and trenches and the low level of hygiene. In some sources of that time, it is even called "trench" or "soldier's" disease.
- The viral nature of mumps has been proven by infecting monkeys with the saliva of sick people.
- Under natural conditions, mumps is a strictly anthroponous disease, that is, only people get sick with it. Only in laboratory conditions is the transmission of the virus to some species of monkeys and dogs possible, but such animals, although they get sick themselves, no longer pose a danger of infection.
- The first vaccine against mumps was received only in 1945.
- Mumps poses a great epidemic danger, so at present more than 80 countries around the world are routinely vaccinating children against this disease.
The causative agent of mumps
The causative agent of mumps is a virus Pneumophila parotiditis from the family Paramyxoviridae... It is a chain of RNA ( genetic material), covered with a dense protein shell. When it enters a cell, the virus begins to multiply, producing a duplication of genetic material. In this case, the cell of the macroorganism is used for the production of proteins necessary for the formation of the capsule. When examined under a microscope, the virus is polymorphic ( different shapes) particles ranging in size from 100 to 600 nm. They are unstable in the external environment and quickly degrade under the influence of various chemical and physical factors.
The following measures can be used to inactivate the pathogen of mumps:
- exposure to high temperatures;
- ultraviolet radiation ( including exposure to direct sunlight);
- drying;
- change in the pH of the environment ( getting into an acidic or alkaline environment);
- exposure to ethyl alcohol ( 50% or more);
- exposure to formalin solution ( 0.1% or more);
- other disinfectants.
In the human body, the glandular cells of some parenchymal organs are sensitive to the mumps virus, first of all. Usually, damage to the salivary glands is observed, somewhat less often - to the pancreas and gonads ( more often male testes than female ovaries). Damage to the tissues of the nervous system is also possible.
Infection with mumps occurs by airborne droplets. During breathing ( less), talking, coughing or sneezing, the patient spreads viral particles with droplets of saliva. When it gets on the mucous membrane of the respiratory tract of another person, the virus infects the glandular cells in the epithelium. Cases of infection have also been described when the virus enters the mucous membrane of the eyes ( conjunctiva). In the cells of the mucous membrane, its primary reproduction takes place in the body. After that, the virus enters the bloodstream ( stage of viremia or viremia) and spreads to all organs and systems. However, a specific viral lesion develops only in the cells of the above organs, which are especially sensitive to this disease.
The mumps virus has the following specific mechanisms of tissue damage:
- Hemagglutinating activity... Hemagglutinating activity consists in the effect on blood red blood cells. Under the influence of specific substances, erythrocytes stick together. This leads to the formation of microthrombi in the capillaries and contributes to the development of edema.
- Hemolytic activity... Hemolytic activity consists in the destruction of blood cells ( primarily erythrocytes) with the release of hemoglobin and a number of other toxic decay products.
- Neuraminidase activity... The specific enzyme neuraminidase facilitates the penetration of viral particles into the cell, which contributes to the multiplication of the virus.
From an immunological point of view, the mumps virus is represented by a number of antigens. These are unique substances that are characteristic only for this group of microorganisms. In mumps virus, antigens are represented by capsule proteins. The human body perceives them as foreign substances. Upon contact with peripheral cells, the structure of the antigen is recognized. The encoded information about the structure of the foreign substance is transmitted to the central organs of the immune system. Based on this information, an immune response is formed. It consists in the production of specific antibodies. These are B-lymphocytes equipped with a special receptor that recognizes the viral antigen. Antibodies circulate in the blood, selectively attaching to viral particles and leading to their destruction.
In people who have had mumps, antibodies in the blood continue to circulate throughout their lives. Therefore, if the virus re-enters the mucous membranes, it will be quickly neutralized by antibodies and the disease will not develop. The action of the anti-mumps vaccine is based on this mechanism. However, even this acquired specific immunity to mumps is not an absolute defense. It is believed that even after the transferred disease, the risk remains ( about 0.5 - 1%) re-infection. In people who have undergone major surgery with massive blood transfusions, or after bone marrow transplantation, the risk of re-infection increases to 20-25%, since a significant part of the antibodies is excreted from the body.
Mumps causes
Mumps is an infectious disease, so the only root cause of its development, one way or another, is a virus that has entered the body. In the body, it leads to the development of specific tissue damage according to the above mechanism. However, a number of predisposing factors can also be attributed to the reasons for the increased incidence of mumps. Their presence greatly increases the risk of infection. Risk factors for contracting mumps include:
- seasonality of the disease;
- refusal to vaccinate;
- weakening of general immunity;
- childhood;
- high population density;
- non-compliance with the sanitary regime.
Seasonality of the disease
The peak incidence of mumps occurs in the spring months ( March - May) in the northern hemisphere and in the autumn months ( October December) - in the south. This pattern is due to weakened immunity. After a cold period, the body weakens and its protective resources are depleted. At this time of the year, the diet of children, as a rule, is the poorest in vegetables and fruits, which leads to hypovitaminosis or vitamin deficiency ( forms of vitamin deficiency). In addition, the mumps virus persists well in the environment at temperatures around 0 degrees, which also increases the chances of infection.Refusal to vaccinate
In recent years, many parents have decided not to vaccinate their children due to the high risk of complications. Such a decision imposes a great responsibility on parents towards their children. In the future, the child will be susceptible to the mumps virus and will be at risk. Unvaccinated people without specific immunity get sick at the first contact with the pathogen of mumps in 95 - 97% of cases. Thus, the child will remain defenseless until the age of majority, when he can independently decide on vaccination. This creates additional problems for doctors and nurses in kindergartens and schools. Children without specific immunity constantly pose a danger to others. With mumps, the patient can be contagious even before the first symptoms appear. This forces doctors with each case of acute respiratory infections ( acute respiratory disease) and ARVI ( acute respiratory viral infection) suspect mumps and carry out additional diagnostic measures.Weakening of general immunity
The state of general immunity plays a significant role in protecting the human body from infection in principle. The immune system is able to fight the vast majority of viral and bacterial diseases, which reduces the likelihood of infection. As noted above, in most people, weakening of the immune system is noted in late winter and early spring. However, the time of year is not the only factor in this case.The child's immunity can be weakened for the following reasons:
- frequent colds;
- a long course of antibiotic treatment;
- a course of treatment with corticosteroid drugs;
- some chronic diseases ( chronic pyelonephritis, diabetes mellitus, etc.);
- irregular and unbalanced diet.
Childhood
As you know, mumps is considered a childhood infection. Most often, children of primary school age are sick. As a result, it is during this period of time that parents should be most attentive. Senior school children ( after 15 years) and adults get sick on average 5 - 7 times less often.High population density
As with any infectious disease, population density plays an important role in mumps. First of all, we are talking about the overcrowding of children in kindergartens and schools. In such conditions, one child with mumps can infect a large number of children at once. Thus, the threat of an outbreak of mumps within educational institutions is increasing. To avoid this, classes should be conducted in large, well-ventilated classrooms.Non-compliance with the sanitary regime
Patients who have not been isolated are at high risk to others. As mentioned above, the patient has been a source of infection from the last days of the incubation period ( 5-6 days before the first symptoms appear) up to 7 - 9 days of the course of the disease. During this period, the patient must stay at home to avoid the spread of infection. Failure to comply with the sanitary regime increases the risk of infection of people who come into contact with the patient.Types of mumps
As noted above, the pathogen of mumps has increased activity against a number of glandular organs. Depending on which of these organs will be affected, certain symptoms will prevail during the course of the disease. In many ways, the clinical form of mumps also predetermines the danger of certain complications and treatment tactics. The main clinical forms of the course of mumps are:
- damage to the salivary glands;
- damage to the testicles;
- damage to the pancreas;
- damage to other organs and systems.
Damage to the salivary glands
The actual name of the disease - mumps - suggests inflammation of the parotid salivary glands. They are located in front and downward relative to the auricle. As a rule, the process affects both parotid glands, but there are also unilateral variants. Symptoms can also develop first on one side, and only after a few days the disease will spread to the paired gland.Somewhat less often, the parotid glands, mumps also affects other salivary glands ( submandibular and sublingual). This variant of the course of the disease, when the inflammatory process develops only within the salivary glands ( one or more) is considered uncomplicated. It is characterized by a number of typical symptoms.
Symptoms of damage to the salivary glands with mumps
| Symptom | Mechanism of appearance | Features for mumps |
| Pain when moving the jaw | Pain appears mainly due to pronounced edema of the tissues of the gland and stretching of its capsule. The formation of pus in the gland is extremely rare, then the pain becomes acute and it is caused by the destruction of the tissues of the gland and irritation of the nerve endings. | Pain and discomfort occurs as edema develops or precedes it. Usually the pains are dull and not intense. They persist for 7 to 10 days until the swelling subsides. |
| The swelling is due to the intensive development of the virus in the cells of the salivary gland. This leads to the establishment of inflammatory edema. | The swelling of the parotid glands gives the face the shape characteristic of mumps, protruding the earlobes to the sides. This symptom is considered specific for mumps and is extremely rare in other diseases. | |
| Increased body temperature | The increase in body temperature is explained by the multiplication of the virus and the ingestion of its waste products into the blood. A chain of biochemical reactions leads to the release of pyrogens - specific substances that affect the thermoregulatory center in the brain. Its irritation leads to an increase in body temperature. | The temperature rises in the prodromal period of the disease, or at the stage of specific appearance of the disease. Often it begins to rise 24 to 48 hours before the lesion of the salivary glands. The rise in temperature is usually sharp, accompanied by chills. Starting from 4 - 5 days of illness, in the absence of complications, the temperature begins to subside. In the early days, it can reach 39 - 40 degrees. |
| Dry mouth | Dry mouth occurs due to dysfunction of the salivary glands. It is often accompanied by redness of the mucous membrane of the mouth and pharynx. | The symptom is usually mild and goes away quickly. Patients experience some discomfort due to dryness only during the first days of the illness. |
| Noise in ears | Tinnitus can be caused by pressure on the ear canal. With damage to the auditory nerve, the symptoms are much more pronounced. This form is referred to as a specific complication - labyrinthitis. | Tinnitus is rare, appears sporadically in the first days of the disease. In the absence of damage to the auditory nerve, patients often do not even mention this symptom at the doctor's appointment. |
| Characteristic head fit | Significant swelling of the salivary glands provokes pain when moving the head, so patients try not to move it. | The symptom is especially noticeable in the early days of the disease, when the swelling increases. The head is usually tilted to the affected side ( with unilateral damage), or slightly retracted into the shoulders when bilateral. |
Testicular damage
Damage to the testicles is one of the serious complications of mumps. It occurs mainly in adult males who have not been vaccinated against mumps in childhood. This form of mumps is less common in children and adolescents. Usually, the spread of the virus to the testicular tissue occurs after the defeat of the salivary glands ( for 5 - 7 days). This is accompanied by the appearance of new symptoms and a noticeable deterioration in the general condition of the patient. In rare cases, orchitis or epididymitis ( inflammation of the testicle or epididymis, respectively) is the first specific manifestation of the disease. In other words, it is not preceded by damage to the salivary glands. In such cases, the diagnosis is often difficult, as doctors are looking for other causes of the inflammatory process. Orchitis is most often unilateral ( only one testicle is affected), but there are also bilateral processes. The disease lasts 7 to 9 days, after which it enters the extinction phase and the symptoms begin to subside.Typical symptoms in the development of orchitis in patients with mumps
| Symptom | Mechanism of appearance | Features for mumps |
| A new wave of fever | A new wave of fever is noted due to the massive destruction of a new tissue site by the virus ( testicle and epididymis). This is accompanied by the circulation of toxic substances in the blood that irritate the center of thermoregulation. | Usually, a new rise in temperature is noted up to 39 - 40 degrees. In the following days, it gradually decreases. Orchitis must be treated in a hospital setting, as there is a risk of irreversible infertility. |
| Testicular enlargement | The testicle enlarges due to inflammatory edema. The virus invades the tissue of the gland, causing inflammation. As leukocytes migrate to the focus, specific mediators are released. They increase the permeability of the capillaries and facilitate the release of fluid from the vessels into the tissues. | The testicle can grow one and a half to two times. Its decrease occurs gradually, as other symptoms recede. |
| Hyperemia of the scrotum | Hyperemia ( redness) of the scrotum is explained by the rush of blood to the affected organ and the establishment of inflammatory edema. | Hyperemia is rarely observed and may go unnoticed with significant hair growth in the groin area. |
| Groin pain | Groin pain appears due to the establishment of inflammatory edema. In this case, there is a mechanical compression of pain receptors. | Pain in the groin with mumps dull, not intense ( as the edema builds up gradually). They can give in the lumbar region, in the leg, or in the suprapubic region. The pain increases with movement or urination. As a result, the patient may limp. |
| Violation of urination | Violations of urination appear reflexively due to increased pain. The contraction of the muscles that empty the bladder somewhat increases the pressure in the scrotum, squeezing the nerve receptors as well. The patient may have a fear of urination ( especially children), they go to the toilet often and little by little. | Urinary disturbances are rare symptoms and usually last no more than a few days during the most active phase of the disease. |
| Priapism (prolonged painful erection) | Due to the edema of the testicle, the receptors responsible for filling the cavernous bodies of the penis with blood are irritated. An erection is established that is not associated with external stimuli. | This symptom is extremely rare and usually lasts no more than 24 - 36 hours ( more often a few hours). |
Damage to the pancreas
The defeat of the pancreas in mumps is observed quite rarely ( 2 - 3% of cases). Some researchers believe that the low percentage is due to insufficient diagnosis, and pancreatitis with mumps is much more common. Be that as it may, this complication requires special attention, since it can lead to serious structural changes in the structure of the gland and dysfunctions of its function. The first specific signs of pancreatitis are noted on the 4th - 7th day of the disease and almost always follow the defeat of the salivary glands. An isolated lesion of the pancreas without affecting other organs and systems is extremely rare in patients with mumps. The patient's condition with the development of pancreatitis deteriorates markedly. Such patients are recommended to be hospitalized for more intensive treatment.Symptoms of the defeat of the pancreas in patients with mumps
| Symptom | Mechanism of appearance | Features for mumps |
| Pain | Pain appears due to tissue edema. Usually, in the case of pancreatitis against the background of mumps, the edema is not so strong, but the organ itself is extremely sensitive. | Pain is localized in the epigastrium ( upper abdomen) and are shingles. They can radiate to the back or shoulder blades and reach significant intensity. |
| Fever | The mechanism of a new round of temperature in pancreatitis is similar to that in other localizations of the virus and is associated with irritation of the thermoregulatory center. | The temperature rises quickly, usually following the onset of pain. It can reach 38 - 39 degrees. Lasts from 3 to 9 days ( depends on the intensity of treatment). |
| Vomit | The pancreas takes an active part in the digestion process. Its defeat by the virus reduces the secretion of digestive enzymes and makes it difficult to digest food. This can cause repeated episodes of vomiting during the course of the illness. In addition, at the onset of the disease, a single vomiting may occur due to reflex irritation of the nerves. | Vomiting is usually one time at the onset of the disease. Repeated episodes indicate massive tissue damage and worsen the prognosis. To prevent and reduce vomiting, you should follow an appropriate diet, which will be described below, and take pancreatic enzymes to facilitate the digestion of food during illness. |
| Diarrhea | Diarrhea also occurs due to insufficient digestion of food in the small intestine. Because of this, many substances enter the colon poorly digested, are not absorbed and cause irritation of the mucous membrane. Reflexively, this leads to increased stool frequency. | Diarrhea is rare and lasts several days. The symptom can be delayed only with the addition of a secondary bacterial infection or the development of complications ( accumulation of pus or necrosis of the pancreas). |
| Abdominal muscle tension | The tension of the abdominal muscles is of a reflex nature due to edema and irritation of the peritoneum. | On palpation, the abdomen is hard, pressure causes increased pain. The patient cannot voluntarily relax the abdominal muscles. |
The main danger of pancreatitis in patients with mumps is the possible irreversible damage to the insulin-producing islets of Langerhans. In this case, after recovery, the patient will suffer from type 1 diabetes mellitus.
Damage to other organs and systems
The defeat of other organs and systems with mumps is quite rare. In general, they do not pose a serious threat to the health of patients. However, some clinical forms of the disease ( serous meningitis) can even lead to death without timely treatment. It is because of the threat of such complications that mass vaccination of children against mumps is now recommended.Damage to other organs and systems in case of mumps
| Complication | Typical Symptoms | Features of the course of the disease |
| Oophoritis (inflammation of the ovaries in women) | Lower abdominal pain, menstrual irregularities ( amenorrhea or dysmenorrhea), intermenstrual bleeding, pain during intercourse. The temperature may remain subfebrile ( 37 - 38 degrees), but more often it rises slightly. | Oophoritis occurs in children more often than in adult women. In general, it refers to a rare complication of mumps, and unlike orchitis in men, it almost never leads to infertility. An ultrasound scan ( Ultrasound). |
| Thyroiditis (inflammation of the thyroid gland) | Enlargement of the thyroid gland ( swelling in the throat), pain in the neck, radiating to the back of the head, lower and upper jaw, enlargement of the cervical lymph nodes, fever, chills, headache, weakness, sweating, increased heart rate. | Thyroiditis as a complication of mumps is rare, but can lead to very serious consequences. In particular, there is a possibility of the development of an autoimmune process. In such cases, the patient, after recovery, may suffer from a deficiency of thyroid hormones. For the treatment of thyroiditis, an endocrinologist is involved. |
| Meningitis and meningoencephalitis (inflammation of the meninges and the brain itself) | Acute onset, fever up to 39-40 degrees, severe headache, vomiting of central origin ( without prior nausea). Meningeal syndrome: stiff neck, Kernig's symptom and Brudzinsky's symptom ( top and bottom), LeSage symptom ( in children). In addition, characteristic changes in the analysis of cerebrospinal fluid are noted: fluid flows out under pressure, protein content is up to 2.5 g / l, cytosis is up to 1000 cells in 1 μl, chlorides and glucose are normal. In case of damage to the brain tissue itself ( encephalitis) there is lethargy, drowsiness, impaired consciousness, paralysis and paresis. | Serous meningitis develops 4-7 days after the lesion of the salivary glands, less often - simultaneously with it. Despite the fact that the course of the disease worsens with the development of meningitis, the prognosis is usually favorable. Treatment is carried out only in stationary conditions and lasts at least 2 - 3 weeks. Meningeal syndrome, with proper treatment, disappears on the 10th - 12th day of the illness. Cerebrospinal fluid indicators ( after 1.5 - 2 months). |
| Prostatitis (inflammation of the prostate gland) | Fever, chills, frequent and painful urination, weakness, headaches, feeling tired. | With a specific lesion of the prostate gland, a sharp deterioration in the patient's condition occurs with a new wave of fever and signs of intoxication. Inpatient treatment of patients with this complication is recommended. With adequate treatment of prostatitis, all symptoms subside with recovery ( within 1 - 2 weeks) without any consequences. |
| Labyrinthitis (damage to the organ of hearing) | Headaches, nausea ( maybe no vomiting), dizziness, impaired coordination of movements, noise and ringing in the ears. Hearing loss or, conversely, ringing in the ears can be unilateral. | Labyrinthitis is a rare complication of mumps. It can be caused by increased pressure in the area of the auricle due to inflammatory edema, but symptoms are more pronounced with specific lesions of the auditory nerve and vestibular apparatus. With the development of labyrinthitis, consultation with an ENT doctor is required. Hearing symptoms usually last no more than a few days and disappear as you recover. |
| Arthritis (joint damage) | Swelling of the joints, soreness, stiffness of movements. | Arthritis rarely develops in mumps, usually 1 to 2 weeks after the onset of the disease. In rare cases, there may be simultaneous damage to large joints ( knee, ankle, elbow, shoulder, wrist) and salivary glands. This complication is more common in men. Symptoms disappear with recovery, rarely leaving serious consequences. With moderate joint damage without intense edema, treatment of this complication at home is allowed. |
| Dacryoadenitis (inflammation of the lacrimal glands) | Swelling of the eyelids ( more often bilateral), pronounced edema, soreness, redness of the eyes, dry eyes. | This complication is quite rare and requires urgent consultation with an ophthalmologist. During the course of the disease, special drops are prescribed that moisturize and nourish the mucous membrane. The prognosis is generally good. It is extremely rare that dacryoadenitis can, in turn, be complicated by an abscess of the lacrimal gland. |
| Mastitis (inflammation of the mammary glands) | The disease is characterized by fever, tenderness, and breast hardening. Rarely, there is a small amount of discharge ( mucus or, less commonly, pus). | Mastitis develops mainly in girls and women, but in men, the appearance of this complication is also possible. The general condition of the patient suffers little. Symptoms are short-lived and quickly resolve with treatment. |
In what period is the patient dangerous to others (infectious)?
The infectivity of a patient with mumps is one of the most important criteria in the course of the disease. It is she who determines the period of time when the patient should be isolated in a hospital or at home. With mumps, the contagious period ( time when the sick person is contagious) can vary. For a better orientation in time, it is necessary to know all the periods of the course of this disease. During mumps, the following stages are distinguished:
- incubation period;
- prodromal period;
- the period of the main manifestations of the disease;
- extinction period;
- recovery period.
Incubation period
The incubation period is the period of time during which the virus has already entered the human body, but the disease as such has not yet occurred. In other words, the patient is not worried about anything and he does not suspect that he is sick. During this period, the virus multiplies in the mucous membrane of the respiratory tract and enters the bloodstream. In rare cases, at the end of the incubation period, the patient begins to be bothered by implicit general symptoms, such as weakness, increased fatigue, and drowsiness.In mumps, the incubation period lasts from 11 to 23 days ( the maximum described duration is 30 - 35 days). The danger lies in the fact that already in the last days of the incubation period, the patient may pose a danger of infection to others. In some cases, particles of the virus can be contained in saliva even before the first obvious symptoms of the disease appear.
Prodromal period
The prodromal period is the period of nonspecific symptoms. That is, a person understands that he is sick, but it is still impossible to diagnose by symptoms. In patients with mumps, the prodromal period usually lasts no more than 24 - 36 hours, but it can often be absent altogether. Typical symptoms are headache, muscle pain, joint pain, and sleep disturbances. If the prodromal period is present, then the patient is contagious throughout this time.The period of the main manifestations of the disease
This period is characterized by the appearance of symptoms that are characteristic of mumps. First of all, we are talking about redness of the mucous membrane of the mouth, throat and pharynx. Redness is especially pronounced in the area of the excretory ducts of the salivary glands. Somewhat later, unpleasant sensations and swelling of the parotid salivary glands appear ( the area below and in front of the earlobe). The patient continues to actively secrete viral particles for another 5 - 9 days after the appearance of the first characteristic symptoms. It can be difficult to unequivocally determine this period, since an increase in the parotid salivary glands is not always the first symptom. In an atypical course of the disease, the virus can first infect the sex glands or pancreas.Extinction period
Specific symptoms usually subside 7 to 9 days after they appear. A longer course of the active phase is observed with damage to several glands or associated complications. During the extinction period, some visible symptoms may still persist ( swelling of the salivary glands and the characteristic shape of the face), but their intensity decreases. As a rule, by this point in time, the temperature also returns to normal. The patient in this phase no longer poses a threat of infection to others and, with normal health and the absence of complications, can return to the educational or work collective.Convalescence period
During the recovery period, all specific and nonspecific symptoms gradually disappear. Treatment is only required in cases where complications of mumps have led to serious health consequences. In this case, there can be no question of any infectiousness of the child. By this time, immunity had already formed and the patient had finally ceased to emit viral particles.Thus, the period of danger to others lasts on average 7 - 9 days. It is for this period that it is recommended to isolate patients who have been diagnosed with mumps.
During the period when the patient is contagious, he requires especially careful and attentive care. The most important task is to prevent the spread of infection. In addition to bed rest, it is necessary to observe all non-specific preventive measures, which will be described in detail below. In the case of an atypical course of the disease ( if the diagnosis was made late), the details of care should be discussed with the attending infectious disease doctor.
Mumps treatment
Treatment of mumps in most cases is carried out at home. Patients are shown bed rest from the moment of diagnosis until the period of extinction of symptoms ( 1 - 2 weeks in the absence of complications). The final decision on the patient care regimen and treatment conditions is made by the attending infectious disease doctor after examining the patient. In the case of complicated mumps, hospitalization of the patient is recommended for more intensive treatment. To prevent residual effects after mumps, in addition to the infectious disease specialist, other specialists are often involved:
- endocrinologist with damage to the gonads, thyroid or pancreas;
- neuropathologist with the development of serous meningitis or meningoencephalitis;
- otorhinolaryngologist ( ENT) with the development of labyrinthitis;
- rheumatologist with concomitant severe joint damage.
Currently, there is no effective treatment for the mumps virus. In this regard, the emphasis is on symptomatic treatment in order to prevent the development of complications and reduce the suffering of the patient. With a favorable course and damage to only the salivary glands, treatment lasts about 2 weeks.
In general, the treatment of mumps can be divided into several areas:
- compliance with the regimen and patient care;
- adherence to a diet;
- drug treatment ( can vary greatly with the development of complications).
Compliance and patient care
During the course of treatment, bed rest is recommended, even with uncomplicated forms of mumps. It must be observed for about 10 days - from the moment of diagnosis until the disappearance of acute symptoms. If necessary, this period can be increased by the attending physician according to individual indications. The patient should avoid physical and emotional stress, as well as avoid hypothermia. Statistically, in people who do not comply with bed rest during the acute period of the disease, various complications are observed several times more often ( this is especially true for orchitis in men).Patient care includes measures to prevent the spread of the disease. It is advisable to use masks or gauze dressings to prevent infection. It is strictly forbidden to admit unvaccinated people to the patient during the infectious period.
Diet
The diet for mumps is followed mainly in order to avoid the development of pancreatitis. To do this, you must follow a few simple principles in nutrition. They belong to the standard Pevzner diet number 5.A diet for the prevention of pancreatitis involves adherence to the following principles:
- restricted calorie diet ( no more than 2600 Kcal);
- accelerated diet ( 4 - 5 times a day in small portions);
- consumption of 1.5 - 2 liters of fluid per day.
Consumption of various products within the Pevzner diet number 5
| Allowed Products | Foods to limit consumption | Prohibited foods |
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|
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The same dietary principles are followed with the development of pancreatitis. A more detailed diet can be drawn up individually with your doctor.
Drug treatment
As noted above, drug treatment for mumps is symptomatic and aimed at eliminating the manifestations of the disease. Usually, the timely initiation of such treatment prevents the development of complications and residual effects after the disease. Severe forms, giving complications even during treatment, can only be observed in people who were not vaccinated in childhood. In people with specific immunity against mumps, the prognosis in the overwhelming majority of cases is favorable. An important condition is rapid diagnosis and initiation of drug treatment. Mumps cannot be treated on its own due to the high risk of complications. It is also impossible to apply warming compresses on the swollen areas - salivary glands or testicles - during the period of increasing edema. This will increase the swelling and aggravate the course of the disease. The groups of drugs used in the treatment of mumps are shown in the table.Groups of drugs used to treat mumps
| Group of drugs | Representatives | Mechanism of action | Directions for use |
| Non-steroidal anti-inflammatory drugs | Ibufen, Ibuprofen, Diclofenac, Aspirin, Piroxicam, Ketoprofen. | Preparations of this series effectively bring down heat and reduce inflammation. | These drugs form the basis of treatment for uncomplicated mumps. The appointment is made by the attending physician based on the patient's age and the intensity of the inflammatory process. |
| Corticosteroid drugs | Dexamethasone, methylprednisolone, prednisone. | These drugs have a significantly stronger anti-inflammatory effect. A side effect is suppression of the immune system. | They are used for severe complications to quickly relieve inflammation ( with orchitis). The dosage and regimen of taking corticosteroids must be agreed with the attending physician. |
| Desensitizing drugs | Suprastin, tavegil, erius. | These drugs also fight intense inflammation and reduce the reactivity of the immune system. | Prescribed in parallel with other drugs throughout the acute period. |
| Analgesics ( pain relievers) | Analgia, baralgin, pentalgin. | Drugs in this group fight severe pain syndrome, if any, in patients. | These drugs are not used in all cases. Pain relief is usually required for pancreatitis, orchitis and meningitis. |
| Pancreatic enzyme preparations. | Festal, pancreatin, mezim. | They contribute to the improvement of digestion and normal absorption of food. They are analogs of natural pancreatic enzymes. | They are used only with the development of pancreatitis with severe symptoms from the gastrointestinal tract ( gastrointestinal tract): vomiting, diarrhea. |
Other groups of drugs are used less frequently. They are prescribed based on which organ or system is affected. The choice of drugs and their dosage should be made only by the attending physician after a thorough examination of the patient. Many drugs used to treat mumps have side effects and can worsen the course of the disease if taken incorrectly.
In addition to drug therapy, irradiation of the salivary glands, a puncture of the spinal cord or cold on the stomach in the projection of the pancreas may be indicated. These measures contribute to a speedy recovery and improve the general condition of the patient.
Consequences of mumps
Despite the fact that with the invention and introduction of the mumps vaccine, deaths are recorded extremely rarely, this infection is still classified as dangerous diseases. This is mainly due to a number of complications and residual effects that can be observed after the transferred mumps. They are quite rare, but in some cases they can lead to irreversible consequences and even cause disability. Mumps, with timely detection and correct treatment, in most cases has a mild course and does not lead to complications. However, with a decrease in the body's defenses or in the presence of concomitant diseases of organs and systems that are targets for the causative agent of mumps, the complications described above may appear. After some of them, serious residual effects may remain, which will make themselves felt throughout life.
The residual effects after suffering from mumps include:
- infertility;
- deafness;
- diabetes;
- dry eye syndrome;
- sensitivity disorders.
Infertility
Infertility as a residual after mumps occurs mainly in men. First of all, this applies to those who were not vaccinated in childhood and do not have specific immunity. For such people in adulthood, there is a high risk of developing orchitis or epididymitis with irreversible damage to the gonads. In women, infertility due to oophoritis against the background of mumps is very rare. Due to the threat of this residual phenomenon, all patients with mumps with signs of damage to the testicles and ovaries must be treated in a hospital under the watchful supervision of specialists.Deafness
Deafness can result from damage to the auditory nerve or inner ear ( consequence of the transferred labyrinthitis). Hearing loss in advanced cases is irreversible. However, such complications are extremely rare, and standard treatment for the infection usually prevents deafness even with obvious signs of hearing damage.Diabetes
Due to a massive inflammatory process at the level of the pancreas, the islets of Langerhans may be damaged. These are areas of cells in the tissue of the gland that produce the hormone insulin. It is needed to lower blood glucose levels and store it in cells for energy. If mumps is complicated by acute pancreatitis, there is a risk of irreversible disturbances in the formation of insulin. The cells that produce this hormone die, which leads to a lack of it. This mechanism of increasing blood sugar is characteristic of type 1 diabetes mellitus. Despite the rarity of this residual phenomenon, doctors pay great attention to its timely diagnosis. Loss of time or errors in treatment can lead to the fact that the patient will suffer from a lack of insulin throughout his life. In case of an increase in blood glucose levels in patients with mumps, it is necessary to consult an endocrinologist.Dry eye syndrome
Dry eye syndrome can be observed for some time after suffering from dacryoadenitis. Inflammation of the lacrimal glands is accompanied by a decrease in the secretion of their secretion and a malnutrition of the eye. This leads to rapid drying of the mucous membrane, permanent cuts in the eyes and discomfort. To solve this problem, you must consult an ophthalmologist. As a rule, these violations are reversible and persist for several weeks ( rarely - months) after an infection.Sensitivity disorders
Sensory disturbances are the result of previous serous meningitis or meningoencephalitis. With these complications, mumps affects the membranes and tissues of the head ( less often spinal) of the brain. Directly during the course of the disease, sluggish current paralysis and paresis can be observed. Sensitivity in severe forms is restored for a long time, which explains the residual effects after a seemingly complete recovery. As a rule, sensitivity is still restored after some time ( months, years). Lifetime persistence of these residual phenomena is extremely rare.Prevention of mumps
Prevention of mumps includes specific and non-specific measures. Their ultimate goal is to reduce the incidence of mumps in general, as well as to prevent severe forms of the disease. Non-specific prevention of mumps includes the following measures:
- Isolation of the sick for the duration of the illness. Isolation is done mainly at home, where the patient receives the necessary treatment. Hospitalization is not provided for the purpose of isolating the patient, but for more intensive treatment in case of complications. Given that mumps is prevalent mainly among children, this measure includes exemption from school or kindergarten while the child is a danger to others. Isolation is carried out during the acute period. The patient is considered non-infectious starting from the 9th day of the acute phase. Unvaccinated children who have been in contact with the sick are subject to isolation for a period of 11 to 21 days ( at the discretion of a doctor-epidemiologist or infectious disease specialist, eliminating the focus of infection).
- Airing the rooms in which the patient was. Given that infection occurs through airborne droplets, ventilation helps reduce its likelihood. At home, it is enough to ventilate the room in which the patient is constantly located several times a day.
- Disinfection of objects with which the patient came into contact. If we are talking about a case of mumps in kindergarten, then toys and other items in the playroom must be disinfected. A single treatment with medical alcohol or chlorine-containing disinfectants is considered sufficient. Microscopic droplets of saliva on objects can retain enough viral particles for infection. Disinfection will eliminate the possibility of such an infection. At home, it is necessary to regularly disinfect the dishes from which the patient eats, and other objects on which drops of saliva may remain.
- Wearing protective masks. Reliable protection against infection is the patient wearing a special protective mask or gauze bandage ( the cheesecloth is folded several times). Drops of saliva with the virus are retained on the tissue and do not fall on the mucous membrane. In theory, the possibility of infection through the conjunctiva of the eyes remains, but such cases are extremely rare.
- Strengthening non-specific immunity. Strengthening nonspecific immunity involves limited alcohol consumption, smoking cessation and regular walks in the fresh air. Hypothermia should also be avoided. Proper nutrition is an important component in strengthening the immune system. It should include both plant and animal foods with adequate amounts of vitamins. A balanced diet, which is essential for strengthening the immune system, should not be confused with a special diet for patients who already have mumps.
Specific prevention of mumps involves large-scale vaccination of children. At the moment, it is being carried out in many countries of the world without fail to prevent epidemics. The emergence and widespread use of the mumps vaccine has reduced the incidence by more than 50 times.
Types of mumps vaccines
There are several types of mumps vaccines. They differ in methods of production, methods of use and the effectiveness of immune defense. Each of the vaccines has a number of advantages and disadvantages.There are the following types of mumps vaccines:
- Inactivated vaccine... Vaccines are called inactivated if they contain a certain amount of killed viral particles. Inactivation is done by ultraviolet light or by exposure to chemicals. In this case, the effect of chemical disinfectants should be moderate, and the radiation should be dosed. The virus must completely lose its pathogenicity ( the ability to cause disease), but keep its structure. The immune system, in response to the ingress of structural proteins, will develop the necessary set of antibodies, which will provide the patient with protection. Vaccination with inactivated viral particles is safe in terms of complications or adverse reactions. The disadvantage of this type of vaccine is its relatively low immunogenicity. In other words, the likelihood of developing reliable immunity against the disease is lower than with live vaccines.
- Live attenuated ( weakened) vaccine... Live vaccines are those that contain live, attenuated viral particles. The common strain of the mumps pathogen is displayed in laboratory conditions on nutrient media. With repeated reseeding of the culture, the pathogenicity of microorganisms decreases. In other words, the virus in the laboratory is not allowed to fully grow and multiply. As a result, a strain is obtained that, once it enters the human body, will no longer cause a serious illness. The patient, in principle, will get sick with mumps in an asymptomatic form without the risk of developing any complications. Since during the introduction of a live vaccine, the integrity of the viral particles is preserved, the immunity acquired by the body is very reliable. The downside to live attenuated vaccines is the higher risk of allergic reactions and other side effects after vaccination.
- Combined vaccine... Combinations are vaccines that contain antigens from two or more different microorganisms. In particular, mumps vaccine often comes in the same vial as measles and rubella vaccine. When these drugs are injected into a healthy child's body, the immune system produces antibodies against each of these infections. Due to the large number of diseases that children are vaccinated against these days, combining several vaccines within one drug greatly facilitates the vaccination process. Most countries give preference to combined drugs when vaccinating against mumps.
The mechanism of action of the vaccine
Regardless of the type of vaccine used, the child's body recognizes the antigens and produces the appropriate antibodies against them. With mumps, in particular, these antibodies will continue to circulate in the blood throughout life. For the reliability of the formation of immunity, revaccination is provided in many countries. This is a second injection of the vaccine several years after the first. It is required, as a rule, precisely when using combined drugs.Terms of vaccination
There is no single universal standard for the time of administration of an anti-mumps vaccine. Many countries using the combined measles-mumps-rubella vaccine vaccinate children twice - at 12 months and at 6 or 7 years of age. However, in the national vaccination calendar for each country, the timing may vary slightly. The drug is injected into the area of the scapula or into the area of the deltoid muscle ( middle or upper third of the shoulder) subcutaneously in a volume of 0.5 ml.If the child was not vaccinated in childhood ( in case of parents' refusal to vaccinate), vaccination can also be carried out in adulthood. This is done at the request of the patient himself or for epidemiological indications ( directly in the epidemic of mumps). Emergency immunoprophylaxis is carried out according to individual indications if a person has come into contact with a person known to be sick with mumps and has been exposed to a high risk of infection. In such cases, urgent vaccination is possible no later than 72 hours after the first contact ( preferably on the first day). Then the body will have time to develop antibodies, and the disease will pass in a mild form without complications.
In addition, there are a number of situations where the timing of vaccination can be changed for medical reasons, even if the parents did not refuse the procedure.
Vaccination may be delayed for the following reasons:
- acute infectious diseases in the last 1 - 2 months before vaccination;
- exacerbation of chronic diseases;
- malnutrition ( inadequate or unbalanced nutrition, leading to wasting of the child);
- taking corticosteroid drugs in the last 1 to 2 months before vaccination;
- diseases of the hematopoietic system;
- other pathological conditions, accompanied by a weakening of the immune system.
Side effects and complications after the vaccine
As noted above, for vaccination against mumps, a live weakened culture of the virus is mainly used. As a result, there is a risk of side effects and complications. Side effects include local nonspecific reactions of the body to the administration of the vaccine. Complications mean the appearance of symptoms that are characteristic of the disease for which the vaccine was administered.The following side effects and complications may occur if an anti-parotitis vaccine is administered:
- Redness and soreness at the injection site. Most often, they are caused by an inadequate response of the body to the vaccine. If there are enough antibodies in the blood ( after the first vaccination or after an illness), then they will actively fight the virus when reintroduced locally.
- Allergic reactions. They are quite rare and can be caused not only by the virus strain itself, but also by other components of the drug. Allergic phenomena ( itching, urticaria) usually go away on their own within a few days. A severe systemic allergic reaction, anaphylactic shock, is extremely rare. It requires resuscitation due to a sharp drop in blood pressure, circulatory disorders and possible respiratory arrest.
- Subfebrile temperature. Temperatures within 37 - 38 degrees can persist for 5 - 7 days after vaccination. For a longer fever or higher temperature, it is advisable to be examined by a general practitioner to rule out other causes.
- Swelling and redness of the throat mucosa. Phenomena resembling catarrhal sore throat can occur due to the abundance of lymphatic tissue in the tonsils. This tissue reacts with inflammation when the vaccine is administered. Symptoms may persist for 5 to 12 days, but almost never progress to severe sore throat with high fever and formation of plaque on the tonsils.
- Enlargement of the parotid salivary glands. This symptom can no longer be attributed to side effects, but to complications of vaccination. The virus contained in the preparation is most sensitive to the tissues of the salivary glands. Therefore, their increase suggests that the body could not cope even with a weakened strain of the virus. On the other hand, this strain will not lead to prolonged fever or complications from other organs. In most cases, the swelling will go away on its own after a few days. The main reason is considered to be the weakening of immunity, which did not allow the virus to be overcome. This suggests that there were any contraindications before vaccination that the doctor did not take into account or did not notice. It was desirable to postpone the administration of the drug. If swelling of the parotid glands appears after the vaccine has been administered, it is advisable to see a general practitioner.
- Serous meningitis. Serous meningitis after vaccination is extremely rare. He says that the patient had contraindications to vaccination and immunity at the time of meeting with the virus was greatly weakened. In rare cases, there is also a violation of the rules of vaccination by medical personnel. The risk of developing severe complications increases with the introduction of an excessive amount of vaccine ( more than 0.5 ml). In addition, a number of drugs contain more viral particles, even in a standard dose. If meningeal symptoms appear, you should urgently seek qualified medical help.
Answers to frequently asked questions
Can you get mumps again?
As a rule, people who have had mumps in childhood do not get sick again. This is due to the mechanism of the immune response to infection. However, cases of reinfection have been reported in the literature. It is believed that the likelihood of recurrent disease is no more than 2% ( for some authors less than 0.5%). The system of vaccination of children against mumps is based on this. For a deeper understanding of the issue, it is necessary to understand in more detail the mechanism of the formation of specific immunity.Specific is the immunity produced by the body against a particular type of microbes. It appears upon contact of microbial antigens ( proteins typical for a given microbe) with special cells in tissues - macrophages. Macrophages not only consume a foreign organism, trying to neutralize it, but also trigger a complex chain of cellular reactions aimed at the formation of an immune response. As a result, special substances appear in the patient's blood - antibodies aimed at destroying a specific type of microbes. Specific immunity develops several weeks or months after the first episode of the disease. The duration of protection depends on how long antibodies will circulate in the patient's blood. This period is different for different infectious diseases.
With mumps, antibodies continue to circulate in the blood for almost all of life. Therefore, when the virus enters the mucous membrane again, it will be quickly identified and destroyed, and the disease will not develop. Artificially provoke the formation of antibodies against mumps with the help of a vaccine. A vaccinated person has almost the same immunity as a person who has had mumps.
However, this mechanism does not provide one hundred percent protection. This applies to both people who have had mumps and vaccinated children. The re-development of the infection is explained by the fact that antibodies against the causative agent of the infection cease to circulate in the blood. This makes the body vulnerable.
Reinfection with mumps can be caused by:
- Long-term direct contact with the patient. As a result, a large number of microbes enter the mucous membrane of the respiratory tract, and there may simply not be enough antibodies in the blood to instantly neutralize all viral particles. Then the person will suffer a mild form of the disease.
- Poor vaccine. A poor quality vaccine or an expired vaccine can cause unreliable immunity to develop. Then the specific protection will last only a few years. The person will think that he is vaccinated against mumps. This can lead to severe illness in adulthood.
- Massive blood transfusions or bone marrow transplants. Antibodies circulating to the blood can be removed from the body by massive blood transfusions. A bone marrow transplant affects the hematopoietic system as a whole. Similarly, a person can lose specific immunity in severe diseases of the hematopoietic system.
- Vaccination in the presence of contraindications. Vaccination is not recommended if there are any acute infections in the body. For example, if the temperature is elevated on the day of vaccination, the procedure can be postponed until recovery. The fact is that diseases in the acute phase affect the reactivity of the immune system. As a result of this influence, the immune response will be insufficient, and protection in the future will be unreliable.
What is the duration of the course of mumps, the timing of recovery?
The total duration of the course of mumps consists of several phases. They are typical for almost all infectious diseases, but in each individual case they have a certain duration. In addition, there are a number of factors that affect the rate of progression of the disease and the timing of final recovery.During mumps, the following stages are distinguished:
- Incubation period... This stage begins when the virus enters the mucous membranes of the respiratory tract. The virus gradually multiplies and spreads with the bloodstream throughout the body. The end of the incubation period is considered the appearance of the first pronounced symptoms. The duration of this stage is from 11 to 23 days ( more often about 2 weeks). Often, patients do not include the incubation period in the duration of the disease, because they themselves do not feel sick.
- Prodromal period... The prodromal period is the period of nonspecific symptoms. A person begins to feel sick, but rarely immediately see a doctor. He is worried about headaches and muscle pains, general weakness, drowsiness, decreased performance. These symptoms are due to the circulation of toxins in the blood. In mumps, the duration of the prodromal period is short - from 24 to 36 hours. In children, it is often completely absent.
- Period of specific manifestations... At this stage, the typical symptoms of mumps appear. It begins with a rapid rise in temperature, in the classic course of the disease up to 39 - 40 degrees. Typical symptoms are redness of the mucous membrane of the mouth in the area of the ducts of the salivary glands, edema of the salivary glands proper. If the disease proceeds without complications, then the duration of this stage is from 7 to 9 days in children and from 10 to 16 days in adults.
- Extinction period... The extinction period is characterized by the gradual disappearance of symptoms and normal body temperature. Clinically, it can be difficult to distinguish it from a period of specific manifestations. In children, these stages of the disease are often combined. In adults, the period of extinction is characteristic mainly for the complicated course of mumps. Its duration depends on what kind of complication was observed in a particular patient.
- Convalescence period. During the recovery period, the patient no longer suffers from the disease itself, but may experience some difficulties due to residual effects. The recovery period ends with the normalization of all analyzes and vital signs ( blood test, analysis of cerebrospinal fluid in serous meningitis). Patients do not attribute this period to the total duration of the disease, since there are no acute symptoms.
Convalescence can be delayed if any complications of mumps appear. Complications in this disease are considered any manifestations of the disease in addition to damage to the salivary glands. Treatment of such forms usually takes longer and is carried out in an inpatient setting.
Possible complications of mumps are:
- orchitis ( inflammation of the testes in men);
- oophoritis ( ovarian inflammation in women);
- pancreatitis ( inflammation of the pancreas);
- serous meningitis or meningoencephalitis ( damage to the lining of the brain);
- dacryoadenitis ( inflammation of the lacrimal glands);
- thyroiditis ( inflammation of the thyroid gland);
- arthritis ( joint inflammation);
- labyrinthitis ( inner ear inflammation);
- mastitis ( inflammation of the breast, more common in women, but possibly in men);
- prostatitis ( inflammation of the prostate gland in men).
What do people with mumps look like?
Mumps or mumps has a number of distinctive symptoms that can be noticed by ordinary people without visiting a doctor. Knowledge of these manifestations of the disease can help parents to suspect mumps earlier and consult a doctor for a more detailed examination.In the initial stages of the disease ( in the prodromal period) people with mumps resemble ordinary people with colds. The mucous membrane of the throat gradually turns red, there may be minor discharge from the nose. At the same time, general weakness, moderate headaches, nausea, sweating are noted. In general, it is possible to suspect a disease and not come into close contact with such people. It is important that it is at this stage that patients already excrete a significant amount of viral particles and pose a threat of infection.
The appearance of specific symptoms helps to suspect mumps directly. If parents notice such changes in children, accompanied by an increase in temperature and other general symptoms, it is necessary to urgently consult a doctor for an accurate diagnosis. Until this moment, it is advisable to isolate the child at home.
Distinctive features of a patient with mumps
| A characteristic symptom | Danger of infection | Patient type |
| Swelling in the area of the salivary glands | Swelling in the area of the salivary glands appears in the early days of the acute course of the disease. The patient is especially contagious during this period and should be isolated. Contact with the patient is allowed only 8-9 days after the onset of this symptom. |  |
| Redness of the oral mucosa | Redness of the mucous membrane of the mouth and throat is observed most often in the acute period of the disease, so the patient is highly infectious and dangerous to others. A distinctive feature of sore throat is that redness extends to the mucous membrane of the oral cavity ( inner surface of the cheeks). Particularly pronounced red spots are formed at the exit into the oral cavity of the ducts of the salivary glands ( Moors' symptom). |  |
| Testicular enlargement | An enlarged testicle or both testicles usually occurs with orchitis. Edema can be significant, causing dull pain and interfering with a person's movement ( pain increases when walking). During this period of time, the patient, as a rule, no longer poses a danger of infection. |  |
With the timely start of treatment, mumps passes quickly enough without leaving serious consequences.
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