mumps assignment

7/29/2019 Mumps Assignment

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Mumps is an extremely contagious viral infection that usually affects children. The condition has a

number of symptoms, the most common one being swelling of one or both of the salivary glands on

the sides of the face.

These glands are called the parotid glands and when they swell the patient develops a "hamster

like" face. Once someone has had mumps, they usually become immune to future infections.

To aid in the battle against the spread of mumps, the MMR vaccine is commonly given at an early

age to help the body become immune to the virus. Before the MMR vaccination was brought in, in

England and Wales there were 1,200 cases involving hospital admission per year.

According to Medilexicon's medical dictionary mumps is:

"An acute infectious and contagious disease caused by a mumps virus of the genus Rubulavirus and

characterized by fever, inflammation and swelling of the parotid gland, and sometimes of other

salivary glands, and occasionally by inflammation of the testis, ovary, pancreas, or meninges."

What are the Signs and Symptoms of Mumps?

A symptom is something the patient feels or reports, while a sign is something that other people,

including the doctor detects. A headache may be an example of a symptom, while a rash may be an

example of a sign.

The symptoms of mumps normally appear 2-3 weeks after the patient has been infected, however

almost 20% of people with the virus do not suffer any signs or symptoms at all.

The main symptom of mumps is painful and swollen parotid (salivary) glands, which cause the

person's cheeks to puff out. Other symptoms can include:

Pain in the sides of the face where it is swollen

Pain experienced when swallowing

Trouble swallowing

Feeling tired and weak

Fever/high temperature


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Headache

Nausea

Dryness in mouth

Pain in joints

Reduced appetite

What Causes Mumps?

A person suffers mumps when infected with the mumps virus. It can be transmitted via respiratory

secretions (e.g. saliva) from a person already affected with the condition. When contracting mumps,

the virus travels from the respiratory tract to the salivary glands and reproduces, causing the glands

to swell. Examples of how it can be spread are:

sneezing or coughing

using the same cutlery/plates with someone infected

sharing food and drink with someone infected

kissing

someone infected touching their nose or mouth and then passing it onto a surface someone else

may touch

Someone infected with the mumps virus is contagious for approximately 15 days (six days beforethe symptoms start to show, up to nine days after they start). The mumps virus is part of the

paramyxovirus family, which is a widespread cause of infection, especially in children.

How is Mumps Diagnosed?

Normally, mumps can be diagnosed by its symptoms alone, especially by examining the facial

swelling. In addition to examining this area and taking a note of the symptoms, a doctor may:

check inside the mouth to see the position of the tonsils - when infected with mumps, a person's

tonsils can get pushed to the side

take the patient's temperature

take a sample of blood, urine or saliva for testing

take a sample of CSF (cerebrospinal fluid) for testing - this is usually in severe cases

How is Mumps Treated?

As mumps is viral, antibiotics cannot be used to treat it, and at present there are no anti-viral

medications able to treat mumps. Treatment can only help relieve the symptoms until the infection

has run its course and the body has developed an immunity, much like a cold. In most cases people


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recover from mumps within two weeks. Steps that can be taken to help relieve the symptoms of

mumps include:

Consuming plenty of fluids, ideally water - avoid fruit juices as they stimulate the production of

saliva, which is painful for someone with mumps.

Putting something cold on the swollen area to alleviate the pain.

Eating mushy or liquid food as chewing will also be painful

Getting sufficient rest and sleep

Gargling warm salt water

Taking painkillers such as paracetamol or ibuprofen

How can Mumps be Prevented?

The mumps vaccine is the general method for preventing mumps; it can come on its own or as part

of the MMR vaccine. The MMR vaccine also defends the body from rubella and measles. The MMR

vaccine is given to an infant when they are just over one year old and again as a booster just before

they start school. Anyone born after the 90s would most probably have been given the MMR vaccine

but if unsure it is always advised to check with your doctor.

Reference:

http://www.medicalnewstoday.com/articles/224382.php

Virus classification

Group: Group V ((-)ssRNA)

Order: Mononegavirales

Family: Paramyxovirus

Genus: Rubulavirus

Mumps virus is the causative agent of mumps, a well-known common childhood disease

characterised by swelling of the parotid glands, salivary glands and other epithelial tissues, causing

high morbidity and in some cases more serious complications such as deafness. Natural infection is

currently restricted to humans and the virus is transmitted by direct contact, droplet spread, or

contaminated objects.
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It is considered a vaccine-preventable disease, although significant outbreaks have occurred in

recent years in developed countries such as America, in areas of poor vaccine uptake. These have

allowed the further evaluation and ennumeration of its efficacy (~7585% after two doses of

MMR).[1]

Mumps virus belongs to the genus Rubulavirus in the family Paramyxovirus and is seen to have a

roughly spherical, enveloped morphology of about 200 nm in diameter. It contains a linear, single-

stranded molecule of negative-sense RNA 15,384 nucleotides long.

Structure

The Mumps virus is a roughly spherical particle made up of concentric layers of fatty lipids, large

protein molecules, and nucleic acid. It is dotted with large 'spikes' made up of protein that enable it

to gain entry to host cells. Inside lies a core of a single, long molecule of RNA wrapped up in protein

that is released into the cell.

Reference:

http://en.wikipedia.org/wiki/Mumps_virus

For other uses of the word Mumps or MUMPS, see Mumps (disambiguation).Mumps

Classification and external resources

Child with mumps

ICD-10 B26

ICD-9 072

DiseasesDB 8449

MedlinePlus 001557

eMedicine emerg/324 emerg/391 ped/1503

MeSH D009107
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Mumps (epidemic parotitis) is a viral disease of the human species, caused by the mumps virus.

Before the development of vaccination and the introduction of a vaccine, it was a common

childhood disease worldwide. It is still a significant threat to health in the third world, and outbreaks

still occur sporadically in developed countries.[1]

Painful swelling of the salivary glands classically the parotid gland is the most typical

presentation.[2] Painful testicular swelling (orchitis) and rash may also occur. The symptoms are

generally not severe in children. In teenage males and men, complications such as infertility or

subfertility are more common, although still rare in absolute terms.[3][4][5] The disease is generally

self-limiting, running its course before receding, with no specific treatment apart from controlling

the symptoms with pain medication.

Fever and headache are prodromal symptoms of mumps, together with malaise and anorexia. Other

symptoms of mumps can include dry mouth, sore face and/or ears and occasionally in more serious

cases, loss of voice. In addition, up to 20% of persons infected with the mumps virus do not show

symptoms, so it is possible to be infected and spread the virus without knowing it.[6]

Males past puberty who develop mumps have a 30 percent risk of orchitis,[7] painful inflammation

of the testicles.[8]Contents [hide]

1 Cause

2 Diagnosis

3 Prevention

4 Treatment

5 Prognosis

6 Epidemiology

7 References

8 External links

[edit]

Cause

Mumps is a contagious disease that is spread from person to person through contact with

respiratory secretions, such as saliva from an infected person. When an infected person coughs or


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sneezes, the droplets aerosolize and can enter the eyes, nose, or mouth of another person. Mumps

can also be spread by sharing food and drinks. The virus can also survive on surfaces and then be

spread after contact in a similar manner.

A person infected with mumps is contagious from approximately 6 days before the onset of

symptoms until about 9 days after symptoms start.[9][10] The incubation period (time until

symptoms begin) can be from 1425 days, but is more typically 1618 days.[11]

[edit]

Diagnosis

A physical examination confirms the presence of the swollen glands. Usually, the disease isdiagnosed on clinical grounds, and no confirmatory laboratory testing is needed. If there is

uncertainty about the diagnosis, a test of saliva or blood may be carried out; a newer diagnostic

confirmation, using real-time nested polymerase chain reaction (PCR) technology, has also been

developed.[12] An estimated 20%-30% of cases are asymptomatic.[13] As with any inflammation of

the salivary glands, serum amylase is often elevated.[14][15]

[edit]

Prevention

The most common preventative measure against mumps is a vaccination with a mumps vaccine,

invented by American microbiologist Maurice Hilleman at Merck.[16] The vaccine may be given

separately or as part of the MMR immunization vaccine which also protects against measles and

rubella. In the US, MMR is now being supplanted by MMRV, which adds protection against

chickenpox. The WHO (World Health Organization) recommends the use of mumps vaccines in all

countries with well-functioning childhood vaccination programmes. In the United Kingdom it is

routinely given to children at age 13 months with a booster at 35 years(preschool) This confers

lifelong immunity. The American Academy of Pediatrics recommends the routine administration of

MMR vaccine at ages 12

15 months and at 4

6 years.[17] In some locations, the vaccine is givenagain between 4 to 6 years of age, or between 11 and 12 years of age if not previously given. The

efficacy of the vaccine depends on the strain of the vaccine, but is usually around 80%.[18][19] The

Jeryl Lynn strain is most commonly used in developed countries but has been shown to have

reduced efficacy in epidemic situations. The Leningrad-Zagreb strain commonly used in developing

countries appears to have superior efficacy in epidemic situations.[20]

Because of the outbreaks within college and university settings, many governments have established

vaccination programs to prevent large-scale outbreaks. In Canada, provincial governments and the


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Public Health Agency of Canada have all participated in awareness campaigns to encourage students

ranging from grade 1 to college and university to get vaccinated.[21]

Some anti-vaccine activists protest against the administration of a vaccine against mumps, claimingthat the attenuated vaccine strain is harmful, and/or that the wild disease is beneficial. There is no

evidence whatsoever to support the claim that the wild disease is beneficial, or that the MMR

vaccine is harmful. Claims have been made that the MMR vaccine is linked to autism and

inflammatory bowel disease, including one study by Andrew Wakefield[22][23] (the paper was

discredited and retracted in 2010 and Wakefield was later stripped of his license after his work was

found to be an "elaborate fraud" [24]) that indicated a link between gastrointestinal disease, autism,

and the MMR vaccine. However, subsequent studies indicate no link between vaccination with the

MMR and autism.[25] Since the dangers of the disease are well known, while the dangers of the

vaccine are quite minimal, most doctors recommend vaccination.

The WHO, the American Academy of Pediatrics, the Advisory Committee on Immunization Practices

of the Centers for Disease Control and Prevention, the American Academy of Family Physicians, the

British Medical Association and the Royal Pharmaceutical Society of Great Britain currently

recommend routine vaccination of children against mumps. The British Medical Association and

Royal Pharmaceutical Society of Great Britain had previously recommended against general mumps

vaccination, changing that recommendation in 1987. In 1988 it became United Kingdom government

policy to introduce mass child mumps vaccination programmes with the MMR vaccine, and MMR

vaccine is now routinely administered in the UK.[citation needed]

Before the introduction of the mumps vaccine, the mumps virus was the leading cause of viral

meningoencephalitis in the United States. However, encephalitis occurs rarely (less than 2 per

100,000).[26] In one of the largest studies in the literature, the most common symptoms of mumps

meningoencephalitis were found to be fever (97%), vomiting (94%) and headache (88.8%).[27] The

mumps vaccine was introduced into the United States in December 1967: since its introduction

there has been a steady decrease in the incidence of mumps and mumps virus infection. There were

151,209 cases of mumps reported in 1968. Since 2001, the case average was only 265 per year,

excluding an outbreak of >6000 cases in 2006 attributed largely to university contagion in young

adults.[28][29]

[edit]

Treatment

There is no specific treatment for mumps. Symptoms may be relieved by the application of

intermittent ice or heat to the affected neck/testicular area and by acetaminophen/paracetamol

(Tylenol) for pain relief. Aspirin is not used due to a hypothetical link with Reye's syndrome. Warm


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salt water gargles, soft foods, and extra fluids may also help relieve symptoms. According to the

Department of Health of Minnesota there is no effective post-exposure recommendation to prevent

secondary transmission, as well as the post-exposure use of vaccine or immunoglobulin is not

effective.[30]

Patients are advised to avoid acidic foods and beverages, since these stimulate the salivary glands,

which can be painful.[31]

Reference:

http://en.wikipedia.org/wiki/Mumps

The incubation period is 16 - 18 days but may vary from 14 - 25 days. Parotid swelling develops in

95% of those with clinical illness. The rate of subclinical infection varies with age, but is on average

30%. In a small proportion of patients, the symptoms may resemble mild URTI. Typically, a

prodromal illness consisting of headache, malaise, myalgia and low grade fever occurs 1 - 2 days

before the onset of parotid enlargement. Patients with classic mumps develop enlargement of one

parotid gland, followed 1 - 5 days later by enlargement of the contralateral gland. The patient

complains of pain and tenderness in the area of the gland. The submandibular and sublingual glands

may occasionally be involved. The parotid swelling starts to subside after 4 to 7 days. Virus shedding

into the saliva begins a couple of days before the onset of parotitis and ends 7 to 8 days later.

Complications

All the other manifestations of mumps can be regarded as systemic complications of mumps rather

than as true complications.

Meningitis ;- Aseptic meningitis occurs in 10% of patients with mumps but as many as 50% show

abnormalities in the CSF. Mumps is the most frequent causative agent of aseptic meningitis, in many

countries being responsible for 10 - 15% of all cases. Symptoms are indistinguishable from other

types of aseptic meningitis and can start one week before parotid swelling before parotid swelling to

3 weeks after it. The CSF reveals a lymphocytosis of usually below 500 lymphocytes/mm3, normal orelevated protein. Virus can be isolated from the CSF during the first 2 to 3 days after onset. Later,

specific antibodies can demonstrated in the CSF. Symptoms of meningitis subside 3 to 10 days after

onset and recovery is usually complete. A study suggests that the majority of cases of meningitis

occur without apparent parotiditis.

Encephalitis ;- encephalitis occurs rarely as a complication of mumps, where lesions are found in the

brain and spinal cord. The incidence of encephalitis is around 1 in 6000 cases of mumps. Probably

both direct viral invasion and allergic inflammatory reactions lie behind the nervous tissue damage.

Clinical features suggesting encephalitis are convulsions, focal neurological signs, movement

disorder and changes in sensory perception. Sometimes polio-like paralysis ensues and fatalities

have been reported.
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Hearing Loss ;- before vaccinations, mumps used to be one of the leading causes of hearing loss in

children and young adults. In most cases, the hearing loss is transient but permanent dysfunction

may occur. Hearing problems did not correlate with meningitis and appears to be due to direct

damage tothe cochlea. The incidence of hearing loss is estimated to be in the region of 1 per 15,000

cases.

Orchitis and oophoritis ;- orchitis and oophoritis are more likely to occur after puberty where the

incidence is 20 - 30%, and in 20 - 40% of cases, there is bilateral involvement. Men are much more

likely to be affected than women.

Pancreatitis ;- the exact incidence of pancreatitis is hard to determine but is thought to be as high as

5%.

Arthralgia ;- arthralgia affecting a large joint may develop 2 weeks after parotitis. They are more

frequent in young male adults.

Myocarditis ;- this can usually only be found on ECG examination in 10 - 15% of patients. Rarely,

congestive heart failure and deaths have been reported.

Transient Renal Dysfunction ;- this is a frequent complication of clinical mumps. Cases of

symptomatic nephritis following mumps are unusual.

Insulin Dependent Diabetes ;- there is some epidemiological evidence to suggest that mumps may

be a triggering mechanism for IDDM. It is thought that immunological mechanisms may be involved

and certain HLA-D haplotypes are particularly susceptible.

Abortion ;- if a pregnant woman contracts mumps during her pregnancy, there is increased risk forabortion. This is thought to be due to hormonal imbalances caused by virus infection.

Thyroiditis ;- there is evidence for a role of mumps virus in the causation of subacute thyroditis.

However, the evidence is not strong.

C. Pathogenesis

Mumps is transmitted by droplet spread or by direct contact. The primary site of viral replication of

the epithelium of the upper respiratory or the GI tract or eye. The virus quickly spreads to the locallymphoid tissue and a primary viraemia ensues, whereby the virus spreads to distant sites in the

body. The parotid gland is usually involved but so may the CNS, testis or epididymis, pancreas and

ovary. A few days after the onset of illness, virus can again be isolated from the blood, indicating

that virus multiplication in target organs leads to a secondary viraemia Parotitis is the most frequent

presentation, occurring in 95% of those with clinical symptoms. Occasionally, meningitis may

precede parotitis by a week. Virus is excreted in the urine in infectious form during the 2 weeks

following the onset of clinical illness. It is not known whether virus actually multiplies in renal tissues

or whether the virus is of haematogenous origin. Life-long immunity is the rule after natural

infection, but reinfections can occur and 1 - 2% of all cases are thought to be reinfections.

Reference:


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http://virology-online.com/viruses/MUMPS.htm
http://virology-online.com/viruses/MUMPS.htmhttp://virology-online.com/viruses/MUMPS.htmhttp://virology-online.com/viruses/MUMPS.htm

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