Mumps is a highly contagious disease caused by the mumps virus, primarily affecting the salivary glands, with inflammation of the parotid gland below the ear being a typical symptom. This virus spreads through respiratory droplets and is commonly found in children and adolescents, but unvaccinated adults can also become infected. Although most patients experience self-limiting symptoms, complications may arise, making it crucial to understand its transmission routes and preventive measures.
In the past, mumps was a common infectious disease among children, but its incidence has significantly decreased with the increase in vaccination rates. However, there remains a risk of outbreaks in areas or populations with insufficient vaccination coverage. This article will detail the causes, symptoms, diagnostic methods, treatment options, and prevention strategies for mumps, helping readers develop a comprehensive understanding of the disease.
The pathogen of mumps is the mumps virus, which primarily spreads through airborne droplets, such as when a patient coughs or sneezes, releasing droplets that others inhale. Touching the mouth or nose after coming into contact with contaminated objects can also lead to infection. Once the virus invades the human body, it replicates in the upper respiratory tract or salivary glands, leading to a localized inflammatory response.
High-risk groups include unvaccinated children and adolescents, especially students in congregate settings. Patients with weakened immune systems, healthcare workers who have been in contact with patients, and unvaccinated adults are also at high risk of infection. It is noteworthy that the mumps virus has a characteristic of asymptomatic transmission, as patients can spread the virus two days before symptoms appear, making outbreak control more challenging.
Typical symptoms usually begin to appear 16 to 18 days after exposure to the virus, primarily manifesting as unilateral or bilateral non-suppurative swelling of the parotid gland, with tenderness upon palpation, and discomfort worsened by the consumption of acidic foods. About 30% of patients may only exhibit nonspecific symptoms such as fever, headache, and fatigue, which can complicate initial diagnosis.
Severe cases may present complications, such as orchitis in male patients, leading to swelling and pain in the scrotum; females may experience oophoritis. Children may occasionally develop meningitis, presenting with neck stiffness and altered consciousness. A small number of cases may develop pancreatitis or hearing loss, and these complications can have long-term health implications for patients.
Clinical diagnosis initially relies on symptom observation and physical examination, where the physician will palpate to confirm the degree of parotid swelling and tenderness. If complications are suspected, ultrasound or computed tomography may be arranged to assess organ damage. In terms of laboratory diagnosis, the virus RNA can be detected through specimens of saliva, blood, or urine, or specific antibodies can be measured using serological methods.
Differential diagnosis is necessary to distinguish mumps from other conditions that cause parotid swelling, such as bacterial parotitis or salivary gland stones. If a patient has been vaccinated but presents with similar symptoms, the possibility of waning vaccine efficacy or viral strain mutation should be considered, necessitating further molecular biology testing to confirm the diagnosis.
Currently, there are no specific antiviral medications that can cure mumps; treatment focuses on symptom relief. Patients are advised to rest adequately, use cold compresses to alleviate parotid swelling and pain, and avoid acidic foods to reduce salivary stimulation. Antipyretics such as acetaminophen can relieve fever and discomfort, but non-steroidal anti-inflammatory drugs should be avoided to prevent complications.
Severe complications require individual management: patients with orchitis may use a scrotal support and receive pain relief; meningitis complications require hospitalization to monitor neurological symptoms. In research on immunotherapy, there is currently no evidence supporting the use of immunoglobulin treatment, but studies continue to explore the potential application of monoclonal antibodies.
Vaccination against mumps is the primary prevention strategy, with recommendations to follow the MMR (measles, mumps, rubella) combined vaccine schedule: the first dose at 12 to 15 months and the second dose at 4 to 6 years. Approximately 90% of individuals develop immunity after vaccination, with protective effects gradually appearing 14 days post-vaccination.
During an outbreak, high-risk groups who have been in contact with patients should undergo 21 days of self-health management and avoid participating in group activities. Public places should enhance ventilation systems and encourage frequent handwashing and mask-wearing. Healthcare institutions should implement isolation measures, arranging for suspected cases to be placed in separate isolation rooms to interrupt the transmission chain.
If swelling of the parotid gland, fever exceeding 38.5°C, or difficulty swallowing occurs, seek medical attention promptly to rule out other possible diseases. If male patients experience scrotal swelling, children show altered consciousness, or adult patients have abdominal pain, immediate professional evaluation is necessary. After contact with confirmed cases, it is advisable to consult a physician regarding post-exposure management, even if asymptomatic.
Pregnant women or individuals with weakened immune systems who have been exposed to the virus should receive immunoglobulin injections within 72 hours and continue to monitor symptom changes. Physicians may arrange further laboratory tests based on epidemiological contact history and the severity of symptoms to confirm the diagnosis.
Mumps can lead to complications such as orchitis (especially in adult males), oophoritis, meningitis, or pancreatitis. Although severe complications are less common in children, those with weakened immune systems or adults should be particularly vigilant for symptom changes and seek immediate medical evaluation.
Can individuals still get infected after receiving the mumps vaccine? How effective is the vaccine?After vaccination, a small number of individuals may still become infected, but symptoms are usually milder. The MMR vaccine (measles, mumps, rubella combined vaccine) provides approximately 88%-95% efficacy after two doses, and adults who have not completed their vaccinations are advised to consult a physician for booster doses.
How long should mumps patients be isolated? What should those who have been in contact with patients do?Patients should be isolated for 9 days after the onset of illness, particularly during the initial symptom period when salivary gland swelling is most contagious. Contacts who are not immune should closely monitor for symptoms, and high-risk groups (such as pregnant women and immunocompromised individuals) may consult a physician regarding the need for immunoglobulin injections.
If fever or parotid swelling occurs during the infectious period, can antipyretics be used to relieve discomfort?Antipyretics (such as acetaminophen) can be used to relieve fever and discomfort, but aspirin should be avoided to prevent Reye's syndrome. Adequate hydration, cold compresses on swollen areas, and strict avoidance of acidic foods to reduce parotid stimulation are recommended.
Can mumps cause long-term sequelae? Which symptoms require immediate medical attention?Severe complications such as hearing loss or infertility are rare, but sudden severe headaches, abdominal pain, testicular swelling, or seizures may indicate meningitis or pancreatitis and require immediate medical evaluation and further examination.
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