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Mumps

Mumps or epidemic parotitis is a viral disease of humans. Prior to the development of vaccination, it was a common childhood disease worldwide, and is still a significant threat to health in the third world. more...

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Symptoms of mumps tend to be mild, such as painful swelling of the salivary glands and testicles, rash and fever. In teenagers and adults, the symptoms can be more severe and complications (such as infertility or subfertility -- PMID 8692089, PMID 2368216, PMID 2100952) are relatively common, although still rare in absolute terms. The disease is generally self-limiting, and there is no specific treatment apart from controlling the symptoms with painkillers.

Causes and risks

The mumps are caused by a paramyxovirus, and is spread from person to person by saliva droplets or direct contact with articles that have been contaminated with infected saliva. The parotid glands (the salivary glands between the ear and the jaw) are usually involved. Unvaccinated children between the ages of 2 and 12 are most commonly infected, but the infection can occur in other age groups. Orchitis (swelling of the testes) occurs in 10-20% of infected males, but sterility only rarely ensues; a viral meningitis occurs in about 5% of those infected. In older people, other organs may become involved including the central nervous system, the pancreas, the prostate, the breasts, and other organs.

The incubation period is usually 12 to 24 days. Mumps is generally a mild illness in children in developed countries. After adolescence, mumps tends to affect the ovary, causing oophoritis, and the testis, causing orchitis. The mature testis is particularly susceptible to damage from mumps which can lead to infertility. Adults infected with mumps are more likely to develop severe symptoms and complications.

Symptoms

Symptoms of mumps may include:

  • facial pain
  • swelling of the parotid glands (in 60%-70% of cases)
  • fever
  • headache
  • sore throat
  • swelling of the temples or jaw (temporomandibular area)
  • Additional symptoms that may be associated with this disease (in 20 to 30% of cases):
    • testicular pain (in boys and men)
    • testicular enlargement (in boys and men)
    • scrotal swelling (in boys and men)
    • abdominal pain due to ovarian swelling (in girls and women)

Signs and tests

A physical examination confirms the presence of the swollen glands. Usually the disease is diagnosed on clinical grounds and no confirmatory laboratory testing is needed. If there is uncertainty about the diagnosis, serology for the virus may be carried out.

Treatment

There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck area, acetaminophen (paracetamol) for pain relief (aspirin is discouraged in children with a viral illness because of the risk of Reye's syndrome). Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.

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MMR & autism - Perspectives on Parenting - mumps, measles, and rubella vaccine - Brief Article
From Pediatrics for Parents, 5/1/03 by Michael K. Meyerhoff

The controversey over a possible relationship between the mumps, measles, and rubella vaccine (MRR) and autism continues. It is important to those who believe a relationship exists that the increase in the incidence of autism occurred at the same time as the use of the MMR vaccine became widespread. There are also individual case reports of the signs of autism appearing shortly after the children received their MMRs. Other evidence that is used to support the relationship is the presence of the measles virus in the small intestine of children with autism who have intestinal problems, but not in children with normal development who also have intestinal problems.

Many in the medical community consider this evidence to be very weak. They question the existence of any relationship. A recent Danish population study supports the no-relationship group.

The researchers reviewed the records of 537,303 children born in Denmark from January, 1991, through December, 1998. Eighty-two percent (440,655) of them received the MMR vaccine. In the entire study group, there were 316 children diagnosed with autism and 422 with other autistic-spectrum disorders, i.e. they had some of the symptoms of autism, but not all.

The analysis found no relationship between the MMR immunization and the development of autism. The risk of developing autism or other autistic-spectrum disorders was the same for both the vaccinated and unvaccinated children. There was no relationship between the age at which children received the MMR vaccine and the onset of the symptoms of autism.

This is the largest study to date looking at this possible relationship. The children were from a large area--all of Denmark--and the follow-up was good. Parents wavering on giving their children the MMR should find this information reassuring.

New England Journal of Medicine, 11/07/02.

COPYRIGHT 2003 Pediatrics for Parents, Inc.
COPYRIGHT 2003 Gale Group

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