Mumps





Mumps


Mumps

Mumps

Mumps is a viral infection that typically affects the salivary glands. It is spread through direct contact with saliva from an infected person.

Infectious Period:

  • The virus can be isolated in saliva from 6 days before swelling of the parotid gland to 9 days after the swelling.
  • Transmission is less likely to occur 24 hours before swelling of the parotid gland and more than 3 days after the swelling subsides.
  • The virus can also be isolated in urine from day 1 to day 14 after the swelling of the parotid gland.
  • Women who have had mumps develop transplacental antibodies that protect their infants for the first 6-8 months of life.

Pathogenesis:

  • Mumps virus enters the body through the respiratory tract, multiplies in the respiratory system, and then spreads through the bloodstream to the salivary glands and/or the central nervous system.
  • Humans are the only known hosts for the mumps virus.

Impact on Parotid Gland:

  • Mumps causes swelling around the parotid duct, invading the lymphatic tissue.
  • It progresses from mild inflammation to complete epithelial exfoliation and duct dilation.
  • Subsequently, the lumen of the duct becomes blocked by epithelial debris.

Stages of Parotid Gland Inflammation:

  • Incubation Stage: Lasts 14-24 days, averaging 17-18 days. Symptoms may include fever, muscle pain, particularly neck pain, headache, and discomfort.
  • Onset Stage: Pain and swelling of the parotid gland lasting 3-7 days, occupying the space between the posterior border of the mandible and the mastoid process, extending forward and downward to the zygomatic bone, pushing the earlobe upward and outward, with pain on palpation.
  • Three Painful Points of Rillet-Barthez: mastoid process – temporomandibular joint – angle of the mandible.
  • Accompanied by pharyngeal edema, ipsilateral palatal arch pushing the tonsil medially, acute laryngeal edema, Stenon’s duct redness and swelling, enlarged and tender pre-auricular and submandibular lymph nodes, moderate fever.
  • Full-blown Stage: Swelling of the parotid, submandibular, and submental glands. Fever of 38-39 degrees Celsius. Less redness and skin elasticity.
  • Recovery Stage: Begins from 1 week later.

Complications:

  • Meningoencephalitis: Occurs 3-10 days after the swelling of the parotid gland.
  • Pathogenesis: Neuron infection, followed by brain tissue infection with myelin degeneration.
  • Clinical Presentation: High fever, vomiting, headache, seizures, neck stiffness, behavioral and personality disturbances.
  • Cerebrospinal Fluid: Clear, hazy, 500 white blood cells/mm.
  • Orchitis: Easily mistaken for appendicitis.
  • Pancreatitis: Occurs 3-5 days after parotid gland inflammation.
  • Easily mistaken for gastroenteritis.

Laboratory Tests:

  • Serum Antibodies:
  • IgM antibodies decline within 6-12 months.
  • IgG antibodies peak within 1 month, persist for 6 months, and disappear within 2 years.

Prevention:

  • Vaccination: Measles-mumps-rubella (MMR) vaccine: Rox, Vax, Priorix, MMR.
  • Intramuscular or subcutaneous injection.
  • A live attenuated vaccine.
  • Dosage:
  • Dose 1: At 12 months of age.
  • Dose 2: Between 3-6 years of age.
  • Re-vaccination for children who received an ineffective vaccine previously, at 11-13 years of age.

Note: Mumps can lead to serious complications. Therefore, complete vaccination is the most effective preventive measure.



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