Mumps - why does this childhood disease occur? Causes and clinical signs of mumps, treatment of pathology

Mumps (colloquially called mumps) used to be one of the most common infections, affecting almost all young children. This continued until the 60s of the twentieth century, until vaccination against this disease was introduced. The pathology is acute, affecting mainly the parotid salivary glands. Viral cells can penetrate various organs of the body and the central nervous system, causing the development of serious complications.

Ways of transmission of the disease

Mumps is a disease that only affects humans. The mechanism of infection for mumps is almost always airborne. The pathogen is found in the saliva and mucous secretions of the patient, which are dispersed into the environment when talking, coughing or sneezing.

Indirect transmission of the virus is possible. You can become infected by contact with surfaces or surrounding objects that have been touched by someone with mumps. With unwashed hands, the infection enters the nasal or oral cavity of a healthy person and infection occurs.

Infection of healthy patients from a patient with mumps is possible in the prodromal phase, two days before the development of primary symptoms, and for five days after the onset of characteristic manifestations of the disease. Therefore, you should refrain from contact with an infected person for 5-6 days after clinical signs of mumps appear.

Symptoms of mumps (mumps)

The disease usually begins acutely. The following symptoms appear:

Symptoms

The clinical picture of mumps, which occurs in adults and children, has almost the same manifestations. The only difference is that in adult patients the pathology is characterized by a more acute course.

There are three main symptoms of mumps:

Hyperthermia – the body temperature of an infected person rises suddenly. The thermometer readings immediately reach critical values. At the same time, it is almost impossible to reduce the temperature with the help of medications in such a case. Although there is no need to worry about this - the immune system itself must eliminate the inflammatory process and produce antibodies to the virus. If the fever persists for a sufficiently long time after the other symptoms of mumps have subsided, then this already indicates the development of another disease.
Swelling of the salivary glands behind the ears - this sign is the most striking evidence of the presence of mumps in a child or adult. The swelling is always large, the area is painful to the touch, and swallowing and chewing food is difficult. Due to the symptoms of mumps, the patient's appearance changes - the cheeks become larger and droop, and the earlobes rise slightly. These manifestations disappear 7-8 days from the start of therapy.
Poor health and weakness - children infected with mumps are usually lethargic and indifferent. In adults, the disease is more severe; they suffer the disease while lying down. Often with this pathology, patients are irritated by extraneous sounds, photophobia and headaches occur.

Causes of mumps

The causative agent of mumps infection is a virus belonging to the genus Paramyxovirus. The source of infection is exclusively a sick person, who becomes infectious starting from the incubation period. Infection of a child occurs mainly through airborne droplets: when communicating with a sick person who, when talking or coughing, releases saliva and nasal secretions containing viruses. Somewhat less often, infection occurs through infected toys, dishes, and personal items.

When an aerosol containing a virus is inhaled, the latter enters the epithelium of the upper respiratory tract, where it multiplies. Then it penetrates the blood and spreads throughout the body, however, since the virus is tropic (oriented) to glandular tissues, it is fixed mainly in them, where it multiplies again, but more massively. Then the virus enters the blood again, which leads to its further spread and the formation of new foci of infection.

In damage to the CNS (central nervous system), the main one is the immune mechanism (weak primary immune response). The mechanism of damage to non-glandular structures has not been fully studied, however, in some individual cases, for example, with damage to the facial nerve with further paralysis of the facial muscles, the damage can be associated with the mechanical effect of the enlarged gland on the nerve due to prolonged compression of the latter. In some other cases (nephritis, myocarditis, arthritis), immune complexes are considered the main damaging mechanism.

Complications after mumps

Mumps provokes the development of various disorders in the body. With this disease, in addition to the salivary glands, other organs can be affected; usually, such complications occur in post-pubertal patients. Among them are:

Damage to the reproductive system - develops in 15-20% of adult men in the form of orchitis (inflammation of the testicles). The disorder usually manifests itself on one side, causing pain in the scrotum, swelling and hyperemia, high sensitivity and a feeling of heat in the problem area. Sometimes the inflammation process ends with testicular atrophy. Oophoritis may occur in women, but it is much less common and is characterized by milder symptoms.
Disruption of the central nervous system - this complication of mumps is observed in 1-10% of patients and is expressed in the form of meningitis and encephalitis. The first occurs with the presence of vomiting, migraine, and decreased neck mobility. Signs of encephalitis include seizures, drowsiness, or coma.
Pancreatitis - occurs on the 6-7th day of the disease. Its clinical signs include stomach pain, vomiting and nausea. The pathology disappears on its own 13-14 days after the first symptoms appear.

Very rare complications of mumps are: nephritis and polyarthritis, prostatitis, hepatitis, deafness, mastitis and myocarditis.

Mumps is an acute infectious disease caused by a virus of the paramyxovirus family. The main signs of the disease are intoxication and inflammation of the parotid salivary glands. In some cases, other organs may be involved in the pathological process: the nervous system, testicles, pancreas. After the disease, in almost all cases, stable lifelong immunity is formed.

There is a vaccine against mumps that can significantly reduce the risk of infection, and before the introduction of mass vaccination, it was widespread. Nowadays, outbreaks of infection are quite rare in developed countries. Most often, children aged 2-12 years become ill, although recently the percentage of adults among those who become ill has increased - those who were not vaccinated in a timely manner and who, as a result of vaccination, did not develop a sufficiently strong immunity.

The prognosis for mumps is generally favorable. Complications are quite rare and in most cases do not lead to irreversible pathological changes. However, sometimes mumps can cause infertility, deafness, and neurological problems.

Synonyms Russian

Mumps, mumps, ear infections.

English synonyms

Parotitis, mumps.

Symptoms

The initial stages of the disease are characterized by nonspecific symptoms of general intoxication. About 20% of patients experience virtually no discomfort - the disease can be unnoticeable. The most characteristic sign of mumps - inflammation of the parotid salivary glands - develops only on the third day of illness or may be completely absent.

The main symptoms of mumps are:

fever,
malaise,
loss of appetite,
swelling, pain in the area of the parotid salivary gland on one or both sides, which intensifies when chewing, drinking sour drinks, or talking.

General information about the disease

The mumps virus belongs to the paromyxovirus family and is structurally similar to the influenza virus. It consists of single-stranded RNA surrounded by a glycoprotein shell.

You can become infected from an infected person through airborne droplets. The virus is not stable in the external environment. The incubation period, that is, the time between contact with the source of infection and the appearance of symptoms, is 2-3 weeks. A sick person is contagious two days before the first symptoms and for about a week after their onset. Uncomplicated mumps usually lasts about seven days, rarely up to ten.

Children aged 2-12 years are most susceptible to mumps. During the first year of life, the child's body is usually protected by maternal antibodies. At the same time, in adults the disease is more severe.

The onset of mumps is usually accompanied by nonspecific symptoms: fever, muscle pain, weakness, loss of appetite. The temperature is highest on the second day of illness. On the third day, 95% of patients experience swelling and pain in the area of the parotid salivary glands, after which the manifestations of general intoxication begin to subside. Swelling of the salivary glands persists for up to 10 days. Inflammation of the parotid salivary glands can be unilateral or bilateral, the pain intensifies when chewing and swallowing. The skin over the glands is tense. The pain is especially pronounced when pressing in front of the earlobe and behind it, as well as in the mastoid area. Mursu's symptom is also observed - inflammation in the area of the excretory duct of the gland. The swelling may also spread to the neck area.

Complications of mumps are rare. The most common violations that occur are:

Damage to the nervous system – encephalitis and meningitis. Mild forms of neurological disorders are observed in 10% of patients with mumps, but in the vast majority of cases they are completely curable and do not lead to serious consequences.
Sensorineural deafness. Reversible hearing impairment develops in 4% of patients, but irreversible deafness is much less common and is often unilateral.
Orchitis is an inflammation of the testicles that affects 20-50% of patients with mumps. Atrophic changes of varying degrees in testicular tissue occur in a third of patients, and fertility (the ability to conceive) may decrease, but infertility as a result of mumps is rare.
Oophoritis is inflammation of the ovaries. It is very rare and does not lead to a decrease in fertility.
Pancreatitis is inflammation of the pancreas. It affects 5% of patients with mumps. Changes in the pancreas are rarely irreversible, but several cases of diabetes mellitus have been identified due to damage to pancreatic cells by the virus.

In addition to the mumps virus, inflammation of the parotid salivary glands can be caused by cytomegalovirus, influenza and parainfluenza viruses, HIV infection, various bacteria, in addition, it can be associated with metabolic disorders, neoplasms, salivary stones, and taking a number of medications.

Who is at risk?

Children from 2 to 12 years old.
Aged people.
Patients with reduced immunity.
Those who have not been vaccinated or those who have not developed a sufficient level of immunity after vaccination.

Diagnostics

Diagnosis of mumps is based primarily on history and presenting symptoms. Additional diagnostic measures may be required to exclude other diseases with a similar clinical picture.

Laboratory diagnostics

Complete blood count (without leukocyte formula and ESR). Leukocyte formula. With mumps, leukopenia with relative lymphocytosis can be detected.
Erythrocyte sedimentation rate (ESR). This is a nonspecific sign of inflammation. With mumps it is increased.
C-reactive protein. With mumps it is sometimes elevated.
Total amylase in daily urine and total amylase in serum. Amylase is an enzyme produced by the pancreas and salivary glands. It is necessary for the digestion of carbohydrates contained in food. With pathology of the salivary glands or pancreas, the level of amylase in the blood and urine may be increased.
Pancreatic amylase. Increased with damage to the pancreas.
Determination of antibodies to the mumps virus in the blood. Class M immunoglobulins and class G immunoglobulins to the mumps virus are detected. IgM is responsible for the primary immune response and appears in the blood in the first days of the disease. IgG begins to be produced a little later.

Other research methods

X-ray (sialography), computed tomography, magnetic resonance imaging of the salivary glands. These methods make it possible to assess the condition of the glands, identify neoplasms, salivary stones, disturbances in the outflow of secretions, and pathological changes in the tissues of the salivary gland or surrounding areas.
Ultrasound of the testicle. May be required for orchitis.

In case of complications, the doctor may prescribe a number of additional tests.

Treatment

There is no specific treatment for mumps; therapy is prescribed depending on the symptoms. Bed rest is of great importance, reducing the risk of complications several times. Patients with complications, severe concomitant diseases, as well as all male patients over 12 years of age are subject to hospitalization.

Prevention

Prevention of mumps involves timely vaccination. It is given to all children aged 12-15 months, usually as part of a comprehensive vaccination against measles, rubella and mumps. Vaccination against mumps is repeated at the age of 4-6 years.

Recommended tests

General blood analysis
Leukocyte formula
Erythrocyte sedimentation rate (ESR)
C-reactive protein, quantitative
Total amylase in daily urine
Serum total amylase
Mumps Virus, IgM
Mumps Virus, IgG

Therapeutic measures

There are no specific treatments for mumps. Treatment is mainly aimed at reducing clinical manifestations and preventing complications of this disease. Patients are prescribed antibacterial agents and novocaine blockades. Be sure to adhere to bed rest, diet and drink plenty of fluids.

In order for the immune system to defeat the virus, the patient needs good rest and sleep for 1.5-2 weeks. The menu of such a patient should not include spicy, fried, fatty and starchy foods. You need to take food in small portions and often.

If a child gets mumps, his diet should consist of plant and dairy products. With mumps, the patient is bothered by severe dryness in the oral cavity, so the oral mucosa must be constantly moisturized. That is why such patients are recommended to drink frequently in large volumes.

Anti-inflammatory and antihistamine medications are prescribed for mumps. It would also be a good idea to take vitamins and antitoxic drugs.

Effective therapy for the disease

The main task of doctors in the process of treating mumps is to prevent the development of complications. The patient is prescribed strict bed rest for 10 days or longer, depending on the condition. Statistics show that if bed rest is not followed, cases of orchitis develop three times more often than in those who follow medical recommendations. In uncomplicated cases, the patient remains at home; hospitalization is necessary only if a severe complication occurs or to prevent further spread of the infection. It is important to provide the patient with proper care, including:

drinking plenty of warm drinks to reduce intoxication by cellular decay products;
liquid or semi-liquid food that does not require chewing;
regular brushing of teeth and rinsing the mouth with boiled water or a weak soda solution;
dry warm compresses on the tumor.

If complications develop, the doctor prescribes appropriate treatment according to the indications. Recovery occurs two to three weeks after the onset of the disease.

The most important factor in the prevention of mumps is the timely administration of a live vaccine to the child. Routine vaccination is carried out for one-year-old children with revaccination at 6 years of age. Older patients are vaccinated according to epidemiological indications. Statistics show that vaccinated children and adults get mumps much less often, and if infected, the risk of developing complications is significantly reduced.

Effectiveness of vaccination

Until recently, mumps was widespread in the world: on average, from 0.1% to 1% (in some countries up to 6%) of the population had this disease. Modern features of the epidemiology of this disease are determined by the prevention of the disease carried out in many countries of the world using a live attenuated vaccine. In most countries of the world in recent years, the incidence of mumps is at a level of 100 to 1000 per 100,000 population with epidemic peaks every 2-5 years. The maximum number of cases occurs between the ages of 5-9 years.

As of January 1, 2014, the incidence rate in our country was 0.2 per 100 thousand people.

Consequences of mumps

With timely consultation with a doctor and timely treatment, the prognosis of the disease is favorable in most cases. However, mumps can cause a number of complications both during the height of the disease and at a later date.

The main complications caused by mumps infection are as follows:

Testicular atrophy after bilateral mumps orchitis, which leads to infertility and eunuchoidism.
Myocarditis (in most cases manifested by heart rhythm disturbances).
Arthritis, arthralgia (mainly large joints are affected).
Optic nerve damage.
Hearing loss. It can be temporary, but permanent hearing loss is also possible, and with a bilateral process, complete deafness.
Paresis.
Neuritis of the facial nerve.
Hydrocephalus due to impaired cerebrospinal fluid dynamics.
Diabetes mellitus (after mumps pancreatitis).
Nephritis.

This disease is extremely dangerous due to its complications, it can lead to disability and a significant deterioration in the child’s quality of life, therefore, at the first suspicion of this disease, you should consult a doctor.

Latest epidemics

In 2004–2010 There were outbreaks of mumps in England, the USA and Moldova, most often affecting teenagers. During an outbreak in the United States in schools for Orthodox Jewish children (3,500 cases), of those affected, 89% were fully vaccinated. It is believed that close contacts help overcome immune defenses. The outbreak was extinguished with the introduction of the 3rd dose of the vaccine.

In 2006, Russia recorded the lowest incidence rate of mumps in the entire history of observation - 1.64 per 100 thousand population. Compared to 1981, the incidence decreased by 294 times. The incidence of mumps has been steadily decreasing over the past five years, which was a consequence of the high level of vaccination coverage of children and especially revaccination from 72% in 1999 to 96.5% in 2006. As of January 1, 2014, the incidence rate in our country was 0.2 per 100 thousand people.

Course of the disease

After infection, mumps does not immediately appear clearly; it gives the virus time to begin to develop and act. During this time - usually a couple of days - the baby simply feels unwell, has a headache, the child gets tired quickly, eats poorly, is capricious, older children may complain of muscle pain and chills. During this period, you can suspect mumps only if you know that the child had contact with a carrier of this virus.

Then the picture changes literally within a few hours - the temperature rises sharply and signs of intoxication appear. The behind-the-ear glands increase in size - sometimes one, sometimes both. It is very painful for the child to swallow and even speak. Children cannot clearly explain what is happening to their body and complain that their ears hurt. The oval of the face of a person suffering from mumps is deformed, and the picture is so obvious that most often the clinical picture is sufficient for diagnosis. But to be sure of the diagnosis, laboratory tests for antibodies are prescribed.

Mumps is very dangerous due to complications, which is why it is so important to follow all doctor’s instructions and care rules.