mumps
dr hadeel fadhil fibms
acute viral disease characterized by :
fever ,swelling and tenderness of one or more salivary glands, usually parotid & some time sublingual or submaxillary glands .
* orchitis, most commonly unilateral, occurs in 20- 30% of cases
* mastitis , occur in up to 31% of female older than 15 years
*sterility, rare
*4o-50% of mumps infections associated with respiratory symptoms , particularly in children less 5 years .
*it can cause sensoryneural hearing loss in children ( 5 per 100,000 cases)
* encephalitis (rare) , pancreatitis usually mild (4% of cases)
acute mumps infection conferm by :
* significant rise in igg , igm antibodies
* positive mumps viral cultures
* virus may be isolated from buccal mucsa from 7 days befor until 9 days after salivary enlargement & from urine from 6 days before to 15 days after the onset of parotitis.
infetious agent :
mums virus
occurrence :
about 1/3 of exposed susceptibe people have inapparent infections , most infections of children less than 2 years of age are subclinical .
winter and spring are seasons of greatest incidence .
reservoir : human
mode of transmission :
* airborn transmission by dropinglet spread
* by direct contact with the saliva of an infected person
incubation period : 15-18 days
** period of communicability :
virus has been isolated from saliva from 6-7 days before overt parotitis to 9 days after onset of illness .
maximum infectiousness occurs between 2 days before to 4 days after onset of illness .
in apparent infections can be communicable .
methods of control
a-preventive measures :
1- public education to encourage mumps immunization .
2- live attenuated mumps v irus vaccine (mmr) . more than 95% of children develop immunity that is long – lasting & may be lifelong .
vaccine may be taken any time after 1 year of age , preferably as mmr at 12-15 months of age. 2nd dose recommended at 4-6 years.
however, in an accelerated mmr schedual , or a catch –up opportunity , the second dose may be given as soon as 1 month after the first dose .
special effort should be made to immunize before puberty all persons with no definite history of mumps or mumps immunization .
vaccine is contraindication in :
* immunosuppressed
*pregnant females or females trying to get pregnant in the next 3 months .
b- control of patient , contact and immediate environment
1- selectively reportable
2- isolation : resp isolation & private room for 9 days from onset of swelling to, less if swelling is subside, exclusion from school & workplace until 9 days after onset of parotitis if susceptible contacts( those not immunized) are present.
3- concurrent disinfection : of articles soiled with nose & throat secretions.
4- quarantine : exclusion of susceptible from school or the workplace from the 12th through the 25th day after exposure if other susceptible are present .
5-immunization of contact : immunization protected against infection from subsequent exposure, ig is not effective & not recommended .
6- investigation of contact & source of infection: susceptible contact should be immunized .
7- specific treatment : none
c- epidemic measures: immunize susceptible, especially those at risk of exposure
*serologic screening to identify susceptible is impractical & un necessary, since there is no risk in immunizing those who are already immune
mmr vaccine
mmr vaccine combination of measles vaccine , mumps vaccine vaccine rubella mmr vaccine is an immunization shot against measles, mumps and rubella (also called german measles). it was first developed by in the late 1960s]
the vaccine is a mixture of three live attenuated viruses, administered via injection. the shot is generally administered to children around the age of one year, with a second dose before starting school.
the second dose is not a booster it is a dose to produce immunity in the small number of persons (2–5%) who fail to develop measles immunity after the first dose
in the united states, the vaccine was licensed in 1971 and the second dose was introduced in 1989.it is widely used around the world since introduction of its earliest versions in the 1970s, over 500 million doses have been used in over 60 countries.