Mumps

Symptoms and Causative Agent

Mumps is caused by a virus from the genus Rubulavirus. Its symptoms include low-grade fever, respiratory problems, and most notably swelling of the salivary glands below the ear. The affected glands are called the parotid glands, and the swelling is known as parotitis. Although parotitis is the most easily recognized symptom of mumps, it occurs only in about 30-40% of cases. Other patients may have non-specific symptoms. Up to 20% of infected individuals may experience no symptoms at all.

Symptoms typically occur two to three weeks after exposure to the virus.

Transmission

Respiratory droplets spread the virus. These can become airborne when an infected person coughs, sneezes, and talks. Additionally, a person can contract the virus by touching surfaces contaminated with infected droplets. Infected individuals are considered most contagious during a period, starting several days before the appearance of parotitis (if it occurs), and running through the fifth day after it first appears. To prevent a patient from spreading the virus to others, isolation is recommended for five days after parotitis begins.

In the United States, cases of mumps have dropped by 99% since the introduction of a vaccine in 1967. Unlike measles and rubella, however, mumps has not yet been eliminated in the United States. Recent large outbreaks have occurred among college students (2006, more than 6,500 cases) and in a tradition-observant Jewish community, sparked by a boy who returned from a trip to the United Kingdom and began showing mumps symptoms while at a summer camp (2009-2010, more than 3,400 cases).

Mumps cases typically peak in late winter or early spring.

Treatment and Care

There is no direct treatment for mumps. Supportive care may be provided, including efforts to lower fever.

Complications

Mumps can be a mild disease, but it is often uncomfortable, and complications are not rare. These include meningitis; testicular inflammation in males who have reached puberty, among whom about half experience some degree of testicular atrophy; inflammation of the ovaries or breasts in females who have reached puberty; and permanent deafness in one or both ears. Before the development of a mumps vaccine, the disease was one of the major causes of deafness in children.

Some research also suggests an increase in miscarriages among pregnant women infected with mumps during their first trimester.

Available Vaccines and Vaccination Campaigns

The live, attenuated mumps vaccine used today in the United States was licensed in 1967. Prolific vaccine researcher Maurice Hilleman developed it, using mumps virus isolated from his daughter, Jeryl Lynn, when she was ill with mumps at age 5. (The vaccine virus strain is referred to as the “Jeryl Lynn strain.”) Hilleman’s mumps vaccine was then used in the combination measles-mumps-rubella (MMR) vaccine, licensed in 1971. The rubella component of the vaccine was changed in 1979, but in the United States, the mumps and measles vaccine viruses have remained the same since 1971.

Most industrialized countries, and some developing countries, include mumps-containing vaccines as part of their national immunization program. The World Health Organization’s position on mumps immunization is that “Routine mumps vaccination is recommended in countries with a well established, effective childhood vaccination programme and the capacity to maintain high-level vaccination coverage with measles and rubella vaccination (that is, coverage that is >80%) and where the reduction of mumps incidence is a public health priority. Based on mortality and disease burden, WHO considers measles control and the prevention of congenital rubella syndrome to be higher priorities than the control of mumps.” WHO recommends that mumps immunization be accomplished via the MMR vaccine, rather than a single component mumps vaccine.

Sources and Additional Reading

• Centers for Disease Control and Prevention. . Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson, W., Wolfe,S., Hamborsky, J. eds. 13th ed. Washington DC: Public Health Foundation, 2015. Accessed 01/25/2018.
• CDC. . Updated 11/20/2017. Accessed 01/25/2018.
• CDC. . Updated 11/22/2016. Accessed 01/25/2018.
• Immunization Action Coalition. . (111 KB). Accessed 01/25/2018.
• Plotkin, S.A., Orenstein, W.A., Offit, P.A. eds. Vaccines, 5th ed. Philadelphia: Saunders; 2008.
• World Health Organization. . Weekly Epidemiological Record. 2007, 82, 49-60. (321 KB). Accessed 01/25/2018.