MUMPS

MUMPS
MUMPS
 Mumps is an acute viral infection of the
paramyxoviruses family. As its alternative
name (infectious parotitis) suggests, the
infection is characterized by swelling more
commonly bilateral than unilateral of the
parotid salivary glands. The incubation
period is 14-21 days and is communicable
from 6 days before to 9 days after facial
swelling is apparent. It can lead to brain
inflammation, deafness or sterility.
Mumps belongs to Parmyxoviridae
 Viruses in the family Parmyxoviridae are
classified in two subfamilies,
Paramyxovirinae and Pneumovirinae. The
latter subfamily contains two genera,
Pneumovirus and Metapneumovirus. The
number of genera in the Paramyxovirinae
was increased in 2002 from three
(Respirovirus, Morbillivirus and
Rubulavirus) to five by the addition of two
new genera, Avulavirus and Henipavirus.
The Phylogenetic tree
Mumps belongs to
Parmyxoviridae
 Looks similar to Orthomyxovirus,
 Larger in size, More Plemomorphic.
 Spherical in shape 100 to 300 nm
 Some times appear as filamentous,Gaint forms
are present.
 But contains only single stranded RNA.
 Do not contain segmented RNA like
Orthomyxoviruses,Antigenic variation absent.
 Reassortments like Influenzae viruses –
ABSENT.
Mumps
 Mumps or epidemic parotitis is a viral
disease of the human species, caused by
the mumps virus. Prior to the
development of vaccination and the
introduction of a vaccine, it was a
common childhood disease worldwide, and
is still a significant threat to health in the
Developing World
Involvement of Salivary Glands
 Painful swelling of the
salivary glands
(classically the
parotid gland is the
most typical
presentation) Painful
testicular swelling (
orchitis) and rash may
also occur
Involvement of Parotid Gland a
Major Manifestation
 Swelling of the
salivary glands follows
these symptoms.
Swelling of the glands
near the jaw line
below the ears may
give you "chipmunk
cheeks
Mumps
 Acute viral illness
 Parotitis and orchitis described by

Hippocrates in 5th century B.C.
 Viral etiology described by Johnson and Good

pasture in 1934
 Frequent cause of outbreaks among military

personnel in prevaccine era
Mumbling speech - Mumps
 Name
"mumps"
comes from
an old word
for "lump" or
an old word
for "mumble."
Mumps Virus
 Paramyxoviruses
 RNA virus
 One antigenic type
 Rapidly inactivated by
chemical agents, heat
and ultraviolet light
Properties of MUMPS virus.
 Posses HN and F
properties.
 Growth in Chick Embryos,
in the Amniotic cavity,
Adopts in allantoic cavity,
 Cell cultures – Primary
Monkey kidney,
 Typical Paramyxoviruses,
produce cytopathic effects.
Pathogenesis - Mumps
 Respiratory
transmission of virus
 Replication in
nasopharynx and
regional lymph nodes
 Viremia 12-25 days
after exposure with
spread to tissues
 Multiple tissues
infected during viremia
Mumps Clinical Features
 Incubation period 14-
18 days
 Nonspecific prodrome
of myalgia, malaise,
headache, low-grade
fever
 Parotitis in 30%-40%
 Up to 20% of infections
asymptomatic
Mumps Clinical Case
Definition
 Acute onset of
unilateral or bilateral
tender, self-limited
swelling of the parotid
or other salivary gland
lasting more than 2
days without other
apparent cause
Immunity
 Antibodies are
produced against the
S and V surface
antigens..
 Mumps rare before 6
months of age.
Definition of Mumps Immunity
 Documentation of adequate
vaccination
 Serologic evidence of mumps
immunity
 Birth before 1957
 Documentation of physician-
diagnosed mumps in the past
Complication with MUMPS.
 Epididymo orchids.
 May lead to atrophy, sterility, Low sperm
counts.
 CNS involvement in 60% cases
 May manifest with Aseptic meningitis,
 Deafness,
 Arthritis,Oopharitis,Nephritis and
Myocarditis,
 Orchitis. This inflammatory condition
causes swelling of one or both testicles.
Orchitis is painful.
 Pancreatitis..
 Encephalitis. A viral infection, such as
mumps, can lead to inflammation of the
brain (encephalitis). Although it's serious,
encephalitis is a rare complication of
mumps.
 Meningitis. Meningitis is infection and
inflammation of the membranes and fluid
surrounding your brain and spinal cord.
 Inflammation of the ovaries. Pain in
the lower abdomen in women may be a
symptom of this problem. Fertility doesn't
seem to be affected.
 Hearing loss.
 Miscarriages.
Laboratory Diagnosis
 No Laboratory confirmation needed.
 Atypical infection needs laboratory Diagnosis.
 Virus isolated from
Saliva
Urine
CSF.
Culturing in Human amnion, He la cells.
Immunoflorecence Methods. Isolation in Chick Embryos
ELISA, Complement fixation tests,
Doctortvrao's ‘e’ learning

CDC recommends
 CDC recommends
that a blood specimen
and buccal /oral swab
be collected from all
patients with clinical
features compatible
with mumps.
 Recommendations
stands mainly for
epidemiological
surveys
Vaccination
 Live attenuated
vaccine
Jernyl Lynn Strain
Grown in chick embryo
fibroblasts
Vaccine as MMR vaccine
A single dose protects
for 10 years.
Mumps (MMR) Vaccine
Indications
 One dose (as MMR) for preschool-age
children 12 months of age and older
and persons born during or after 1957
not at high risk of mumps exposure
Need for second dose
 Second dose (as MMR) for school-age
children and adults at high risk of mumps
exposure (i.e., healthcare personnel,
international travelers and students at post-
high school educational institutions
Passive immunization against
mumps
– Immune globulin ineffective for post
exposure prophylaxis
 does not prevent disease or reduce
complications
– Transplacental maternal antibody appears

to protect infants for first year of life
Epidemiology
 Endemic – Prevalence all over the world
 Immunization . Reduced the incidence.
 Epidemics in children between 5-15.
 No carriers.
 Spread by Direct Contact
 Saliva and urine are infective.
 One Attack produces life time Immunity.
Promoting Mumps Vaccination
MMR Vaccine
Contraindications and Precautions
 Severe allergic reaction to vaccine
component or following a prior dose
 Pregnancy
 Immunosuppression
 Moderate or severe acute illness of other
etiologies
MMR Vaccine and Autism
 There is no scientific evidence that the risk of autism
is higher among children who receive measles or MMR
vaccine than among unvaccinated children
“The evidence favors a rejection of a causal
relationship at the population level between MMR
vaccine and autism spectrum disorders (ASD).”
- Institute of Medicine, April 2001

MMR combined vaccine is
beneficial than separate component
vaccines
 Separate administration of measles,
mumps, and rubella vaccines to children
provides no benefit over administration of
the combination MMR vaccine and could
result in delays in immunization.
Paediatricians need to work with families
to ensure that children are protected early
in the second year of life from these
preventable diseases.
Mumps Vaccine and HIV
Infection
 MMR recommended
for persons with
asymptomatic and
mildly symptomatic
HIV infection
 NOT recommended
for those with
evidence of severe
immunosuppression
 HIV testing before
vaccination is not
recommended
Mumps control:
 Mumps control: The control of mumps can be
achieved through high routine coverage with an
effective mumps-containing vaccine
administered at 12–18 months of age.
Children immunized with most mumps vaccines
at the age of 12 months or older have excellent
serological response rates. Programmes should
aim at infant coverage of more than 90%. Low
immunization coverage may reduce the number
of cases in infants but fails to interrupt
circulation of the mumps virus in the community.

MUMPS

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MUMPS

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MUMPS

 Parotitis and orchitis described by

 Viral etiology described by Johnson and Good

 Frequent cause of outbreaks among military

 One antigenic type

Doctortvrao's ‘e’ learning

– Transplacental maternal antibody appears

- Institute of Medicine, April 2001

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