Mumps
Introduction
Mumps is a contagious viral infection that used to be common in children.
It’s most recognisable by the painful swellings located at the side of the face under the ears (the parotid glands), giving a person with mumps a distinctive "hamster face" appearance. Other symptoms include headache, joint pain and a high temperature.
Read more about the symptoms of mumps.
See your GP if you suspect that you or your child has mumps. While the infection is not usually serious, mumps share symptoms with more serious types of infection, such as glandular fever and tonsillitis. It is always best to visit your GP so that they can confirm or rule out mumps.
Mumps is spread in the same way as colds and flu: inside infected droplets of saliva that can be inhaled or picked up from surfaces and passed into the mouth or nose.
A person is most contagious one to two days before the onset of symptoms, and for five days afterwards.
During this time, it is important to try to prevent spreading the infection to others; particularly teenagers and young adults who have not been vaccinated.
Once you have been infected by mumps, you normally develop a life-long immunity to further infection.
Treatment
There is currently no cure for mumps but the infection should pass within two weeks.
Treatment is used to relieve symptoms and includes using painkillers, such as ibuprofen and paracetamol, and applying a cold compress to swollen glands to relieve pain.
Read more about treating mumps.
The MMR vaccine
You can protect your child against mumps by making sure they are given the combined MMR vaccine (mumps, measles and rubella).
The MMR vaccine is part of the routine childhood immunisation schedule. Your child should be given one dose when they are around 12-13 months and a second booster dose before they start school. Once both doses are given, the vaccine provides 95% protection against mumps.
Who is affected
Before the introduction of the MMR vaccine in 1988 mumps was a very common infection in school-aged children. It was responsible for about 1,200 hospital admissions a year in England and Wales.
Mumps is much less common now, with the majority of cases occurring in younger people (usually born between 1980 and 1990) who didn’t receive the MMR vaccine as part of their childhood vaccination schedule, or have mumps as a child.
Complications
Mumps should pass without causing serious damage to a person's health. Serious complications are rare.
However, mumps can lead to viral meningitis if the virus moves into the outer layer of the brain. Other complications include swelling of the testicles in males and the ovaries in females who have gone through puberty.
Read more about the complications of mumps.
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Symptoms
The symptoms of mumps usually develop 14 to 25 days after a person is infected with the mumps virus (the incubation period). The average incubation period is around 17 days.
Swelling of the parotid glands is the most common symptom of mumps. The parotid glands are a pair of glands responsible for producing saliva. They are located on either side of your face, just below your ears.
Both glands are usually affected by the swelling, although only one gland can be affected. The swelling can cause pain, tenderness and difficulty with swallowing.
Other symptoms of the mumps include:
- headache
- joint pain
- feeling sick
- dry mouth
- mild abdominal pain
- feeling tired
- loss of appetite
- a high temperature (fever) of 38C (100.4F), or above
When to seek medical advice
If you suspect that you or your child has mumps, it's important to call your GP.
While the infection is not usually serious, mumps share symptoms with other, more serious types of infection, such as glandular fever and tonsillitis. It's always best to visit your GP so that they can confirm (or rule out) a diagnosis of mumps.
It's also important to let your GP know in advance if you are coming to the surgery so they can take any necessary precautions to avoid the spread of infection.
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Causes
Mumps is caused by the mumps virus, which belongs to a family of viruses known as paramyxoviruses. Paramyxoviruses are a common source of infection, particularly in children.
When you get mumps, the virus moves from your respiratory tract (your nose, mouth and throat) into your parotid glands, where it begins to reproduce. This causes inflammation and swelling of the glands.
The virus can also enter your cerebrospinal fluid (CSF), which is the fluid that surrounds and protects your brain and spine. Once the virus has entered the CSF, it can spread to other parts of your body, such as your brain, pancreas, testicles (in boys and men) and ovaries (in girls and women).
How mumps is spread
Mumps is an airborne virus and can be spread by:
- an infected person coughing or sneezing and releasing tiny droplets of contaminated saliva, which can then be breathed in by another person
- an infected person touching their nose or mouth, then transferring the virus onto an object, such as a door handle, or work surface; if someone else then touches the object shortly afterwards, they can transfer the virus into their respiratory tract
- sharing utensils, such as cups, cutlery or plates with an infected person
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Diagnosis
Mumps is usually diagnosed from the symptoms, in particular from the swelling around your parotid glands.
If you have mumps, your GP can see and feel the swelling. By looking inside your mouth, they may be able to see that your tonsils have been pushed out of their usual position.
If you have mumps you may also have a raised temperature, between around 37.5C and 39.5C (100F to 103F).
To confirm the diagnosis, particularly in a case where symptoms are severe or there are complications, a blood, urine or cerebrospinal fluid (CSF) test can be used. The CSF test or spinal tap involves taking a sample of the fluid that runs through your spine.
If you think that you or your child has mumps, visit your GP so that a diagnosis can be confirmed.
Read about treating mumps.
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Treatment
There are currently no anti-viral medications that can be used to treat mumps. Treatment is focused on relieving symptoms until your body’s immune system manages to fight off the infection.
The self-care techniques listed below should help.
- Get plenty of bed rest until your symptoms have passed.
- Over-the-counter (OTC) painkillers, such as ibuprofen or paracetamol, can relieve pain (children aged 16 or under should not be given aspirin).
- Drink plenty of fluids, but avoid acidic drinks such as fruit juice as these can irritate your parotid glands. Water is usually the best fluid to drink.
- Applying a cold compress to your swollen glands should help to reduce the pain.
- Eat foods that don't require a lot of chewing, such as soup, mashed potatoes and scrambled eggs.
If your symptoms don’t improve after seven days, or they suddenly worsen, contact your GP for advice.
Preventing the spread of infection
If you or your child has mumps, it’s important to prevent the infection spreading, particularly around younger people who were born between 1980 to 1990 (these people are unlikely to have immunity due to previous infection, but are also unlikely to have been vaccinated).
The best way to do this is to:
- Stay away from school, college or work until five days after the onset of your symptoms.
- Wash your hands regularly, using soap and water.
- Always use a tissue to cover your mouth and nose when you cough and sneeze. Throw the tissue in a bin immediately afterwards.
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Complications
Common complications
Common complications of mumps include:
- pain and swelling of the testicles (orchitis ) - which affects 20% of all males who get mumps after puberty,
- pain and swelling of the ovaries (oophoritis ) - which affects 5% of all females who get mumps after puberty,
- inflammation of the pancreas (pancreatitis) - which occurs in 5% of cases, and
- viral meningitis - which occurs in as estimated 1-10% of all cases.
Orchitis, oophoritis, viral meningitis and pancreatitis are explained in more detail below.
Orchitis
The most common symptom of orchitis is the painful swelling of the testicles. The pain can range from mild to severe. The testicles usually begin to swell 4-8 days after the onset of mumps symptoms.
Other symptoms of orchitis include:
- high temperature (fever) of 38C (100F) or above,
- vomiting,
- headache, and
- a general feeling of being unwell.
The swelling should resolve within a week, although your testicles may feel tender for several weeks.
Symptoms of pain can be eased using over-the-counter (OTC) painkillers, such as paracetamol or ibuprofen. If the pain is particularly severe, you should contact your GP who may prescribe a stronger painkiller for you.
Applying cold compresses to your testicles, and wearing supportive athletic underwear, may also help to reduce any pain.
An estimated 50% of men who get mumps will notice some shrinkage of their testicles. An estimated 7-13% of men will experience some drop in their sperm count (the amount of healthy sperm that their body can produce). However, this is rarely large enough to cause infertility.
Oophoritis
Oophoritis is the inflammation (swelling) of your ovaries which can cause symptoms of:
- lower-abdominal pain,
- high temperature (fever) of 38C (100F), or above, and
- vomiting.
The symptoms of oophoritis usually pass once the body has fought off the underlying mumps infection.
There have been a number of cases where oophoritis has triggered an early menopause and caused infertility, although this is thought to be a rare complication.
Pancreatitis
The most common symptom of pancreatitis is the sudden onset of pain in the centre of your upper abdomen. Other symptoms of acute pancreatitis can include:
- nausea,
- vomiting,
- diarrhoea,
- loss of appetite,
- high temperature (fever) of 38C (100F), or above,
- tenderness of the abdomen and, less commonly,
- yellowing of the skin and the whites of the eyes (jaundice).
Although pancreatitis that is associated with mumps is usually mild, admission to hospital may be recommended so that the functions of your body can be supported until your pancreas recovers.
Viral meningitis
Viral meningitis is a viral infection of the outer membranes (meninges) of your brain and spinal cord.
Unlike bacterial meningitis, which is regarded as a potentially life-threatening medical emergency, viral meningitis causes much milder, flu-like symptoms, and the risk of serious complications are low.
Symptoms of viral meningitis include:
- high temperature (fever) of 38C (100F), or above,
- sensitivity to light (photophobia),
- headache,
- nausea, and
- vomiting.
The symptoms of viral meningitis will usually pass within 14 days.
Mumps and pregnancy
Women who develop a mumps infection during the first 12-16 week of pregnancy have a slightly higher risk of miscarriage. There is no evidence that mumps causes birth defects.
Rare complications of mumps
Rare but potentially serious complications of mumps include:
- a serious brain infection (encephalitis) - which occurs in 1 in every 6,000 cases, and
- permanent hearing loss - which occurs in 1 in every 15,000 cases.
Encephalitis requires emergency admission to an intensive care unit (ICU). Unfortunately, there is no treatment that can be used to reverse hearing loss.
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Prevention
MMR Vaccine
The best way to prevent catching mumps is to be immunised with the measles, mumps and rubella (MMR) vaccine.
Advice for children
The MMR vaccine is part of the routine childhood immunisation programme. One dose is given to a child at around the age of 13 months. A second booster dose is given before they start school, usually between the ages of three to five years old.
Contact your GP if you are uncertain about whether your child’s vaccinations are up-to-date.
Advice for adults
The MMR vaccine can be given at any age, so there may be circumstances where you are advised to have it.
For example, if you were born between 1980-1990, you may not be protected against mumps. It is unlikely that you will have been previously exposed to a mumps infection, so vaccination may be recommended.
If you were born before 1979, it is unlikely that you have been vaccinated against mumps, although you may have been previously exposed to mumps. Vaccination may be recommended if you have a high risk of exposure to mumps.
You may be more at risk of exposure to mumps if you:
- live or work in an environment that contains a high number of young people living in close contact, such as a college, university or army base
- are a healthcare worker
You also have a higher risk of exposure if you are travelling to a part of the world that does not offer routine vaccination against mumps, such as:
- most of Africa, except Egypt
- Pakistan
- India
- Japan
- southeast Asia
Vaccination is also recommended if you are a migrant from a part of a world that does not offer routine vaccination.
MMR and autism
There has been some controversy about the MMR vaccine and autism following a study published in 1998 by Dr Andrew Wakefield. He claimed that his initial findings appeared to show a link between the MMR vaccine and autism and bowel disease.
However, Andrew Wakefield’s work has since been discredited.
Subsequent studies during the last eight years have found no link between the MMR vaccine and autism or bowel disease.
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Q&A
Pregnancy and mumps
Mumps is an infectious disease that many people in the UK have been vaccinated against, which means they're immune to it. The mumps vaccine is part of the MMR jab. Mumps is not known to cause any problems in unborn babies, but it can increase the risk of miscarriage (as a result of the illness and fever).
Mumps is caused by a contagious virus, which is transmitted through airborne droplets from the coughs and sneezes of infected people. Mumps mainly affects children between 5 and 15 (who have not been vaccinated), but can be caught at any age.
Mumps is normally a mild illness, although in a minority of cases there can be severe complications, such as meningitis. The symptoms of mumps are:
- fever,
- headache,
- swelling of the cheeks or jaw, and
- swollen glands, which can last up to 7-10 days.
These symptoms usually appear 2-3 weeks after coming into contact with the infection, but it can take longer. The patient is infectious from one week before the symptoms appear until several days after their glands have begun to swell.
Pregnant women who develop mumps in the first 12-16 weeks of pregnancy have a slightly higher risk of miscarriage, but there is no evidence that mumps can cause defects in the unborn child.
If you're planning on getting pregnant and you're not sure if you're immune to mumps, see your GP to find out. They can arrange for you to have the MMR vaccination. If you're not immune, you cannot have the jab while pregnant because the vaccination contains a live virus which could cause infection in the baby. For the same reason, you should not become pregnant for at least a month after having your jab.
If you're pregnant and you think you've come into contact with someone with mumps and you know you're not immune, you should see your GP immediately. Although there is no cure for mumps, your GP will be able to suggest treatment to relieve your symptoms.
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