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Baby and childhood infectious diseases: mumps BABY AND CHILDHOOD INFECTIOUS DISEASES: MUMPS
The other name for mumps is epidemic parotitis. (Don't you enjoy these gobbledegook names that doctors use? It makes even the simplest problem seem difficult. That's probably why they use them!)
Mumps is a common infectious disease, rarely seen in persons under the age of three, but rife after that. It can occur at virtually any age, from young to old, but children are the usual victims. It is caused by a virus, and usually attacks the parotid gland. This is a large organ that sits in front of and below the ears. It produces saliva, and for some unknown reason the virus simply loves having an affair with it. Also, various other glands under the jaw (the submaxilliary salivary gland) may also become involved.
It is not as highly infectious as some of the other childhood disorders, such as measles and chicken pox, and is usually spread via contamination of toys and articles shared with others. A person may infect another from two days before the appearance of the glandular swelling, until it has subsided completely. The glands are not always affected. It takes 12-24 days for the germ to incubate and produce symptoms.
During the prodromal period (the days immediately before the glands are noticeably involved), there is usually a fever, a feeling of being unwell, and probably pains about the ear when eating and swallowing. The skin may feel sensitive and tingly.
Suddenly the salivary glands become affected. They swell, become tender to touch, and this is aggravated by any movement of the jaw, such as eating, talking, swallowing food or fluid. The fever may reach 40°C (104°F) or it may be only mild. There may be headaches, aches and pains and a general feeling of misery and being off-colour.
The most serious complication is the onset of a severe headache, stiffness of the neck or back muscles, vomiting, lethargy, and a further increase in temperature which may reach 41.1°C (106°F).
This may indicate meningeal irritation—meaning the virus has attacked the lining of the brain.
Another important and fairly serious complication is when the virus moves to the testes in males or the ovaries in females. This may cause swelling and pain in the scrotum or lower pelvic regions. In fact, it may prolong the illness and cause a great deal of discomfort. The main hazard is that this may reduce fertility in later life; and cases of subsequent sterility, whilst not common, have often been reported. Occasionally the pancreas (a gland in the abdomen which produces insulin), the kidneys and the ears may be attacked and can produce serious symptoms. But these complications, in the total picture, are not common.
Treatment
There is no specific antibiotic—as with most other viral infections—that will cut short the attack. Ideally, the treatment is bed for a few days, until the temperature has fallen and the child feels improved. Once again, most children are good barometers and will want to get up and start moving about as soon as they feel a little better. Isolation is often suggested until swelling of the salivary glands has subsided, for the virus is transmissible to others.
Plenty of fluids are advised, for they require little effort apart from swallowing and do not unduly exercise the jaws. Water, water-based drinks and fruit juices are all good. Any food may be served, but those requiring little chewing are best. Softly boiled and poached eggs, mashed vegetables, stewed fruit, broth and soup, custards, ice-cream, jellies and soft toast are all suitable. There is no restriction on food to be served to the patient.
Pain and fever may be reduced by giving analgesics and antipyretics. Paracetamol elixir for children aged under six is suitable; and for those over six years, paracetamol or aspirin tablets may be given. Dosage is usually written on the label.
Warm applications such as compresses may give relief if the swollen areas of the face are sore. Warm, salty-water mouth rinses may give a feeling of freshness, and improve the outlook.
Most patients recover with few, if any, problems. Even those with gonadal involvement usually recover. If there are any symptoms that appear odd, or that are not responding to simple home remedies fairly promptly, call the doctor for further advice on management. This is especially important if any of the symptoms indicating complications develop, particularly high fevers, headaches, neck stiffness, lower abdominal pain or testicular pain. These are the main problem areas.
A vaccine is available for children to prevent mumps. This may be given at the age of 12 months, and consists of one single injection. In time, it may be available as a combined mumps-measles vaccine. Its use is not widespread at present, for some doctors do not think mumps is serious enough to warrant routine immunization, but this attitude is now rapidly altering. In 1981 the National Health and Medical Research Council recommended routine immunization of children against mumps.
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