Mumps

Mumps is a contagious viral infection that affects not only children, but also adults. Typical symptoms are painful, swollen parotid glands between the masticatory muscle and the ear. In particular, teens and adults can be affected by complications such as testicular inflammation or meningitis and deafness.  

Initial symptoms appear between approx. 2 to 3 weeks after infection with the virus. Typically, the parotid glands on one or both sides become painful and swollen. This lasts for approximately 6 to 8 days. The parotid glands on the lower jaw and under the tongue can be affected as well. Prior to this, a person may experience headaches, aching limbs, fever, and a loss of appetite for multiple days. 

Patients are contagious as early as 7 before to 9 days after the swollen parotid glands appear. Even infected persons without symptoms can transmit the virus.  

Mumps is caused by the mumps virus and is found globally. The virus occurs only in humans, therefore mumps is always transmitted only from human to human.

The mumps virus is spread via “respiratory droplets”. Tiny droplets from the nose and mouth contain the virus and are distributed in the air. This happens when someone talks, sneezes, or coughs. Other people become infected with the virus through the air or direct contact with saliva. Transmission through objects that have the virus on their surface is rather rare. 

Mumps is found throughout the world. In Germany, the prevalence of the mumps infection has sharply declined because most children are vaccinated. However, larger outbreaks do occur now and then. In 2018, there were 0.6 infections per 100,000 inhabitants in Germany.

In young children, the mumps infection often progresses without symptoms or symptoms are similar to those of a cold. However, the older the person is the more often complications appear.

Effects on the central nervous system

Symptoms of the central nervous system (CNS) can occur along with the infection and appear before or after. They can also be the only symptoms during the infection.

These include:

• encephalitis (less than one percent) with paralysis, can be fatal in rare cases
• meningitis (up to 10 percent) with severe headaches, stiff neck and vomiting, however without permanent injury
• temporary loss of hearing of high tones (approx. 4 percent)
• permanent deafness in one ear (one in 20,000)

Testicular inflammation 

Testicular inflammation in one or both testicles appears approx. 4 to 8 days after swollen parotid glands appear and lasts one to two weeks. The fever spikes again and the testicles become swollen and painful. Approximately 15 to 30 percent of infected male teens and adults are affected. In rare cases, testicular inflammation can lead to infertility.

Inflammation of the breasts and ovaries 

Up to 30 percent of infected women experience an infection of the mammary glands, and up to 5 percent experience an infection of the ovaries. Contrary to previous assumptions, mumps in pregnant women does not put the unborn child at risk.

Further possible complications

Further possible complications related to mumps include:

• pancreatitis
• inflammation of the kidneys
• arthritis
• anemia
• myocardial inflammation

A vaccination can provide protection from mumps. The German Standing Committee on Vaccination (STIKO) of the Robert Koch Institute recommends the following procedure: 

Vaccination for children 

Children should receive their first mumps vaccination between the ages of 11 to 14 months. A second vaccination is required between the age of 15 and 23 months. The minimum amount of time between the first and second vaccination is 4 weeks. Missed vaccinations can be administered until 18 years of age. The second dose provides lifelong protection without the need for a booster.  

Vaccination for adults 

Adults born after 1970 who work in the medical field or community facility should receive a vaccination for mumps if they were never vaccinated or vaccinated only once, or if the status of their inoculation protection is unclear.  

Typically, the vaccination is administered as part of a combined live virus vaccine (MMR) that also protects the person from measles and rubella. Doctors can also administer a vaccination (MMRV) that offers additional immunity against chicken pox (varicella).

The website of the Robert Koch Institute provides answers to frequently asked questions about the mumps vaccination. 

Mumps is often diagnosed by the typical swelling of the parotid glands. However, sick persons who have been vaccinated should have the infection confirmed by a lab. Doctors can confirm the virus within 7 days of the onset of symptoms through a throat swab or urine sample. Furthermore, virus antibodies can be found in a blood sample. 

If a mumps infection is confirmed, the type of treatment depends on who has been infected.  

Treating the acutely ill 

There is no special treatment for the mumps virus. Pain medication that lowers fever and has an anti-inflammatory effect can be taken to treat symptoms such as fever and painful swelling of the parotid glands.  

Treatment of contacts 

Anyone born after 1970 without sufficient or with unknown inoculation protection should be vaccinated once against mumps within 3 days of contact with an infected person. This helps to limit the spread of the virus in the event of an outbreak. No action must be taken by people who have been sufficiently vaccinated or who were born before 1970.  

Attending or working at a community facility 

Those who have come in contact may enter a community facility only if they have been sufficiently vaccinated prior to a possible infection. Alternatively, they can be vaccinated immediately after contact. Otherwise, they may not enter the community facility for 18 days.  

Treating high-risk patients 

Patients with a weakened immune system, as well as pregnant women without mumps immunity, are at a higher risk of infection and experiencing complications. However, treatment with antibodies is not effective. Therefore, it is important to limit contact with those who are infected.