Mumps
From Free net encyclopedia
| Mumps virus | |
|---|---|
| Image:PHIL 1874.jpg TEM micrograph of the mumps virus. Template:Taxobox begin placement virus Template:Taxobox group v entry | |
| Order: | Mononegavirales |
| Family: | Paramyxoviridae |
| Genus: | Rubulavirus |
| Species: | Mumps virus |
|}
- For the computer language of the same name, see MUMPS.
Mumps or epidemic parotitis is a viral disease of humans. Prior to the development of vaccination and the introduction of MMR vaccine, it was a common childhood disease worldwide, and is still a significant threat to health in the third world.<ref name=Harrison>Template:Cite book</ref>
Painful swelling of the salivary glands (classically the parotid gland) and fever is the most typical presentation.<ref name=Barron>Template:Cite book</ref> Painful testicular swelling and rash may also occur. While symptoms are generally not severe in children, in teenagers and adults, the symptoms can be more severe and complications such as infertility or subfertility are relatively common, although still rare in absolute terms.<ref>Template:Cite journal }}</ref>,<ref>Template:Cite journal }}</ref>,<ref>Template:Cite journal }}</ref> The disease is generally self-limiting, and there is no specific treatment apart from controlling the symptoms with painkillers.
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Contents |
Causes and risks
The mumps are caused by a paramyxovirus, and are spread from person to person by saliva droplets or direct contact with articles that have been contaminated with infected saliva. The parotid glands (the salivary glands between the ear and the jaw) are usually involved. Unvaccinated children between the ages of 2 and 12 are most commonly infected, but the infection can occur in other age groups. Orchitis (swelling of the testes) occurs in 10–20% of infected males, but sterility only rarely ensues; a viral meningitis occurs in about 5% of those infected. In older people, the central nervous system, the pancreas, the prostate, the breasts, and other organs may be involved.
The incubation period is usually 18 to 21 days, but may range from as few as 12 to as many as 35 days.<ref name=Barron /> Mumps is generally a mild illness in children in developed countries. After adolescence, mumps tends to affect the ovary, causing oophoritis, and the testes, causing orchitis. The mature testis is particularly susceptible to damage from mumps which can lead to infertility. Adults infected with mumps are more likely to develop severe symptoms and complications. [1] [2]
Symptoms
The more common symptoms of mumps are:
- Swelling of the parotid gland (or parotitis) in >90% of patients, and pain behind the lower jaw when chewing.
- Fever
- Headache
- Sore throat
- Orchitis, referring to painful inflammation of the testicle.<ref>Template:Cite journal }}</ref>
Signs and tests
A physical examination confirms the presence of the swollen glands. Usually the disease is diagnosed on clinical grounds and no confirmatory laboratory testing is needed. If there is uncertainty about the diagnosis, serology or a saliva test for the virus may be carried out.
Treatment
Palliative treatments
There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck area and by acetaminophen (paracetamol) for pain relief (aspirin is discouraged in children with a viral illness because of the risk of Reye's syndrome). Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.
Patients are advised to avoid fruit juice or any acidic foods, since these stimulate the salivary glands, which can be painful.
Research treatments
- A 1996 publication reported that a chemical extracted from Spirulina platensis, a species of blue-green algae, inhibited mumps virus replication in a viral plaque assay.<ref>Template:Cite journal }}</ref>
- A University of Tokyo research group reported in 1992 that research compound TJ13025 ((6'R)-6'-C-methylneplanocin A) had an antiviral effect on four Mumps virus strains cultured in Vero cells.(see 16526604, tables 1 and 2) Additional research improved the synthesis of a particular isomer, RMNPA, of TJ13025 from the racemic product.<ref name=Shuto_1997>Template:Cite journal }}</ref><ref name=Shuto_2002>Template:Cite journal }}</ref>
- A 2005 publication in a Russian journal reports that Myramistin has antiviral activity against mumps virus in vero cells culture.<ref>Template:Cite journal }}</ref>
Prognosis
The disease is self-limiting, and general outcome is good, even if other organs are involved. Sterility in men from involvement of the testes is very rare. After the illness, life-long immunity to mumps generally occurs.
Complications
Known complications of mumps include:
- Infection of other organ systems
- Sterility in men (this is quite rare, and mostly occurs in older men)
- Mild forms of meningitis (rare, 40% of cases occur without parotid swelling)
- Encephalitis (very rare, rarely fatal)
- Profound (91 dB or more) but rare sensorineural hearing loss, uni- or bilateral
Prevention
The most common preventative measure against mumps is the MMR immunization (vaccine). This not only protects against mumps, but also protects against measles and rubella. The WHO recommends the use of mumps vaccines in all countries with well-functioning childhood vaccination programmes. In the United Kingdom it is routinely given to children at age 15 months. The American Academy of Pediatrics recommends the routine administration of MMR vaccine at ages 12-15 months and 4-6 years. [3] The vaccination is repeated in some locations between 4 to 6 years of age, or between 11 and 12 years of age if not previously given. Efficacy of the vaccine depends on the strain of the vaccine, but is usually around 80%. <ref>Template:Cite journal }}</ref>,<ref>Template:Cite web</ref>
Some anti-vaccine activists protest against the administration of a vaccine against mumps, claiming that the attenuated vaccine strain is harmful, and/or that the wild disease is beneficial. Disagreeing, the WHO, the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, the American Academy of Family Physicians, the British Medical Association and the Royal Pharmaceutical Society of Great Britain currently recommend routine vaccination of children against mumps. The British Medical Association and Royal Pharmaceutical Society of Great Britain had previously recommended against general mumps vaccination, changing that recommendation in 1987. In 1988 it became United Kingdom government policy to introduce mass child mumps vaccination programmes with the MMR vaccine, and MMR vaccine is now routinely administered in the UK.
Before the introduction of the mumps vaccine, the mumps virus was the leading cause of viral meningoencephalitis in the United States. However, encephalitis occurs rarely (less than 2 per 100,000).<ref name=PinkBook_2006>Template:Cite book</ref> In one of the largest studies in the literature, the most common symptoms of mumps meningoencephalitis were found to be fever (97%), vomiting (94%) and headache (88.8%).<ref>Template:Cite journal }}</ref> The mumps vaccine was introduced into the United States in December 1967: since its introduction there has been a steady decrease in the incidence of mumps and mumps virus infection. There were 152,209 cases of mumps reported in 1968; in 1998 there were only 666 cases reported.
Recent Outbreaks
Wisconsin (2006)
As of April 19th, there are 14 confirmed cases in Wisconsin, and half of these are at the University of Wisconsin-Milwaukee campus. A vaccination clinic is being held at UWM in response to this as questions rise as about the cause of the outbreak.
As of April 21st there are now 10 confirmed cases at the University of Wisconsin-Milwaukee campus, and the number of people in contact with this group has expanded to 1000. 3 more vaccination clinics have been scheduled.
Iowa (2005–2006)
In early 2006, for reasons still not fully understood, the state of Iowa experienced a large surge in the number of reported mumps infections.<ref name=MMWR_2006a>Template:Cite journal }}</ref> According to the New York Times, college students accounted for about a quarter of the 245 cases [4], while about half of the cases are people aged 17 to 25. Doctors are attributing the rise in mumps case frequency to low vaccination rates in Iowa's youth, coupled with the close quarters in dormitories, classrooms and cafeterias. Template:Quotation Still more cases are being reported from this outbreak, the majority of them in Dubuque County.
According to Canadian media reports [5], there may be something novel about this mumps strain which indicates a standard MMR-series vaccination is not 95% effective, as was thought. Although there may not be a direct link with the mumps outbreak in Ireland, CDC Director Dr. Julie Gerberding has been quoted stating that the genotype from the U.S. outbreak, "in the early cases of this outbreak, was the same genotype of virus that was associated with the United Kingdom outbreak." [6] Entrez Gene contains a placeholder database record for a new Mumps gene; the record is dated 23 Feb 2006.[7]
As of April 14, 2006, in addition to Iowa, which has seen an epidemic of more than 600 suspected cases since December, other states reporting cases are California, Illinois, Kansas, Minnesota, Missouri, Nebraska, and Wisconsin. The Centers for Disease Control and Prevention agency has not yet released the name of the eighth Midwestern state, however there have been confirmed cases in Michigan [8]. The mumps outbreak is the nation's largest in 20 years.
There have been three confirmed cases of the mumps at Southern Illinois University-Carbondale, and has spread to three other neighboring counties in the Southern Illinois area.
As of April 18, 2006, 815 cases have been reported [[9]] in Iowa alone, representing a caseload increase of 200 in the last week.
United Kingdom
In the United Kingdom over the last two years, a mumps outbreak has involved over 100,000 patients.[10]<ref>Template:Cite journal }}</ref> The cause of the outbreak is low immunity in those too young to have received MMR, but old enough to have not had Mumps as children. A catch-up programme of immunisation of under 25 year olds, particularly in university towns such as Exeter was implemented.