MUMPS

Dr.T.V.Rao MD
 MUMPS
 Mumps is an acute viral infection of the
paramyxoviruses family. As its alternative
name (infectious parotits) 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.
Data on M ump s
 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.
Th e Ph ylo gen et ic t ree
ORTHOMYXO / PA RAM YXO
Vi ruse s
 Mum ps b elongs to
Pa rmy xov iridae
 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 –
ABS ENT .
 Mump s
 Mumps or epi dem ic pa ro ti tis 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
 In volvem ent o f S ali vary
Gl and s
 Painful swelling of the
salivary glands
(classically the
parotid gland is the
most typical
presentation) Painful
testicular swelling (
orchitis) and rash may
also occur
In volvement o f Par otid Gl and
a Maj or Man ifestati on
 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

Hi ppo cr ate s i n 5th ce ntur y B .C .

 Viral etiology described by Johnson and Good

pasture in 1934

 Frequent cause of outbreaks among military

personnel in prevaccine era
Mumb lin g s peech - M umps
 Na me
"m ump s"
co mes f ro m
an ol d wo rd
for " lu mp" o r
an ol d wo rd
for
"m umb le. "
Mu mps Viru s
 Paramyxoviruses

 RNA virus

 One antigenic type

 Rapidly inactivated by
chemical agents, heat
and ultraviolet light
Prop ert ies of MU MPS viru s.
 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.

Pa thogen es is - Mu mps
 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
Mum ps C linic al Fe atu res
 Incubation period 14-18
days
 Nonspecific prodrome
of myalgia, malaise,
headache, low-grade
fever
 Parotitis in 30%-40%
 Up to 20% of infections
asymptomatic
 Mump s Clin ica l Ca se
Def in it ion
 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
Immu nit y
 Antibodies are
produced against the
S and V surface
antigens..
 Mumps rare before 6
months of age.
Definiti on o f M umps Im mu nity
 Documentation of adequate
vaccination
 Serologic evidence of mumps
immunity
 Birth before 1957
 Documentation of physician-
diagnosed mumps in the past
 Comp lic ation wit h M UM PS .
 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,
 Comp lic ation wit h M UM PS .
 Orc hi ti s .
This inflammatory condition
causes swelling of one or both testicles.
Orchitis is painful.
 Panc reat it is. .
 Enc epha lit is. 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.
 Comp lic ation wit h M UM PS .
 Meningi ti s. Meningitis is infection and
inflammation of the membranes and fluid
surrounding your brain and spinal cord.
 Infl am mati on of the ova ries . Pain in
the lower abdomen in women may be a
symptom of this problem. Fertility doesn't
seem to be affected.
 Heari ng l oss .
 Mis carri ages.
 Laborat or y Dia gnos is
 No Lab ora tory co nfirmat io n nee ded .
 Atypical infection needs laboratory Diagnosis.
 Virus isolated from
Sali va
Uri ne
CSF.
Culturing in Hu ma n amn io n, He la cel ls .
Immunoflorecence Methods. Isolation in Chick Embryos
EL ISA, Compl eme nt fixa tio n tes ts ,

Doc tort vrao' s ‘e’ l earni ng

 CD C recomm en ds
 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
Vaccin at ion
 Live attenuated
vaccine
Jernyl Lynn St ra in
Grown in chick embryo
fibroblasts
Vaccine as MMR vaccine
A single dose protects
for 10 years.
 Mump s ( MMR) Va ccin e
In dica tion s
 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
Nee d fo r s econd 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
 Pas si ve im muni za tio n
ag ain st mu mps
– 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
 Epidemiolog y
 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.
Pro motin g M ump s V acci nati on
 MMR V ac ci ne
Contrai ndic ati ons a nd Pr ecau ti on s
 Severe allergic reaction to vaccine
component or following a prior dose
 Pregnancy
 Immunosuppression
 Moderate or severe acute illness of other
etiologies
 MMR Va ccin e an d Au tis m
 There is no scienti fi c evid enc e 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
caus al re lat ions hip at the
po pula tion leve l be twee n MM R
va ccine and autism spe ctrum
di so rde rs (ASD) .”

- Institute of Medicine, April 2001

 MMR c om bi ned v acc in e 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 Va cc in e a nd H IV
Inf ec tion
 MMR recommended
for persons with
asymptomatic and
mildly symptomatic
HIV infection
 NOT recommended
for those with
evidence of severe
immuno- suppression
 HIV test ing befor e
va cc ina ti on is not
recomme nde d
 Mump s con tro l:
 Mumps co ntr o l: The control of mumps can be
achieved through high routine coverage with an
effective mumps-containing vaccine
administered at 12–18 mont hs of a ge .
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.
Created for Awareness to
Medical and Health Care
Workers in the Developing
World
Dr.T.V.Rao MD
Em ail
doctortvrao@gmail.com