Mumps

Topic Overview

What is mumps?

Mumps is a contagious viral infection that can cause painful swelling of the salivary glands , especially the parotid glands , between the ear and the jaw. About 1 out of 3 people with mumps will not have gland swelling. They may have an upper respiratory tract infection ( URI ) instead. ¹

What causes mumps?

Mumps is spread when an infected person coughs or sneezes near you or shares food or drinks.

What are the symptoms?

Mumps can affect many body systems and cause flu-like symptoms, abdominal pain, swollen cheeks, and swollen and painful testicles. But some people who are infected with the mumps virus do not have any symptoms.

The incubation period—the time from when a person is first infected with the virus until the first symptoms develop—is usually 16 to 18 days, although it can be as long as 25 days. Infected people can spread the virus 1 to 2 days before symptoms start and for 5 to 9 days after symptoms start.

How is mumps diagnosed?

Mumps is most often diagnosed by a history of exposure to the disease, the presence of swelling and tenderness of the parotid glands, and other symptoms, including neck stiffness, headache, and painful testicles.

If needed, a blood test, such as an enzyme-linked immunosorbent assay (ELISA, EIA), can be done to confirm the diagnosis and eliminate the possibility that another illness is causing the symptoms.

The mumps virus itself can be identified with a viral culture of samples of urine, saliva, or cerebrospinal fluid obtained by a lumbar puncture . These tests are rarely done.

How is it treated?

In most cases, people recover from mumps with rest and care at home. In complicated cases, hospitalization may be required.

Can mumps be prevented?

Mumps can almost always be prevented by getting a series of shots with the combination measles - mumps - rubella (MMR) vaccine. Two shots provide lifelong protection ( immunity ) against getting mumps: one at 12 to 15 months of age, the other at 4 to 6 years of age. There is also a measles, mumps, rubella, and varicella (MMRV) vaccine that includes a vaccine for chickenpox (varicella). This vaccine is called ProQuad and can be substituted for either or both doses of MMR.

Most babies do not become infected with mumps during their first year of life because of the short-term immunity they received before birth from their mothers. Before the mumps vaccine existed, mumps was a common childhood disease in the United States.

Frequently Asked Questions

Symptoms

The mumps virus enters your body through the nose and throat. You may start to feel symptoms as the virus multiplies and spreads to the brain and the membranes that cover it, to the glands (usually the salivary glands ), pancreas , testicles , ovaries , and to other areas of the body.

Symptoms usually last about 10 days and may include:

• Swelling and pain in one or more of the salivary glands . One or both cheeks may look swollen. Many people consider swollen parotid glands to be a classic sign of mumps, but this symptom can also develop with other conditions.
• Fever of 101 °F (38 °C) to 104 °F (40 °C).
• Headache, earache, sore throat, and pain when swallowing or opening the mouth.
• Pain when eating sour foods or drinking sour liquids, such as citrus fruit or juice.
• Tiredness, with aching in the muscles and joints.
• Poor appetite and vomiting.

Up to one-third of people who are infected with the mumps virus do not have any symptoms, especially children younger than 2 years.

Infected people can spread the virus 1 to 2 days before symptoms start and for 5 to 9 days after symptoms start.

The incubation period—the time from when a person is first infected with the virus until the first symptoms develop—is usually 16 to 18 days, although it can be as long as 25 days.

Contact your doctor immediately if you have symptoms of complications, such as a stiff neck or severe headache (related to meningitis ), painful, tender testicles (from orchitis ), and upper or lower belly pain (caused by pancreatitis or oophoritis ).

Exams and Tests

Mumps is most often diagnosed by a history of exposure to the disease and the presence of symptoms. Swelling and tenderness of the salivary glands , especially the parotid glands, is a common symptom to spot.

If needed, a blood test can be done to confirm the diagnosis and rule out other illnesses. This test measures the level of antibodies the body has developed against the mumps virus.

The mumps virus itself can be identified with a viral culture of a sample of urine, saliva, or cerebrospinal fluid obtained by a lumbar puncture . These tests are rarely done.

Treatment Overview

In cases without complications, mumps is treated with bed rest and care at home.

Home treatment includes medicines you can buy without a prescription to relieve pain and reduce fever. Acetaminophen (for example, Tylenol) or nonsteroidal anti-inflammatory medicines (for example, Advil, Motrin, Aleve) are often used. Do not give aspirin to anyone younger than 20 because of its link to a rare but serious illness called Reye syndrome .

Complications may require treatment in the hospital. Medicines to relieve pain associated with orchitis , meningitis , pancreatitis , and other complications may be given. Treatment with other medicines, such as interferon for severe orchitis, is experimental. Antibiotics are not given to treat mumps or other viral infections.

Home Treatment

Children with mumps should not go to school, day care, or public places until 5 days after the salivary glands first start to swell. ²

In general, it is not necessary to separate a child from the family, because by the time mumps is diagnosed, most household members have already been exposed.

If you or your child has mumps:

• Use acetaminophen for fever or headache. Do not give aspirin to anyone younger than 20 because its use has been linked to a rare but serious illness called Reye syndrome .
• Place an ice or a heat pack, whichever feels better, on the swollen jaw if there is pain from the swelling. Place a light towel between the jaw and the ice pack or heat pack to protect the skin. Remove the pack after 20 minutes.
• Place an ice pack intermittently on tender testicles. Gentle support may also be comforting and reduce swelling. See how to make and use an ice pack.
• Suck on ice chips or flavored ice treats, such as Popsicles. Eat soft foods that do not require chewing.
• Do not eat sour foods or sour liquids. Because infected salivary glands are extremely sensitive, it may be difficult to eat these foods.
• Drink extra fluids or suck on Popsicles. This can help reduce fever and prevent dehydration . But don't force yourself or your child to take fluids. It may cause vomiting.

If you or your child has mumps, call your local health department. The health department needs to record all cases of the illness. If you visit your doctor, he or she will report it for you.

Prevention

Before the mumps vaccine existed, mumps was a common childhood disease in the United States. The mumps vaccine is now routinely given as part of the measles, mumps, and rubella (MMR) vaccine (What is a PDF document?) . There is also a measles, mumps, rubella, and varicella (MMRV) vaccine that includes a vaccine for chickenpox (varicella). The MMRV vaccine is also called ProQuad and can be substituted for either or both doses of MMR. For more information, see the topic Immunizations.

The benefits of the MMR and MMRV vaccines far outweigh the risks. But you may have concerns, such as:

• Whether your child is at risk for autism after receiving the MMR vaccine. Numerous studies show there is no evidence that the MMR vaccine causes or is related to autism. ³
• Whether your child will have an allergic reaction from the MMR vaccine or MMRV vaccine. The risk of allergic reaction from these vaccines is very low.

Check your immunization status before you travel to countries where mumps is common.

Other Places To Get Help

Organizations

Related Information

• Immunizations
• Meningitis
• Swollen Glands and Other Lumps Under the Skin
• Vaccine Information Statements

References

Citations

1. American Academy of Pediatrics (2006). Mumps. In LK Pickering, ed., Red Book: 2006 Report of the Committee on Infectious Diseases, 27th ed., pp. 464–468. Elk Grove Village, IL: American Academy of Pediatrics.
2. Centers for Disease Control and Prevention (2008). Updated recommendations for isolation of persons with mumps. MMWR, 57(40): 1103–1105. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5740a3.htm?s_cid=mm5740a3_e.
3. Madsen KM, et al. (2002). A population-based study of measles, mumps, and rubella vaccination and autism. New England Journal of Medicine, 347(19): 1477–1482.

Other Works Consulted

• American Academy of Pediatrics (2006). Children in out-of-home child care. In LK Pickering, ed., Red Book: 2006 Report of the Committee on Infectious Diseases, 27th ed., pp. 130–145. Elk Grove Village, IL: American Academy of Pediatrics.
• American Academy of Pediatrics (2006). Measles. In LK Pickering, ed., Red Book: 2006 Report of the Committee on Infectious Diseases, 27th ed., pp. 441–452. Elk Grove Village, IL: American Academy of Pediatrics.
• Centers for Disease Control and Prevention (2005). Notice to readers: Licensure of a combined live attenuated measles, mumps, rubella, and varicella vaccine. MMWR, 54(47): 1212–1214. Also available online: http://www.cdc.gov/mmwr/PDF/wk/mm5447.pdf. [Erratum in MMWR, 54(48): 1237. Also available online: http://www.cdc.gov/mmwr/pdf/wk/mm5448.pdf.]
• Elliman D, et al. (2007). Measles, mumps, and rubella: Prevention, search date July 2006. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
• Gnann JW (2008). Mumps. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., pp. 2480–2482. Philadelphia: Saunders.
• Levin MJ, Weinberg A (2009). Mumps section of Infections: Viral and rickettsial. In WW Hay et al., eds., Current Diagnosis and Treatment: Pediatrics, 19th ed., pp. 1105–1106. New York: McGraw-Hill.
• Mason WH (2007). Mumps. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 1341–1344. Philadelphia: Saunders Elsevier.

Credits