How Do Mumps Start?

Mumps is a viral illness that attacks the salivary glands and causes swelling in the face.

Mumps is a viral illness characterized by the swelling of the salivary glands (the parotid glands) in front of the ears and above the jaw.

Symptoms of mumps include:

• Swelling of the salivary glands in front of the ears and above the jaw
• Fever
• Headache
• Feeling unwell (malaise)
• Ear pain localized near the ear lobe that is aggravated by chewing 
• Sour taste in the mouth
• Sudden hearing loss may occur 
• Tender swelling of the thyroid gland (thyroiditis) may occur 
• Pancreatitis (severe, rare); symptoms include upper abdominal pain and tenderness, accompanied by fever, chills, nausea, and vomiting
• Inflammation of the testicles
• Inflammation of ovaries and/or Fallopian tubes; symptoms include abdominal and/or pelvic pain and tenderness

Mumps are caused by infection with the Paramyxovirus mumps virus.

Risk factors for developing mumps include:

• Not being immunized
• International travel
• Immune deficiencies 

Laboratory studies used to diagnose mumps include:

• Serum amylase 
• Serum lipase 
• Complete blood cell (CBC) with differential 
• C-reactive protein 
• Erythrocyte sedimentation rate (ESR)
• Urine tests
• Nasopharyngeal swabs, blood, and fluid from the mouth 
• Cell cultures 
• Polymerase chain reaction (PCR) assay of the cerebrospinal fluid (CSF) 
• Immunoglobulin M (IgM) titer 
• Mumps-specific immunoglobulin G (IgG) antibody titers 

Imaging studies may be needed if certain complications associated with mumps infection arise such as meningitis or encephalitis: 

• Head computed tomography (CT) scans without contrast 
• Scrotal ultrasonography when orchitis is suspected

Complicated cases of mumps may require additional testing to determine if other organs are involved, such as

• Auditory testing if there is hearing impairment
• Lumbar puncture to obtain CSF if meningitis or encephalitis are suspected

If there are no major complications, mumps usually goes away on its own within about 2 weeks. Patients diagnosed with mumps should be isolated for five days from the onset of symptoms so as not to infect others. Treatment is directed at relieving symptoms, and may include:

• Adequate oral fluid intake and hydration 
• Bed rest
• Avoid acidic foods (e.g., tomato, vinegar-containing food additives) and liquids (e.g., orange juice) because they can cause swallowing problems and gastric irritation
• Pain relievers (analgesics) such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for headaches or discomfort 
• Topical application of warm or cold packs to the swollen parotid area 
• Stronger pain relievers may be needed or patients with orchitis (testicular swelling) along with bed rest, scrotal support, and ice packs

Patients with complications such as meningitis, encephalitis, myocarditis, nephritis, or severe pancreatitis may require inpatient care such as:

• Intravenous fluid stabilization
• Pain management
• Continuous close observation

Complications from mumps infection include:

• Aseptic meningitis/encephalitis
• Hearing loss/deafness 
• Inflammation of the spinal cord (transverse myelitis)
• Loss of muscle control or coordination (with encephalitis)
• Nerve inflammation (polyneuritis)
• Guillain-Barré syndrome
• Eye inflammation (keratouveitis)
• Inflammation of the heart muscle (myocarditis)
• Inflammation of the thyroid gland (thyroiditis)
• Inflammation of breast tissue (mastitis)
• Pneumonia
• Pancreatitis
• Arthritis
• Kidney inflammation (nephritis)
• Inflammation of the testicles (orchitis)
• Inflammation of ovaries and/or Fallopian tubes (oophoritis)
• Thrombocytopenia purpura

If patients have no complications associated with mumps, the prognosis is excellent.

Death due to mumps is rare because of vaccines. More than half of all fatalities occur in patients older than 19 years.

The main way to prevent mumps and mumps complications is with immunizations (vaccines). The measles-mumps-rubella (MMR) and measles-mumps-rubella-varicella (MMRV) vaccines contain immunizations for the mumps. Two doses of mumps vaccine are 88% (range 31% to 95%) effective at preventing the disease; one dose is 78% (range 49% to 91%) effective.