Disease Information for Mumps: Definition

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  • An acute infectious disease caused by RUBULAVIRUS, spread by direct contact, airborne droplet nuclei, fomites contaminated by infectious saliva, and perhaps urine, and usually seen in children under the age of 15, although adults may also be affected; (From Dorland, 28th ed.) Epidemiology; Peak Age 10-19 years; Incidence U.S. Cases in 1968: 152,000! U.S. Cases in 2000: 338 cases! Caused by paramyxovirus; Transmission; Infected Salivary secretions or urine; Infectious: Start: 6 days before Parotitis ; Ends: 2 weeks after symptom onset; Incubation: 12-25 days; Subclinical presentation in 30-40% of cases; Sudden onset pain in cheeks; Provoked by chewing or swallowing; Worse with sour foods; Fever ; Malaise; Headache ; Anorexia; Signs: Sialadenitis and Parotitis ; Tender swelling of all Salivary Glands; Skin over Parotid Gland not warm or red ; Contrast with Bacterial Sialadenitis; Tenderness at mandibular angle; Parotid duct opening appears red in Buccal mucosa ; Orchitis (20-35% of postpubertal males); Occurs 7-10 days after Parotitis; Testicular Atrophy (50%); Sterility if bilateral involvement;

    Complications: Pancreatitis (usually uncomplicated); Central Nervous System Involvement; Asymptomatic Cerebrospinal Fluid Leukocytosis (50%); Less common causes: Encephalitis (1 case per 400 to 6000 Mumps cases); Bacterial Sialadenitis; Tenderness at mandibular angle; Parotid duct opening appears red in Buccal mucosa ; Orchitis (20-35% of postpubertal males); Occurs 7-10 days after Parotitis; Testicular Atrophy (50%); Sterility if bilateral involvement; Also Encephalitis mortality Mortality: 1-2% death rate; Paralytic Polio-like syndrome; Transverse myelitis; Cerebellar ataxia; Miscellaneous: Subacute Thyroidis; Dacryoadenitis; Optic Neuritis; Iritis; Conjunctivitis; Myocarditis ; Hepatitis; Thrombocytopenia Purpura ; nterstitial Pneumonia; Migratory Polyarthritis; Labs: Complete Blood Count; Parotitis: Relative Lymphocytosis ; Orchitis: Marked Leukocytosis; Serum Amylase increased; Cerebrospinal Fluid : White Blood Cells: 1000-2000 with Neutrophils ; Culture: Blood, Throat, CSF, Urine; Immunofluorescence positive in 2-3 days; Serology Titer increases 4 fold; RX Orchitis Symptomatic relief : Prednisone 60 mg qd tapered over 7-10 days; Prevention :MMR Vaccine after age 1 year; Prognosis good.

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