Diagnosis
Usually, mumps can be diagnosed by the patient’s clinical presentation (symptoms). At times, not all mumps cases display classical symptoms of orchitis and parotitis, and some individuals may present without this classical presentation
Laboratory testing then becomes necessary to confirm a mumps infection. Clinical symptoms and positive laboratory tests can confirm a mumps infection.
Lab tests include antibody testing, viral cultures, or real-time reverse transcription polymerase chain reaction (rRt-PCR).
When the individual suspected of mumps infection initially presents himself, the clinician should collect 2 specimens: a buccal swab for RT-PCR and a blood serum specimen for IgM and IgG antibodies.
Mumps virus can be isolated in viral cell culture or it can be detected by rRT-PCR from nasopharyngeal swabs, fluid from the buccal cavity, or urine, though a urine sample is less preferred.
rRT-PCR test can be done from seven days before and until nine days after the onset of parotitis (parotid salivary gland inflammation).
Ideally, though, buccal specimens should be collected within 3 days of the onset of parotid gland swelling and no later than 8 days after.
Serological testing of blood serum to detect the presence of mumps-specific IgM antibodies in saliva samples is done during the first six weeks (between one and six weeks) after the onset of rash or parotid swelling. This test is sensitive and if positive, confirms the diagnosis.
However, the IgM antibodies may not be detectable for up to 5 days after the symptoms have presented in unvaccinated individuals and may not be detectable at all in vaccinated people.
Detection of IgM antibodies indicates that you have an active mumps infection or had one recently. The IgM antibodies appear early after exposure to the virus, reach a peak concentration, and then decline and disappear after 8 to 12 weeks.
An IgM antibody test can come falsely negative and if your clinical symptoms are suspicious of mumps, further tests should be done.
If IgG antibodies are found in serum, it indicates a past infection or you have been vaccinated with the mumps vaccine. The IgG antibodies are not detected early after your exposure to the mumps virus but appear over time and remain in your body for life offering you life-long immunity against mumps.
Treatment
Mumps is a notifiable disease and clinicians treating patients with confirmed mumps should notify the concerned state health authority according to the public health laws and regulations of the respective state.
There is no specific treatment for mumps. It is a viral infection and the disease is allowed to run its course. No antiviral drug is indicated for the treatment of this viral illness, as mumps is a self-limiting disease.
Mumps without any major complications can be managed on an OPD (outpatient) basis. Management is mostly supportive and includes:
- Adults should isolate for at least five days after the onset of the salivary glands swelling. Children should isolate themselves until their symptoms are completely resolved.
- Bed rest
- Avoid spicy and oily foods. Eat foods that are easy to chew and swallow.
- Maintain oral hygiene.
- Medication such as ibuprofen and acetaminophen for fever and pain relief can be taken. Aspirin should not be taken by children under 16.
- Stay well-hydrated. Consume plenty of oral fluids to avoid dehydration
- Use a warm or cold compress for swollen and painful salivary glands
- Similar fermentation can be given for swollen and painful testicles along with scrotal support
Mumps infection is mostly self-limiting and ends as the immune system of the body clears it. Most uncomplicated cases resolve within 3 to 10 days.
Prevention
Prevention requires self-help measures and taking the mumps vaccine (MMR vaccine).
Self-help measures
- Wash your hands regularly with soap and water every day
- Wear a mask that covers your eyes and nose, especially during an outbreak
- Wear glasses or goggles, especially in crowded places
- Avoid traveling in crowded conveyances, especially during an outbreak
- Avoid touching any objects unnecessarily
- Avoid traveling to places where mumps is endemic
- Avoid shaking hands
- Do not share utensils, water bottles, glasses, cups, and towels with other individuals
- Take the mumps MMR vaccine if you haven’t taken one.
MMR vaccine
The best way to protect yourself against mumps is to take the mumps vaccine. It is called the MMR vaccine and offers you protection against measles, mumps, and rubella. Children should get two doses of the MMR vaccine
- First dose at age 12–15 months
- Second dose at age 4–6 years
Getting two doses of the vaccine can reduce the risk of mumps by 88%. If you have one dose, it can reduce the risk by 78%.6 If you aren’t sure whether you have had the vaccine, you can take the vaccine.
If an infant has been immunized at less than one year of age, it will still require 2 additional doses given after their first birthday as prescribed above.
Susceptible vaccinated individuals, who have had a history of contact with an infected individual or are at an increased risk of mumps during an outbreak, should be vaccinated with a third dose.
The vaccine may cause a mild non-communicable infection. There is a fever of more than 38° C, 5 to 10 days after inoculation in less than 15% of cases, which can be followed by skin rash. Central nervous system symptoms are exceedingly rare. As believed by some, the MMR vaccine does not cause autism.
Teenagers and adults who do not have presumptive evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.
If you, as a teenager or adult, do not have written proof of having taken the MMR vaccine, you should get vaccinated with two doses of MMR vaccine separated by at least 28 days.
The vaccine is safe and presents no harm if you take another dose even if you are already immune to measles, mumps, or rubella.
However, MMR is a live vaccine and it is contraindicated during pregnancy and in severely immune-suppressed individuals.
