Mumps: Symptoms, Causes, Treatment, and Prevention

Overview

Mumps is a contagious viral infection that primarily affects the salivary glands, particularly the parotid glands located below and in front of the ears. While mumps can occur at any age, it most commonly affects children between 5 and 15 years old. Before the introduction of the mumps vaccine, it was a common childhood disease. Thanks to widespread vaccination, cases have significantly declined—by over 99% in the U.S. since the pre-vaccine era, according to the CDC.

However, outbreaks can still occur, especially in unvaccinated populations or close-contact settings like schools or colleges. In recent years, the U.S. has seen a few hundred to a few thousand cases annually, with larger outbreaks in 2016 and 2017. Globally, mumps remains a concern in regions with lower vaccination rates.

Symptoms

Mumps symptoms typically appear 16 to 18 days after infection, though this incubation period can range from 12 to 25 days. Some people, especially those who are vaccinated, may have very mild symptoms or none at all. Common symptoms include:

• Swollen salivary glands: The hallmark symptom is painful swelling of the parotid glands, which can cause the cheeks to puff out. Swelling may occur on one or both sides and can make it difficult to open the mouth or swallow.
• Fever: Often between 101°F (38.3°C) and 103°F (39.4°C), accompanied by chills.
• Headache and muscle aches: Generalized discomfort or pain in muscles and joints.
• Fatigue and weakness: A feeling of tiredness that may persist for several days.
• Loss of appetite: Due to difficulty chewing or swallowing.
• Pain while chewing or swallowing: Caused by swollen glands.

Less common symptoms may include:

• Mild abdominal pain
• Dry mouth
• Sore throat
• Earache (due to pressure from swollen glands)

Symptoms usually resolve within 7 to 10 days, with gland swelling peaking around day 3 and subsiding by day 7. However, fatigue may linger for several weeks.

Causes and Risk Factors

Mumps is caused by the mumps virus, a member of the Paramyxovirus family. It spreads through:

• Direct contact with respiratory droplets (e.g., coughing, sneezing, or talking).
• Sharing items like cups, utensils, or water bottles with an infected person.
• Touching surfaces contaminated with the virus and then touching the mouth or nose.

The virus is most contagious from 2 days before symptoms appear to 5 days after. People with mumps should isolate during this period to prevent spreading the infection.

Risk Factors

Certain factors increase the risk of contracting mumps:

• Lack of vaccination: The MMR vaccine (measles, mumps, rubella) is highly effective. Two doses are about 88% effective at preventing mumps, while one dose is about 78% effective.
• Age: Children and young adults (especially those in close-contact settings like colleges) are at higher risk during outbreaks.
• Weakened immune system: People with conditions like HIV/AIDS or those taking immunosuppressant medications may be more susceptible.
• International travel: Traveling to areas with low vaccination rates or ongoing outbreaks increases exposure risk.
• Seasonal trends: Mumps cases often peak in winter and spring.

Diagnosis

Mumps is often diagnosed based on symptoms, particularly the characteristic swelling of the parotid glands. However, lab tests may be used to confirm the diagnosis, especially in areas with low mumps prevalence or during outbreaks. Common diagnostic methods include:

• Reverse transcription-polymerase chain reaction (RT-PCR): This test detects the mumps virus in samples from the throat, saliva, or cerebrospinal fluid (if meningitis is suspected). It is highly accurate and can confirm mumps even in vaccinated individuals with mild symptoms.
• Viral culture: A sample from the throat or saliva is cultured to grow and identify the virus. This method is less common due to its slower turnaround time.
• Blood tests (serology): These tests check for antibodies to the mumps virus. IgM antibodies indicate a recent infection, while IgG antibodies suggest past infection or vaccination.

Your healthcare provider may also perform a physical exam to check for gland swelling and rule out other conditions with similar symptoms, such as:

• Swollen lymph nodes (lymphadenopathy)
• Salivary gland stones or infections
• Other viral infections (e.g., influenza, Coxsackie virus)

Treatment Options

There is no specific antiviral treatment for mumps; the infection typically resolves on its own. Treatment focuses on relieving symptoms and preventing complications. Options include:

Medications

• Pain relievers: Over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) can reduce fever and ease discomfort. Avoid aspirin in children due to the risk of Reye’s syndrome.
• Warm or cold compresses: Applying a warm washcloth or ice pack to swollen glands can help reduce pain and swelling.
• Hydration and nutrition: Drink plenty of fluids (water, broth, herbal tea) to stay hydrated. Eat soft foods like soup, yogurt, or mashed potatoes to avoid chewing discomfort.

Lifestyle and Home Remedies

• Rest as much as possible to help your body recover.
• Avoid acidic foods or drinks (e.g., citrus, soda) that may irritate swollen glands.
• Gargle with warm salt water to soothe throat pain.
• Practice good hygiene, such as frequent handwashing, to prevent spreading the virus.

When Hospitalization Is Needed

Most cases of mumps can be managed at home. However, hospitalization may be required if complications arise, such as:

• Severe dehydration due to difficulty swallowing.
• Meningitis or encephalitis (inflammation of the brain or its lining).
• Orchitis (testicular swelling) or oophoritis (ovarian swelling) with severe pain.

Living with Mumps

If you or your child has mumps, follow these tips to manage daily life and prevent spreading the virus:

• Isolate for 5 days: Stay home from school, work, or public places for at least 5 days after symptoms begin to avoid infecting others.
• Wear a mask: If you must be around others, wear a surgical mask to reduce the risk of transmission.
• Avoid sharing items: Do not share utensils, cups, towels, or toothbrushes.
• Disinfect surfaces: Regularly clean commonly touched surfaces (e.g., doorknobs, countertops) with disinfectant.
• Monitor for complications: Watch for signs of worsening symptoms, such as severe headache, stiff neck, or abdominal pain, and seek medical attention if they occur.

Most people recover fully within 2 weeks, though fatigue may persist longer. Children can typically return to school or daycare after the isolation period, provided they feel well enough.

Prevention

The most effective way to prevent mumps is through vaccination. The MMR vaccine protects against measles, mumps, and rubella and is recommended as part of routine childhood immunizations. The WHO and CDC recommend:

• First dose: At 12 to 15 months of age.
• Second dose: Between 4 and 6 years of age (before starting school).

For unvaccinated older children and adults, the CDC recommends:

• One or two doses of the MMR vaccine, depending on risk factors (e.g., healthcare workers, international travelers, or college students).

Other preventive measures include:

• Ensuring all family members are up to date on vaccinations.
• Avoiding close contact with infected individuals.
• Practicing good hygiene, such as handwashing and covering coughs/sneezes.
• Boosting immunity through a healthy diet, regular exercise, and adequate sleep.

If you’re unsure about your vaccination status, consult your healthcare provider. They can perform a blood test to check for immunity or recommend vaccination if needed.

Complications

While most people recover from mumps without issues, complications can occur, especially in adolescents and adults. Potential complications include:

• Orchitis: Inflammation of the testicles, which occurs in up to 30% of post-pubescent males with mumps. It can cause pain, swelling, and, in rare cases, fertility issues.
• Oophoritis: Inflammation of the ovaries, affecting about 5% of post-pubescent females. It may cause abdominal pain but rarely affects fertility.
• Meningitis: Inflammation of the membranes surrounding the brain and spinal cord. Symptoms include severe headache, stiff neck, and light sensitivity. It usually resolves without long-term effects.
• Encephalitis: A rare but serious inflammation of the brain that can cause seizures, confusion, or neurological problems.
• Pancreatitis: Inflammation of the pancreas, leading to abdominal pain, nausea, and vomiting.
• Hearing loss: Permanent hearing loss is rare but can occur if the virus affects the inner ear.
• Miscarriage: Mumps during the first trimester of pregnancy may increase the risk of miscarriage, though it does not cause birth defects.

Complications are more likely in unvaccinated individuals. Prompt medical attention can help manage these issues if they arise.

When to Seek Emergency Care

Key Takeaways

• Mumps is a viral infection that causes swollen salivary glands, fever, and fatigue.
• The MMR vaccine is the best way to prevent mumps and its complications.
• Most cases resolve within 2 weeks with rest, hydration, and symptom relief.
• Complications are rare but can be serious, especially in adolescents and adults.
• Seek emergency care for signs of meningitis, encephalitis, or severe pain.

References

• Centers for Disease Control and Prevention (CDC) – Mumps
• Mayo Clinic – Mumps
• World Health Organization (WHO) – Mumps
• NHS – Mumps
• National Center for Biotechnology Information (NCBI) – Mumps