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24 November, 2009

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Mumps

Mumps is a viral illness that causes fever and swollen salivary glands. Serious and potentially lethal complications include inflammation of the brain (encephalitis) or heart muscle (myocarditis). The disease is spread from person-to-person and is about as contagious as the flu.

Mumps is uncommon in developed countries including Australia because of the widespread use of the mumps vaccine. However, outbreaks still occur so it is important to continue vaccinating children.

Symptoms
Signs and symptoms of mumps may include:

Fever
Headache
Fatigue
Weight loss
Swollen parotid gland (the salivary gland located just in front of the ear) on one or both sides of the face
Painful chewing
Painful swallowing.

Complications
The inflammation may spread to other areas of the body. Some of the complications of mumps can include:

Mastitis – breast inflammation
Orchitis – testicle inflammation
Oophoritis – ovary inflammation
Meningitis – inflammation of the membranes called ‘meninges’ surrounding the brain and spinal cord
Encephalitis – brain inflammation
Myocarditis – heart muscle inflammation
Pancreatitis – pancreas inflammation
Hepatitis – liver inflammation
Thyroiditis – thyroid inflammation
Miscarriage in the first trimester of pregnancy
Nerve deafness, usually in both ears.

How it is spread
Mumps is about as contagious as the flu. Mumps is most commonly spread when someone ingests (swallows) or inhales the cough or sneeze droplets from an infected person. The virus is also carried in urine. Symptoms occur between 14 and 25 days following infection.

One person in three who contracts mumps does not have any symptoms and doesn’t realise they are sick; however, they are still contagious and may infect a lot of other people. An apparently healthy person who spreads an infectious disease is called a ‘carrier’.

High-risk groups
Mumps is uncommon in Australia thanks to vaccination, but cases still occur. At high risk is anyone who hasn’t been vaccinated, particularly if they travel to developing nations where vaccination programs aren’t widespread.

Diagnosis
Tests used to diagnose mumps may include:

Medical history, including immunisation status
Physical examination
Travel history
Blood test.

Treatment
No specific medical treatment for mumps exists. Antibiotics don’t work because the illness is viral. Treatment aims to ease symptoms and reduce the risk of complications. Options may include:

Bed rest
Plenty of fluids
Paracetamol to reduce pain and fever
Cold compresses held against the swollen parotid glands
Soft and easy to swallow foods such as soup, porridge or pureed vegetables
Isolation, to reduce the risk of spreading the disease.

Seek medical attention
An uncomplicated case of mumps usually resolves within about two weeks. See your doctor if the sick person:

Complains of pain anywhere else, as this may be a sign of inflammation in another organ
Runs a high fever
Appears to be getting sicker.

Prevention
Immunisation is the best way to prevent mumps. People who are caring for someone with mumps should practice strict hygiene. For example, you should wash your hands frequently, particularly before handling, preparing or eating food and after visiting the toilet or changing a nappy. Don’t share food or drink utensils. Encourage the sick person to cough or sneeze into a tissue.

Vaccination is available
The mumps vaccine in Australia is combined with measles and rubella (German measles) vaccines. A free vaccine that offers protection against mumps is available to:

Young children – at 12 months of age
Children – at four years of age
School-age children – as a ‘catch-up’ immunisation, if they have not been fully vaccinated.

Immunisation is also recommended for adults born during or since 1966 – unless you have evidence of having received two doses of MMR. If you have not received the vaccine, speak to your doctor about catch-up doses.

Vaccination is not suitable for everyone
Not everyone should have the mumps vaccination. A person with an impaired immune system should not be vaccinated. Some of the possible causes of impaired immunity may include:

Taking certain medications such as corticosteroids
Receiving immunosuppressive treatment
Having some types of cancer such as Hodgkin’s disease or leukaemia
Hypogammaglobulinaemia, a congenital or acquired condition characterised by extremely low levels of antibodies.

Pregnancy
You should not be given the vaccine if you are already pregnant and pregnancy should be avoided for 28 days after the vaccination.

Pre-immunisation checklist
Before immunisation, it is important that you tell your immunisation provider if you (or your child) are:

Unwell (temperature over 38.5˚C)
Have had a serious reaction to any vaccine
Had a severe allergy to anything
Have had a ‘live’ vaccine in the last month
Pregnant.

Possible side effects of the vaccine
The vaccine is effective and safe. However, all medicines can have unwanted side effects. Side effects from the mumps vaccine are uncommon and usually mild but may include:

High fever (over 39˚C)
Faint red rash (not infectious)
Drowsiness or tiredness
Head cold or runny nose
Cough
Puffy eyes
Swollen salivary glands
Soreness and redness at the injection site.

Treating mild side effects
Some side effects may occur up to 10 days after immunisation but usually resolve quickly. There are a number of treatment options to reduce the side effects of the vaccination:

Paracetamol to reduce any fever – check the label for the correct dose (especially for children)
A cold, wet cloth held against the injection site
Extra drinks
Appropriate clothing – do not overdress.

Anaphylaxis is an extremely rare side effect
There is a very small risk of a serious allergic reaction to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following vaccination in case further treatment is required. Apart from anaphylaxis, other extremely rare side effects include encephalitis and thrombocytopenia (abnormal bleeding caused by insufficient blood platelets).

If reactions are severe and persistent, or if you are worried, contact your doctor for further information.

Where to get help

Your doctor
Always call an ambulance in an emergency Tel. 000
Emergency department of your nearest hospital
Your local council immunisation service
Immunisation Program - Department of Health Victoria – Tel. 1300 882 008
Nurse on Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
The Maternal and Child Health Line is available 24 hours a day Tel. 132 229.
National Immunisation Infoline Tel. 1800 671 811

Things to remember

Mumps is a viral illness that causes fever and swollen salivary glands.
Mumps is uncommon in developed countries including Australia due to the widespread use of the mumps vaccine.
Mumps is contagious, so people caring for someone with mumps should practice strict hygiene: for example, wash hands frequently, particularly before handling, preparing or eating food.

You might also be interested in:
Chickenpox.
Diphtheria.
Immunisation - childhood.
Immunisation - common misconceptions.
Infections - bacterial and viral.
Measles.
Rubella.
Tetanus.
Vaccines.
Whooping cough.

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