Mumps disease. Viral mumps disease (mumps) Is mumps a contagious disease or not?

Parotitis ( piggy) is a respiratory viral infection that poses a serious epidemiological danger due to its high contagiousness. The disease most often occurs in children ( most often at the age of 5 – 8 years). In children under 3 years of age, the infection is extremely rare. The increased risk of infection remains until the age of 15–16 years. Adults are less susceptible to mumps, but the possibility of infection remains.

Mumps does not pose a serious threat to the patient's life, however, much attention is paid to the treatment of the disease due to the high risk of complications. In recent decades, severe disease has been rare. Also, thanks to mass vaccination, the overall incidence of mumps has dropped in most countries.

Interesting Facts

Parotitis often called mumps or behind the ears because of the characteristic swelling of the upper part of the cheeks in front of the ears.
The first description of a classic patient with mumps was made by Hippocrates 2,400 years ago.
Great progress in the diagnosis and treatment of mumps was made by military doctors in the 17th – 19th centuries. During this period, mumps was often observed among soldiers due to the large crowding of people in the barracks and trenches and low level hygiene. Some sources of that time even called it “trench” or “soldier’s” disease.
The viral nature of mumps was proven by infecting monkeys with the saliva of sick people.
Under natural conditions, mumps is a strictly anthroponotic disease, that is, only people get it. Only in laboratory conditions is it possible to transmit the virus to some species of monkeys and dogs, but such animals, although they themselves get sick, no longer pose a risk of infection.
The first vaccine against mumps was obtained only in 1945.
Mumps poses a great epidemic danger, so currently more than 80 countries around the world routinely vaccinate children against of this disease.

The causative agent of mumps

The causative agent of mumps is a virus Pneumophila parotiditis from the family Paramyxoviridae. It is a strand of RNA ( genetic material), covered with a dense protein shell. When it enters a cell, the virus begins to multiply, duplicating genetic material. The cell of the macroorganism is used to produce proteins necessary for the formation of the capsule.

When examined under a microscope, the virus appears as a polymorphic ( different shapes ) particles ranging in size from 100 to 600 nm. They are unstable in the external environment and are quickly destroyed under the influence of various chemical and physical factors.

To inactivate the causative agent of mumps, the following measures can be used:

exposure to high temperature;
ultraviolet radiation ( including the impact of direct sun rays );
drying;
pH change environment (exposure to an acidic or alkaline environment);
impact ethyl alcohol (50% or more);
exposure to formaldehyde solution ( 0.1% or more);
other disinfectants.

Under optimal conditions, at temperatures less than -10 degrees and high humidity, the virus can persist for up to 3 weeks, but its pathogenic ( pathogenic) the potential is greatly reduced. Thus, the virus can be considered unstable in the external environment.

In the human body, glandular cells of some parenchymal organs are sensitive to the mumps virus. Lesion is usually observed salivary glands, somewhat less frequently - the pancreas and gonads ( more often male testes than female ovaries). Tissue damage is also possible nervous system.

Mumps infection occurs through airborne droplets. While breathing ( less), talking, coughing or sneezing, the patient spreads viral particles with droplets of saliva. In case of contact with the mucous membrane respiratory tract In another person, the virus infects glandular cells in the epithelium. Cases of infection when the virus enters the mucous membrane of the eyes have also been described ( conjunctiva). Its primary reproduction in the body occurs in the cells of the mucous membrane. After this, the virus enters the blood ( viremia or viremia stage) and spreads throughout all organs and systems. However, specific viral damage develops only in the cells of the above organs, which are particularly sensitive to this disease.

The mumps virus has the following specific mechanisms of tissue damage:

Hemagglutinating activity. Hemagglutinating activity is the effect on red blood cells. Under the influence of specific substances, red blood cells stick together. This leads to the formation of microthrombi in the capillaries and contributes to the development of edema.
Hemolytic activity. Hemolytic activity involves the destruction of blood cells ( primarily red blood cells) with the release of hemoglobin and a number of other toxic breakdown products.
Neuraminidase activity. The specific enzyme neuraminidase facilitates the penetration of viral particles into the cell, which promotes the multiplication of the virus.

Under the influence of the above pathological mechanisms, pronounced inflammatory edema develops. It is observed mainly in the acute period of the disease. Leukocytes and lymphocytes also migrate to the site of virus reproduction, infiltrating the surrounding tissues. The result of the inflammatory process and damage to functional cells is serious disturbances in the functioning of the organ. Depending on the intensity of inflammation, structural changes may become irreversible. In this case, even after recovery, serious residual effects may be observed.

From an immunological point of view, the mumps virus is represented by a number of antigens. These are unique substances characteristic only of this group of microorganisms. In mumps virus, antigens are represented by capsule proteins. The human body perceives them as foreign substances. Upon contact with peripheral cells, recognition of the antigen structure occurs. Encoded information about the structure of a foreign substance is transmitted to central authorities immune system. Based on this information, an immune response is formed. It involves the production of specific antibodies. These are B lymphocytes equipped with a special receptor that recognizes the viral antigen. Antibodies circulate in the blood, selectively attaching to viral particles and leading to their destruction.

In people who have had mumps, antibodies continue to circulate in their blood throughout their lives. Therefore, when the virus re-enters the mucous membranes, it will be quickly neutralized by antibodies and the disease will not develop. The action of the mumps vaccine is based on this mechanism. However, even such acquired specific immunity to mumps is not absolute protection. It is believed that even after an illness, the risk remains ( about 0.5 – 1%) re-infection. In people who have undergone major surgery with massive blood transfusions, or after transplantation bone marrow the risk of re-infection increases to 20–25%, since a significant part of the antibodies is excreted from the body.

Causes of mumps

Mumps is an infectious disease, so the only root cause of its development, one way or another, is the virus that has entered the body. In the body, it leads to the development of specific tissue damage according to the above mechanism. However, a number of predisposing factors can also be attributed to the reasons for the increased incidence of mumps. Their presence greatly increases the risk of infection.

Risk factors for contracting mumps include:

seasonality of the disease;
refusal to vaccinate;
weakening of general immunity;
childhood;
high population density;
failure to comply with sanitary conditions.

Seasonality of the disease

The peak incidence of mumps occurs in the spring months ( March – May) in the northern hemisphere and during the autumn months ( October December) - in the south. This pattern is explained by weakened immunity. After a cold period, the body weakens and its protective resources are depleted. At this time of year, children's diets are usually poorest in vegetables and fruits, which leads to hypovitaminosis or vitamin deficiency ( forms of vitamin deficiency). In addition, the mumps virus survives well in the environment at temperatures around 0 degrees, which also increases the chances of becoming infected.

Refusal of vaccination

IN last years Many parents decide not to vaccinate their children due to the high risk of complications. Such a decision imposes a great responsibility on parents to their children. In the future, the child will be susceptible to the mumps virus and will be at risk. Unvaccinated people without specific immunity get sick upon first contact with the mumps pathogen in 95–97% of cases. Thus, the child will remain defenseless until adulthood, when he can make his own decision about vaccination. This creates additional problems for doctors and nurses in kindergartens and schools. Children without specific immunity constantly pose a danger to others. With mumps, the patient may be contagious even before the first severe symptoms appear. This forces doctors in every case of acute respiratory infections ( acute respiratory disease ) and ARVI ( acute respiratory viral infection ) suspect mumps and carry out additional diagnostic measures.

Weakening of general immunity

The state of general immunity plays a significant role in protecting the human body from infection in principle. The immune system is able to fight the vast majority of viral and bacterial diseases, which reduces the likelihood of infection. As noted above, most people experience weakened immunity in late winter and early spring. However, the time of year in this case is not the only factor.

A child’s immunity may be weakened for the following reasons:

frequent colds;
long course of antibiotic treatment;
course of treatment with corticosteroid drugs;
some chronic diseases ( chronic pyelonephritis, diabetes mellitus, etc.);
irregular and unbalanced diet.

Childhood

As you know, mumps is considered a childhood infection. Children of primary school age are most often affected. As a result, it is during this period of time that parents should be most attentive. Children of senior school age ( after 15 years) and adults get sick on average 5–7 times less often.

High population density

As with any infectious disease, population density plays an important role in mumps. First of all, we are talking about crowding of children in kindergartens and schools. In such conditions, one child with mumps can infect a large number of children at once. This increases the risk of mumps outbreaks within educational institutions. To avoid this, it is necessary to conduct classes in large, well-ventilated classrooms.

Failure to comply with the sanitary regime

Patients who have not been isolated pose a high risk to others. As mentioned above, the patient has been a source of infection since recent days incubation period (5 – 6 days before the first symptoms appear) until 7–9 days of the disease. During this period, the patient should stay at home to avoid the spread of infection. Failure to comply with the sanitary regime increases the risk of infection of people who come into contact with the patient.

Types of mumps

As noted above, the mumps pathogen has increased activity in relation to a number of glandular organs. Depending on which of these organs are affected, certain symptoms will predominate during the course of the disease. In many ways, the clinical form of mumps also determines the risk of certain complications and treatment tactics.

The main clinical forms of mumps are:

damage to the salivary glands;
testicular damage;
damage to the pancreas;
damage to other organs and systems.

Damage to the salivary glands

The actual name of the disease, mumps, suggests inflammation of the parotid salivary glands. They are located in front and downwards relative to auricle. As a rule, the process affects both parotid glands, but unilateral variants also occur. Symptoms can also develop first on one side, and only after a few days the disease spreads to the paired gland.

Somewhat less often than the parotid glands, mumps also affects other salivary glands ( submandibular and sublingual). This variant of the course of the disease, when the inflammatory process develops only within the salivary glands ( one or more), is considered uncomplicated. It is characterized by a number of typical symptoms.

Symptoms of damage to the salivary glands due to mumps

Symptom	Appearance mechanism	Features of mumps
*Pain when moving the jaw*	Pain appears mainly due to severe swelling of the gland tissue and stretching of its capsule. It is extremely rare to observe the formation of pus in the gland, then the pain becomes acute and is caused by the destruction of gland tissue and irritation of the nerve endings.	Pain and discomfort appear as swelling develops or precede it. Usually the pain is dull and not intense. They persist for 7 to 10 days until the swelling subsides.
	The swelling is explained by the intensive development of the virus in the cells of the salivary gland. This leads to the establishment of inflammatory edema.	Swelling of the parotid glands gives the face the characteristic shape of mumps, protruding the earlobes to the sides. This symptom is considered specific to mumps and appears extremely rarely in other diseases.
*Increased body temperature*	An increase in body temperature is explained by the multiplication of the virus and the entry of its waste products into the blood. A chain of biochemical reactions leads to the release of pyrogens - specific substances that affect the thermoregulation center in the brain. Its irritation leads to an increase in body temperature.	The temperature rises in the prodromal period of the disease, or at the stage of specific manifestations of the disease. It often begins to rise 24 to 48 hours before the salivary glands are affected. The rise in temperature is usually sharp, accompanied by chills. Starting from the 4th – 5th day of illness, in the absence of complications, the temperature begins to subside. In the first days it can reach 39 - 40 degrees.
*Dry mouth*	Dry mouth occurs due to dysfunction of the salivary glands. It is often accompanied by redness of the mucous membrane of the mouth and pharynx.	The symptom is usually not very pronounced and goes away quickly. Patients experience some discomfort due to dryness only during the first days of illness.
*Noise in ears*	Tinnitus can be caused by pressure on the external auditory canal. When the auditory nerve is damaged, the symptoms are much more pronounced. This form is classified as a specific complication – labyrinthitis.	Tinnitus is rare and appears sporadically in the first days of illness. In the absence of damage to the auditory nerve, patients often do not even mention this symptom when visiting a doctor.
*Characteristic head posture*	Significant swelling of the salivary glands provokes pain when moving the head, so patients try not to move it.	The symptom is especially noticeable in the first days of the disease, when the swelling increases. The head is usually tilted to the affected side ( with unilateral damage), or slightly pulled into the shoulders when bilateral.

Testicular damage

Testicular damage is one of the serious complications of mumps. It occurs mainly in adult men who were not vaccinated against mumps in childhood. In children and adolescents, this form of mumps is less common. Typically, the spread of the virus to testicular tissue occurs after damage to the salivary glands ( for 5 - 7 days). This is accompanied by the appearance of new symptoms and a noticeable deterioration in the general condition of the patient. In rare cases, orchitis or epididymitis ( inflammation of the testicle or epididymis, respectively) is the first specific manifestation of the disease. In other words, it is not preceded by damage to the salivary glands. In such cases, making a diagnosis is often difficult, as doctors look for other causes of the inflammatory process. Orchitis is most often unilateral ( only one testicle is affected), however, two-way processes also occur. The disease lasts 7–9 days, after which it enters the extinction phase and the symptoms begin to subside.

Typical symptoms during the development of orchitis in patients with mumps

Symptom	Appearance mechanism	Features of mumps
*New wave of fever*	A new wave of fever is noted due to massive damage to a new area of tissue by the virus ( testicle and epididymis). This is accompanied by the circulation of toxic substances in the blood, irritating the thermoregulation center.	Usually there is a new increase in temperature to 39 - 40 degrees. In the following days, it gradually decreases. Orchitis must be treated in a hospital setting, as there is a risk of irreversible infertility.
*Testicular enlargement*	The testicle enlarges due to inflammatory edema. The virus penetrates the gland tissue, causing inflammation. As leukocytes migrate to the site, specific mediators are released. They increase capillary permeability and promote the release of fluid from vessels into tissues.	The testicle can increase in size by one and a half to two times. Its decrease occurs gradually as other symptoms recede.
*Hyperemia of the scrotum*	Hyperemia ( redness) of the scrotum is explained by a rush of blood to the affected organ and the establishment of inflammatory edema.	Hyperemia is observed quite rarely and may go unnoticed with significant hair growth in the groin area.
*Groin pain*	Pain in the groin appears due to the establishment of inflammatory edema. In this case, there is mechanical compression of pain receptors.	Pain in the groin with mumps is dull, not intense ( as the swelling increases gradually). They can radiate to the lumbar region, to the leg or to the suprapubic region. When moving or urinating, the pain intensifies. As a result, the patient may limp.
*Urinary disorders*	Urinary problems appear reflexively due to increased pain. Contraction of muscles that empty bladder, slightly increases the pressure in the scrotum, squeezing the nerve receptors. The patient may experience fear of urinating ( especially children), they go to the toilet often and little by little.	Urinary problems are a rare symptom and usually last no more than a few days during the most active phase of the disease.
*Priapism (prolonged painful erection)*	Due to testicular swelling, irritation of the receptors responsible for filling the cavernous bodies of the penis with blood occurs. An erection is established that is not associated with external stimuli.	This symptom is observed extremely rarely and usually lasts no more than 24–36 hours ( usually several hours).

Pancreatic damage

Damage to the pancreas in mumps is quite rare ( 2 – 3% of cases). Some researchers believe that the low percentage is due to insufficient diagnosis, and pancreatitis with mumps is much more common. Be that as it may, this complication requires special attention, as it can lead to serious structural changes in the structure of the gland and disorders of its function. The first specific signs of pancreatitis are observed on days 4–7 of the disease and almost always follow damage to the salivary glands. Isolated damage to the pancreas without affecting other organs and systems in patients with mumps is extremely rare. The patient's condition noticeably worsens with the development of pancreatitis. Such patients are recommended to be hospitalized for more intensive treatment.

Symptoms of pancreatic damage in patients with mumps

Symptom	Appearance mechanism	Features of mumps
*Pain*	Pain occurs due to tissue swelling. Usually, in the case of pancreatitis against the background of mumps, the swelling is not so severe, but the organ itself is extremely sensitive.	The pain is localized in the epigastrium ( top part belly) and are encircling in nature. They can radiate to the back or shoulder blades and reach significant intensity.
*Fever*	The mechanism of a new round of temperature in pancreatitis is similar to that in other localizations of the virus and is associated with irritation of the thermoregulation center.	The temperature rises quickly, usually following the onset of pain. Can reach 38 – 39 degrees. Lasts from 3 to 9 days ( depends on the intensity of treatment).
*Vomit*	The pancreas takes an active part in the digestion process. Its infection by the virus reduces the release of digestive enzymes and makes it difficult to digest food. This may cause repeated episodes of vomiting over the course of the illness. In addition, at the beginning of the disease, single vomiting can be observed due to reflex irritation of the nerves.	Vomiting is usually one-time at the onset of the disease. Repeated episodes indicate massive tissue damage and worsen the prognosis. To prevent and reduce vomiting, you should follow an appropriate diet, which will be described below, and take pancreatic enzymes to facilitate the digestion of food during illness.
*Diarrhea*	Diarrhea is also observed due to insufficient digestion of food in small intestine. Because of this, many substances enter the colon poorly digested, are not absorbed and cause irritation of the mucous membrane. This reflexively leads to increased bowel movements.	Diarrhea is rare and lasts several days. The symptom can only drag on when a secondary bacterial infection or development of complications ( accumulation of pus or necrosis of the pancreas).
*Abdominal muscle tension*	Tension of the abdominal muscles is a reflex in nature due to swelling and irritation of the peritoneum.	On palpation, the abdomen is hard, pressure causes increased pain. The patient cannot voluntarily relax the abdominal muscles.

The main danger of pancreatitis in patients with mumps is the possible irreversible damage to the islets of Langerhans, which produce insulin. In this case, after recovery, the patient will suffer from type 1 diabetes.

Damage to other organs and systems

Damage to other organs and systems with mumps is quite rare. In general, they do not pose a serious threat to the health of patients. However, some clinical forms diseases ( serous meningitis) can even lead to death without timely treatment. It is precisely because of the threat of such complications that mass vaccination of children against mumps is currently recommended.

Damage to other organs and systems due to mumps

Complication	Typical symptoms	Features of the course of the disease
*Oophoritis (inflammation of the ovaries in women)*	Lower abdominal pain, menstrual irregularities ( amenorrhea or dysmenorrhea), intermenstrual bleeding, pain during sexual intercourse. The temperature may remain low-grade ( 37 – 38 degrees), but more often it increases slightly.	Oophoritis occurs more often in children than in adult women. In general, it is a rare complication of mumps, and unlike orchitis in men, it almost never leads to infertility. To confirm the diagnosis it is usually sufficient ultrasound examination (Ultrasound).
*Thyroiditis (inflammation thyroid gland)*	Enlargement of the thyroid gland ( swelling in the throat area), pain in the neck area, radiating to the back of the head, lower and upper jaw, enlarged cervical lymph nodes, increased body temperature, chills, headache, weakness, sweating, increased heart rate.	Thyroiditis as a complication of mumps is rare, but can lead to very serious consequences. In particular, there is the possibility of developing an autoimmune process. In such cases, the patient may suffer from thyroid hormone deficiency after recovery. To treat thyroiditis, an endocrinologist is involved.
*Meningitis and meningoencephalitis (inflammation of the meninges and the brain itself)*	Acute onset, increased body temperature to 39 - 40 degrees, severe headache, vomiting of central origin ( without previous nausea). Meningeal syndrome: stiff neck, Kernig's sign and Brudzinski's sign ( top and bottom), Lesage's sign ( in children). In addition, characteristic changes are noted in the analysis of cerebrospinal fluid: fluid flows out under pressure, protein content is up to 2.5 g/l, cytosis is up to 1000 cells in 1 μl, chlorides and glucose are normal. When the brain tissue itself is damaged ( encephalitis) lethargy, drowsiness, disturbances of consciousness, paralysis and paresis are observed.	Serous meningitis develops 4–7 days after damage to the salivary glands, less often - simultaneously with it. Despite the fact that the course of the disease sharply worsens with the development of meningitis, the prognosis is usually favorable. Treatment is carried out only in a hospital setting and lasts at least 2 to 3 weeks. Meningeal syndrome with proper treatment disappears on the 10th – 12th day of illness. The cerebrospinal fluid indicators are the last to return to normal ( in 1.5 – 2 months).
*Prostatitis (inflammation of the prostate gland)*	Fever, chills, frequent and painful urination, weakness, headaches, feeling tired.	With a specific lesion of the prostate gland, a sharp deterioration in the patient’s condition occurs with a new wave of fever and signs of intoxication. Recommended hospital treatment patients with this complication. With adequate treatment of prostatitis, all symptoms subside as you recover ( within 1 – 2 weeks) without any consequences.
*Labyrinthitis (damage to the hearing organ)*	Headaches, nausea ( maybe without vomiting), dizziness, lack of coordination of movements, noise and ringing in the ears. Hearing loss or, conversely, ringing in the ears can be one-sided.	Labyrinthitis is a rare complication of mumps. It can be called high blood pressure in the area of the auricle due to inflammatory edema, however, the symptoms are more pronounced with specific damage to the auditory nerve and vestibular apparatus. If labyrinthitis develops, consultation with an ENT doctor is required. Hearing symptoms usually last no more than a few days and disappear as you recover.
*Arthritis (joint damage)*	Swelling of the joints, pain, stiffness of movement.	Arthritis in mumps rarely develops, usually 1 to 2 weeks after the onset of the disease. In rare cases, simultaneous damage to large joints may occur ( knee, ankle, elbow, shoulder, wrist) and salivary glands. This complication is more common in men. Symptoms disappear as you recover, rarely leaving serious consequences. With moderate joint damage without intense swelling, treatment of this complication at home is allowed.
*Dacryoadenitis (inflammation of the lacrimal glands)*	Swelling of the eyelids ( often bilateral), severe swelling, soreness, redness of the eyes, dry eyes.	This complication is quite rare and requires urgent consultation ophthalmologist. During the course of the disease, special drops are prescribed to moisturize and nourish the mucous membrane. The prognosis is usually favorable. It is extremely rare that dacryoadenitis can, in turn, be complicated by an abscess of the lacrimal gland.
*Mastitis (inflammation of the mammary glands)*	The disease is characterized by fever, tenderness and hardening of the mammary glands. Rarely there is a small amount of discharge ( mucus or, less commonly, pus).	Mastitis develops mainly in girls and women, but in men the appearance of this complication is also possible. The general condition of the patient suffers little. Symptoms are short-lived and quickly subside with treatment.

During what period is the patient dangerous for others (infectious)?

The infectiousness of a patient with mumps is one of the most important criteria in the course of the disease. It is she who predetermines the period of time when the patient should be isolated in a hospital or at home. With mumps, the contagious period ( time when the patient is contagious) may vary. For better orientation in time, it is necessary to know all periods of the course of this disease.

During mumps, the following stages are distinguished:

incubation period;
prodromal period;
period of main manifestations of the disease;
period of extinction;
recovery period.

Incubation period

The incubation period is the period of time during which the virus has already entered the human body, but the disease as such has not yet occurred. In other words, nothing bothers the patient and he does not suspect that he is sick. During this period, the virus multiplies in the mucous membrane of the respiratory tract and penetrates the bloodstream. In rare cases, at the end of the incubation period, the patient begins to be bothered by subtle general symptoms such as weakness, increased fatigue, and drowsiness.

For mumps, the incubation period lasts from 11 to 23 days ( maximum described duration – 30 – 35 days). The danger is that already in last days During the incubation period, the patient may pose a risk of infection to others. In some cases, virus particles may be present in saliva even before the first obvious symptoms of the disease appear.

Prodromal period

The prodromal period is a period of nonspecific symptoms. That is, a person understands that he is sick, but it is still impossible to make a diagnosis based on the symptoms. In patients with mumps, the prodromal period usually lasts no more than 24–36 hours, but can often be absent altogether. Typical symptoms include headache, muscle pain, joint pain, sleep disorders. If a prodromal period is present, then the patient is infectious throughout this time.

Period of main manifestations of the disease

This period is characterized by the appearance of symptoms characteristic of mumps. First of all, we are talking about redness of the mucous membrane of the mouth, throat and pharynx. Redness is especially pronounced in the area of the excretory ducts of the salivary glands. Appear somewhat later discomfort and swelling of the parotid glands ( area below and in front of the earlobe). The patient continues to actively secrete viral particles for another 5–9 days after the appearance of the first characteristic symptoms. It can be difficult to unambiguously determine this period, since enlargement of the parotid salivary glands is not always the first symptom. In an atypical course of the disease, the virus may first infect the gonads or pancreas.

Extinction period

Specific symptoms usually subside 7 to 9 days after their onset. A longer course of the active phase is observed when several glands are affected or associated complications. During the decline period, some visible symptoms may still persist ( swelling of the salivary glands and characteristic facial shape), but their intensity decreases. As a rule, by this point in time the temperature also returns to normal. The patient in this phase no longer poses a threat of infection to others and, if he feels normal and there are no complications, can return to the educational or work team.

Recovery period

During the recovery period, all specific and nonspecific symptoms gradually disappear. Treatment is only required when complications from mumps have led to serious health consequences. In this case, there can be no talk of any contagiousness of the child. By this time, immunity had already formed and the patient finally stopped releasing viral particles.

Thus, the period of danger for others lasts on average 7–9 days. It is for this period that it is recommended to isolate patients who have been diagnosed with mumps.

During the period when the patient is contagious, he requires especially careful and attentive care. The most important task is to prevent the spread of infection. In addition to bed rest, it is necessary to observe all nonspecific preventive measures, which will be discussed in detail below. In the case of an atypical course of the disease ( if the diagnosis was made late), specific care should be discussed with the attending infectious disease specialist.

Treatment of mumps

Treatment of mumps in most cases is carried out at home. Patients are prescribed bed rest from the time of diagnosis until the period of symptoms subsiding ( 1 – 2 weeks in the absence of complications). The final decision on the patient's care regimen and treatment conditions is made by the attending infectious disease specialist after examining the patient. In case of complicated mumps, hospitalization of the patient for more intensive treatment is recommended.

To prevent residual effects after mumps, in addition to an infectious disease specialist, other specialists are often involved:

endocrinologist with damage to the gonads, thyroid or pancreas;
neurologist with the development of serous meningitis or meningoencephalitis;
otorhinolaryngologist ( ENT) with the development of labyrinthitis;
rheumatologist with concomitant severe joint damage.

Does not currently exist effective treatment, directed against the virus that causes mumps. In this regard, emphasis is placed on symptomatic treatment to prevent the development of complications and reduce the suffering of the patient. If the course is favorable and only the salivary glands are affected, treatment lasts about 2 weeks.

In general, treatment of mumps can be divided into several areas:

adherence to the regimen and patient care;
diet;
drug treatment ( can vary greatly with the development of complications).

Compliance with the regime and patient care

During treatment, bed rest is recommended, even for uncomplicated forms of mumps. It must be observed for about 10 days - from the moment of diagnosis until the acute symptoms disappear. If necessary, this period can be increased by the attending physician according to individual indications. The patient should avoid physical and emotional stress, and also avoid hypothermia. Statistically, in people who do not comply with bed rest during the acute period of the disease, various complications are observed several times more often ( This is especially true for orchitis in men).

Patient care includes measures to prevent the spread of the disease. It is advisable to use masks or gauze bandages to prevent infection. It is strictly forbidden to allow unvaccinated people to visit a patient during the infectious period.

Diet

A diet for mumps is followed primarily to avoid the development of pancreatitis. To do this, you need to follow a few simple nutritional principles. They belong to the standard diet number 5 according to Pevzner.

A diet for the prevention of pancreatitis involves adherence to the following principles:

limited calorie diet ( no more than 2600 Kcal);
frequent diet ( 4 – 5 times a day in small portions);
consumption of 1.5 - 2 liters of fluid per day.

To fulfill these conditions, emphasis is placed on easily digestible foods. Thus, the body does not need large amounts of pancreatic enzymes, and the risk of pancreatic damage is significantly reduced. The list of foods that are allowed, limited or prohibited by diet number 5 is given in the table.

Consumption of various foods as part of diet number 5 according to Pevzner

Authorized Products	Products whose consumption should be limited	Prohibited Products
lean boiled meat ( beef, veal, chicken, rabbit); fresh boiled lean fish ( perch, pike perch); fresh vegetables and fruits; low-fat soups; confectionery and honey; porridge and pasta; low-fat dairy products.	butter – no more than 60 g; eggs in the form of an omelet 2 – 3 times a week; sausages; fish caviar; tomato paste; cheeses.	spicy seasonings; alcohol; legumes ( soybeans, peas, beans); fresh bread; chocolate; canned food; fat meat; fried foods and smoked foods; onion, garlic, radish.

The same principles of diet are followed during the development of pancreatitis. A more detailed diet can be developed individually with your doctor.

Drug treatment

As noted above, drug treatment for mumps is symptomatic and aimed at eliminating the manifestations of the disease. Typically, timely initiation of such treatment prevents the development of complications and residual effects after the disease. Severe forms, which cause complications even during treatment, can only be observed in people who were not vaccinated in childhood. In people with specific immunity against mumps, the prognosis in the vast majority of cases is favorable. An important condition is quick diagnostics and the beginning drug treatment. Mumps cannot be treated on your own due to the high risk of complications. You should also not apply warm compresses to swollen areas - salivary glands or testicles - during the period of swelling. This will increase swelling and worsen the course of the disease. The groups of medications used in the treatment of mumps are shown in the table.

Groups of drugs used to treat mumps

Group of drugs	Representatives	Mechanism of action	Directions for use
Nonsteroidal anti-inflammatory drugs	*Ibufen, ibuprofen, diclofenac, aspirin, piroxicam, ketoprofen.*	Drugs in this series effectively reduce high fever and reduce inflammation.	These drugs form the basis of treatment in cases of uncomplicated mumps. The appointment is made by the attending physician based on the patient’s age and the intensity of the inflammatory process.
Corticosteroid drugs	*Dexamethasone, methylprednisolone, prednisone.*	These drugs have a significantly stronger anti-inflammatory effect. A side effect is suppression of the immune system.	Used for severe complications quick removal inflammation ( for orchitis). The dosage and regimen of taking corticosteroids must be agreed with the attending physician.
Desensitizing drugs	*Suprastin, Tavegil, Erius.*	These drugs also fight intense inflammation and reduce the reactivity of the immune system.	Prescribed in parallel with other drugs throughout the acute period.
Analgesics ( painkillers)	*Analgia, baralgin, pentalgin.*	Drugs in this group combat severe pain syndrome, if present in patients.	These drugs are not used in all cases. Pain relief is usually required for pancreatitis, orchitis and meningitis.
Pancreatic enzyme preparations.	*Festal, pancreatin, mezim.*	Helps improve digestion and normal absorption of food. They are analogues of natural pancreatic enzymes.	They are used only in the development of pancreatitis with severe gastrointestinal symptoms ( gastrointestinal tract): vomiting, diarrhea.

Other groups of drugs are used less frequently. They are prescribed based on which organ or system is affected. The choice of drugs and their dosage should be made only by the attending physician after a thorough examination of the patient. Many drugs used in the treatment of mumps have side effects and can aggravate the disease if taken incorrectly.

In addition to drug therapy, irradiation of the salivary glands, puncture spinal cord or cold on the stomach in the projection of the pancreas. These measures contribute to a speedy recovery and improve the general condition of the patient.

Consequences of mumps

Despite the fact that with the invention and introduction of the mumps vaccine, deaths are recorded extremely rarely, this infection is still classified as dangerous diseases. This is mainly due to a number of complications and residual effects that can be observed after mumps. They are quite rare, but in some cases they can lead to irreversible consequences and even cause disability.

When detected early and treated correctly, mumps in most cases has a mild course and does not lead to complications. However, with a decrease in the body's defenses or in the presence of concomitant diseases of organs and systems that are targets for the causative agent of mumps, the complications described above may occur. After some of them, serious residual effects may remain that will make themselves felt throughout life.

Residual effects after mumps include:

infertility;
deafness;
diabetes;
dry eye syndrome;
sensitivity disorders.

Infertility

Infertility as a residual phenomenon after mumps occurs mainly in men. First of all, this applies to those who were not vaccinated in childhood and do not have specific immunity. For such people in adulthood, there is a high risk of developing orchitis or epididymitis with irreversible damage to the gonads. In women, infertility due to oophoritis due to mumps is very rare. Because of the threat of this residual phenomenon, all patients with mumps with signs of damage to the testicles and ovaries must be treated in a hospital setting under the watchful supervision of specialists.

Deafness

Deafness may develop due to damage to the auditory nerve or inner ear (a consequence of labyrinthitis). Hearing loss in advanced cases is irreversible. However, such complications are extremely rare, and the standard treatment regimen for infection usually prevents deafness even when signs of hearing damage are obvious.

Diabetes

Due to a massive inflammatory process at the level of the pancreas, the islets of Langerhans may be damaged. These are areas of cells in the gland tissue that produce the hormone insulin. It is necessary to lower blood glucose levels and store them in cells as an energy reserve. If mumps becomes more complicated acute pancreatitis, there is a risk of irreversible disturbances in the formation of insulin. The cells that produce this hormone die, leading to its deficiency. This mechanism of increasing blood sugar is characteristic of type 1 diabetes. Despite the rarity of this residual phenomenon, doctors treat its timely diagnosis with great attention. Loss of time or errors in treatment can lead to the patient suffering from a lack of insulin throughout his life. If blood glucose levels increase in patients with mumps, it is necessary to consult an endocrinologist.

Dry eye syndrome

Dry eye syndrome can be observed for some time after dacryoadenitis. Inflammation of the lacrimal glands is accompanied by a decrease in the secretion of their secretions and impaired nutrition of the eye. This leads to rapid drying of the mucous membrane, constant pain in the eyes and discomfort. To solve this problem, you need to consult an ophthalmologist. As a rule, these disorders are reversible and persist for several weeks ( rarely – months) after an infection.

Sensory disorders

Sensory disturbances are the result of serous meningitis or meningoencephalitis. With these complications of mumps, the membranes and tissues of the brain are affected ( less often than dorsal) brain. Directly during the course of the disease, sluggish paralysis and paresis may be observed. Sensitivity in severe forms takes a long time to recover, which explains the residual effects after a seemingly complete recovery. As a rule, sensitivity is restored after some time ( months, years). Lifelong persistence of these residual effects is extremely rare.

Prevention of mumps

Prevention of mumps includes specific and nonspecific measures. Their ultimate goal is to reduce the incidence of mumps in general, as well as to prevent severe forms of the disease.

Nonspecific prevention of mumps includes the following measures:

Isolation of sick people during illness. Isolation is carried out mainly at home, where the patient receives the necessary treatment. Hospitalization is provided not for the purpose of isolating the patient, but for more intensive treatment in case of complications. Considering that mumps is common mainly among children, this measure includes exemption from school or kindergarten for as long as the child poses a danger to others. Isolation is carried out during the acute period. The patient is considered non-infectious starting from the 9th day of the acute phase. Unvaccinated children who have been in contact with a sick person are subject to isolation for a period of 11 to 21 days ( at the discretion of the epidemiologist or infectious disease specialist eliminating the source of infection).
Ventilation of the rooms in which the patient was located. Considering that infection occurs through airborne droplets, ventilation helps reduce its likelihood. At home, it is enough to ventilate the room in which the patient is constantly located several times a day.
Disinfection of objects with which the patient has been in contact. If we are talking about a case of mumps in kindergarten, then it is necessary to disinfect toys and other items in the playroom. A single treatment is considered sufficient medical alcohol, or chlorine-containing disinfectants. Microscopic drops of saliva on objects can retain enough viral particles to cause infection. Disinfection will eliminate the possibility of such infection. At home, it is necessary to regularly disinfect the dishes from which the patient eats, and other objects on which drops of saliva may remain.
Wearing protective masks. Reliable protection infection is prevented by the patient wearing a special protective mask or gauze bandage ( the gauze is folded several times). Drops of saliva containing the virus linger on the tissue and do not reach the mucous membrane. Theoretically, there remains the possibility of infection through the conjunctiva of the eyes, but such cases are extremely rare.
Strengthening nonspecific immunity. Strengthening nonspecific immunity involves limiting alcohol consumption, quitting smoking and regular walks in the fresh air. Hypothermia must also be avoided. An important component in strengthening the immune system is proper nutrition. It should include both plant and animal foods with sufficient vitamins. A balanced diet, which is necessary to strengthen the immune system, should not be confused with a special diet for patients who already have mumps.

Specific prevention of mumps involves widespread vaccination of children. At the moment, it is carried out in many countries of the world without fail to prevent epidemics. The advent and widespread use of the mumps vaccine has reduced the incidence of the disease by more than 50 times.

Types of mumps vaccines

There are several types of mumps vaccines. They differ in the methods of production, methods of use and the effectiveness of immune protection. Each vaccine has a number of advantages and disadvantages.

Exist the following types mumps vaccines:

Inactivated vaccine. Inactivated vaccines are those that contain a certain amount of killed viral particles. Inactivation is carried out by ultraviolet light or exposure chemical substances. In this case, exposure to chemical disinfectants should be moderate, and irradiation should be dosed. The virus must completely lose its pathogenicity ( possibility of causing disease), but retain its structure. The immune system, in response to the ingress of structural proteins, will produce the necessary set of antibodies, which will provide the patient with protection. Vaccination with inactivated viral particles is safe in terms of complications or adverse reactions. The disadvantage of this type of vaccine is its relatively low immunogenicity. In other words, the likelihood of developing reliable immunity against the disease is lower than with live vaccines.
Live attenuated ( weakened) vaccine. Live vaccines are those drugs that contain live, weakened viral particles. The common strain of the mumps pathogen is bred in the laboratory on nutrient media. With repeated reseeding of the culture, the pathogenicity of microorganisms decreases. In other words, the virus in the laboratory is not allowed to fully grow and multiply. As a result, a strain is obtained, which, once in human body, will no longer cause serious illness. The patient, in principle, will recover from mumps in an asymptomatic form without the risk of developing any complications. Since the administration of a live vaccine preserves the integrity of the viral particles, the immunity acquired by the body is very reliable. The disadvantage of live attenuated vaccines is that they are more high risk allergic reactions and other side effects after vaccination.
Combination vaccine. Combination vaccines are those containing antigens from two or more different microorganisms. In particular, the mumps vaccine often comes in the same vial as the measles and rubella vaccine. When such drugs are introduced into a healthy child's body, the immune system produces antibodies against each of these infections. Due to the large number of diseases against which children are vaccinated these days, combining several vaccines within one drug greatly simplifies the vaccination process. Most countries give preference to combination drugs when vaccinating against mumps.

Mechanism of action of the vaccine

Regardless of what type of vaccine was used, the child’s body recognizes the antigens and produces appropriate antibodies against them. With mumps in particular, these antibodies will continue to circulate in the blood throughout life. To ensure the formation of immunity, revaccination is provided in many countries. This is a second injection of the vaccine several years after the first. It is required, as a rule, when using combination drugs.

Vaccination dates

There is no single universal standard for the timing of administration of the mumps vaccine. Many countries that use the combined measles-mumps-rubella vaccine vaccinate children twice, at 12 months and at 6 or 7 years. However, in the national vaccination calendar for each country, the timing may vary slightly. The drug is injected into the area of the scapula or the deltoid muscle ( middle or upper third of the shoulder) subcutaneously in a volume of 0.5 ml.

If the child was not vaccinated as a child ( in case of parental refusal to vaccinate), vaccination can also be carried out in adulthood. This is done at the request of the patient himself or according to epidemiological indications ( directly during a mumps epidemic). Emergency immunoprophylaxis is carried out according to individual indications, if a person has been in contact with a person known to have mumps and has been exposed to a high risk of infection. In such cases, urgent vaccination is possible no later than 72 hours after the first contact ( preferably on the first day). Then the body will have time to produce antibodies, and the disease will pass in a mild form without complications.

In addition, there are a number of situations when the timing of vaccination can be changed for medical reasons, even if the parents did not refuse the procedure.

Vaccination may be delayed for the following reasons:

acute infectious diseases in the last 1 - 2 months before vaccination;
exacerbation of chronic diseases;
malnutrition ( insufficient or unbalanced nutrition leading to malnutrition of the child);
taking corticosteroid drugs in the last 1–2 months before vaccination;
diseases of the hematopoietic system;
other pathological conditions accompanied by weakened immunity.

In the above cases, a weakening of the immune system is observed to varying degrees. As a result, the body will not be able to adequately respond to the introduction of viral antigens and will not produce sufficient antibodies. The result may be unreliable and short-lived protection against future infection. In addition, concomitant diseases greatly increase the risk of complications and side effects from the vaccine.

Side effects and complications after the vaccine

As noted above, for vaccination against mumps, mainly a live attenuated culture of the virus is used. As a result, there is a risk of developing side effects and complications. Side effects include local nonspecific reactions of the body to the administration of the vaccine. Complications imply the appearance of symptoms characteristic of the disease for which the vaccine was administered.

If the mumps vaccine is administered, the following side effects and complications may occur:

Redness and soreness at the injection site. Most often, they are caused by an inadequate response of the body to the vaccine. If there is a sufficient amount of antibodies in the blood ( after the first vaccination or after an illness), then they will actively fight the virus upon repeated local injection.
Allergic reactions. They are quite rare and can be caused not only by the virus strain itself, but also by other components of the drug. Allergic phenomena ( itching, urticaria) usually go away on their own within a few days. A severe systemic allergic reaction – anaphylactic shock – is extremely rare. He demands resuscitation measures due to a sharp drop in blood pressure, poor circulation and possible respiratory arrest.
Low-grade fever. Temperatures within 37 – 38 degrees can remain for 5 – 7 days after vaccination. If the fever lasts longer or the temperature is higher, it is advisable to be examined by a general practitioner to rule out other causes.
Swelling and redness of the mucous membrane of the throat. Phenomena resembling catarrhal tonsillitis may occur due to the abundance of lymphatic tissue in the tonsils. This tissue responds with inflammation to the vaccine. Symptoms may persist for 5 to 12 days, but almost never progress to severe sore throat with high fever and plaque formation on the tonsils.
Enlargement of the parotid salivary glands. This symptom can no longer be attributed to side effects, but to complications of vaccination. The virus contained in the drug is most sensitive to the tissues of the salivary glands. Therefore, their increase indicates that the body could not cope even with a weakened strain of the virus. On the other hand, this strain will not lead to a prolonged increase in temperature or complications from other organs. In most cases, the swelling will disappear on its own within a few days. The main reason is considered to be weakened immunity, which did not allow one to overcome the virus. This suggests that before vaccination there were any contraindications that the doctor did not take into account or did not notice. It was desirable to postpone the administration of the drug. If swelling of the parotid glands appears after the vaccine is administered, it is advisable to see a general practitioner.
Serous meningitis. Serous meningitis develops extremely rarely after vaccine administration. He says that the patient had contraindications to vaccination and his immunity was greatly weakened at the time of encountering the virus. In rare cases, medical personnel violate the rules of vaccination. The risk of severe complications increases when an excess amount of vaccine is administered ( more than 0.5 ml). In addition, a number of drugs contain a larger number of viral particles, even at a standard dose. If meningeal symptoms appear, you should urgently seek qualified medical help.

Given the large number of possible side effects and complications, many parents have refused vaccination in recent years. However, it should be understood that unvaccinated people are much more likely to develop severe complications of mumps if infected. In addition, from an epidemiological point of view, such children pose some danger to others, since they can become infected with a mild form of mumps and spread the infection for some time. As a result, WHO ( World Organization Healthcare) strongly recommends large-scale vaccination of the population. It should be noted that with careful attention and appropriate care, none of the side effects will cause serious harm to the child’s health.

Answers to frequently asked questions

Is it possible to get mumps again?

As a rule, people who had mumps in childhood do not get sick again. This is explained by the mechanism of the immune response to infection. However, cases of reinfection have been described in the literature. It is believed that the probability of recurrent disease is no more than 2% ( according to some authors less than 0.5%). This is the basis for the mumps vaccination system for children. For a deeper understanding of the issue, it is necessary to understand in more detail the mechanism of formation of specific immunity.

Specific immunity is the one produced by the body against a specific type of microbe. It appears upon contact of microbial antigens ( proteins typical for a given microbe) with special cells in tissues - macrophages. Macrophages not only absorb a foreign organism, trying to neutralize it, but also trigger a complex chain of cellular reactions aimed at forming an immune response. As a result, special substances appear in the patient’s blood – antibodies, aimed at destroying a specific type of microbe. Specific immunity is formed several weeks or months after the first episode of the disease. The duration of protection depends on how long the antibodies circulate in the patient’s blood. This period is different for different infectious diseases.

With mumps, antibodies continue to circulate in the blood for almost your entire life. Therefore, when the virus enters the mucous membrane a second time, it will be quickly identified and destroyed, and the disease will not develop. Artificially provoke the formation of antibodies against mumps using a vaccine. A vaccinated person has almost the same immunity as a person who has had mumps.

However, this mechanism does not provide 100% protection. This applies to both people who have had mumps and vaccinated children. The re-development of the infection is explained by the fact that antibodies against the infectious agent stop circulating in the blood. This makes the body vulnerable.

The reasons for re-infection with mumps may be:

Prolonged direct contact with the patient. As a result, a large number of microbes enter the mucous membrane of the respiratory tract, and there may simply not be enough antibodies in the blood to instantly neutralize all viral particles. Then the person will suffer a mild form of the disease.
Poor quality vaccine. Poor quality vaccine or vaccine with expired suitability may cause the formation of unreliable immunity. Then the specific protection will last only a few years. The person will think that he has been vaccinated against mumps. This can lead to severe forms of the disease in adulthood.
Massive blood transfusions or bone marrow transplants. Antibodies circulating in the blood can be removed from the body by massive blood transfusions. Bone marrow transplantation affects the hematopoietic system as a whole. Similarly, a person can lose specific immunity in severe diseases of the hematopoietic system.
Vaccination if there are contraindications. Vaccination is not recommended if there are any infections in the body in the acute phase. For example, if you have a high temperature on the day of vaccination, the procedure can be postponed until you have recovered. The fact is that diseases in the acute phase affect the reactivity of the immune system. As a result of this influence, the immune response will be insufficient and future protection will be unreliable.

However, cases of reinfection with mumps are extremely rare. Usually this disease is classified as an infection that occurs only once in a lifetime.

What is the duration of mumps and recovery time?

The total duration of the course of mumps consists of several phases. They are typical for almost all infectious diseases, but in each individual case they have a certain duration. In addition, there are a number of factors that affect the speed of the disease and the timing of final recovery.

During mumps the following stages are distinguished:

Incubation period. This stage begins when the virus enters the mucous membranes of the respiratory tract. The virus gradually multiplies and spreads through the bloodstream throughout the body. The end of the incubation period is considered to be the appearance of the first pronounced symptoms. The duration of this stage ranges from 11 to 23 days ( usually about 2 weeks). Patients often do not include the incubation period in the duration of the disease because they themselves do not feel sick.
Prodromal period. The prodromal period is a period of nonspecific symptoms. A person begins to feel sick, but rarely immediately consults a doctor. He is worried about headaches and muscle pain, general weakness, drowsiness, and decreased performance. These symptoms are due to toxins circulating in the blood. With mumps, the duration of the prodromal period is short - from 24 to 36 hours. In children it is often completely absent.
Period of specific manifestations. At this stage, typical symptoms of mumps appear. It begins with a rapid increase in temperature, with the classic course of the disease up to 39 - 40 degrees. Characteristic symptoms are redness of the oral mucosa in the area of the ducts of the salivary glands, swelling of the salivary glands themselves. If the disease proceeds without complications, then the duration of this stage is from 7 to 9 days in children and from 10 to 16 days in adults.
Extinction period. The period of extinction is characterized by the gradual disappearance of symptoms and normal body temperature. Clinically, it can be difficult to distinguish it from a period of specific manifestations. In children, these stages of the disease are often combined. In adults, the period of extinction is characteristic mainly of a complicated course of mumps. Its duration depends on what kind of complication was observed in a particular patient.
Recovery period. During the recovery period, the patient no longer suffers from the disease itself, but may experience some difficulties due to residual effects. The recovery period ends with the normalization of all tests and vital signs ( blood test, cerebrospinal fluid test for serous meningitis). Patients do not consider this period to be the total duration of the disease, since acute symptoms are missing.

Thus, the total duration of uncomplicated mumps may vary from 2 to 3 weeks from the patient's point of view. During this period, he will be bothered by acute symptoms and will need to undergo intensive treatment. From the doctor's point of view, the course of the disease must also include the incubation period and the recovery period. Thus, the duration will be from 1 to 4 months.

Recovery may be delayed if any complications of mumps occur. Complications of this disease are considered to be any manifestations of the disease other than damage to the salivary glands. Treatment of such forms usually takes longer and is carried out in a hospital setting.

Possible complications with mumps are:

orchitis ( inflammation of the testicles in men);
oophoritis ( inflammation of the ovaries in women);
pancreatitis ( inflammation of the pancreas);
serous meningitis or meningoencephalitis ( damage to the membranes of the brain);
dacryoadenitis ( inflammation of the lacrimal glands);
thyroiditis ( inflammation of the thyroid gland);
arthritis ( joint inflammation);
labyrinthitis ( inflammation of the inner ear);
mastitis ( inflammation of the mammary gland, more common in women, but also possible in men);
prostatitis ( inflammation of the prostate gland in men).

These complications usually appear at the height of the disease, at the stage of specific manifestations. Because of them, the temperature may rise again and a new round of illness may begin. This will lengthen the recovery time by an average of 1 to 2 weeks. In addition, after some complications, residual effects are possible that will last a lifetime. Such cases are extremely rare, mainly in unvaccinated adults in the absence of qualified treatment. Lifetime residual effects are infertility ( more often in men after orchitis), diabetes mellitus type 1 ( after pancreatitis) and deafness ( after suffering from labyrinthitis).

What do patients with mumps look like?

Mumps or mumps has a number of distinctive symptoms that can be noticed by ordinary people without visiting a doctor. Knowing these manifestations of the disease can help parents suspect mumps earlier and consult a doctor for a more detailed examination.

In the initial stages of the disease ( during the prodromal period) patients with mumps remind ordinary people with a cold. The mucous membrane of the throat gradually turns red, and there may be slight discharge from the nose. In this case, general weakness, moderate headaches, nausea, and sweating are noted. In general, it is possible to suspect the disease and not come into close contact with such people. It is important that it is at this stage that patients already release a significant amount of viral particles and pose a threat of infection.

The appearance of specific symptoms helps to suspect mumps directly. If parents notice such changes in their children, accompanied by fever and other general symptoms, it is necessary to urgently consult a doctor to make an accurate diagnosis. Until this moment, it is advisable to isolate the child at home.

Distinctive features of a patient with mumps

Characteristic symptom	Danger of infection	Type of patient
*Swelling in the area of the salivary glands*	Swelling in the area of the salivary glands appears in the first days acute course diseases. The patient is especially contagious during this period and should be isolated. Contact with the patient is allowed only 8–9 days after the onset of this symptom.
*Redness of the oral mucosa*	Redness of the mucous membrane of the mouth and throat is most often observed during the acute period of the disease, so the patient with high degree is likely to be contagious and pose a danger to others. Distinctive feature from a sore throat is that the redness spreads to the mucous membrane of the oral cavity ( inner cheeks). Especially pronounced red spots form at the point where the ducts of the salivary glands exit into the oral cavity ( Mursu's sign).
*Testicular enlargement*	Enlargement of the testicle or both testicles usually occurs with orchitis. Swelling can reach significant sizes, causing dull pain and preventing a person from moving ( pain gets worse when walking). During this period of time, the patient, as a rule, no longer poses a risk of infection.

With timely initiation of treatment, mumps goes away quickly enough without leaving serious consequences.

Mumps is the scientific name for a childhood disease, popularly called mumps. The causative agent is a virus from the paramycovirus family. Affects the central nervous system and glandular organs (pancreas and salivary glands, testes).

Children under the age of 15 are at risk, with the peak occurring between 3 and 7 years of age. Boys get sick twice as often as girls. And for them this infection is fraught with serious complications in the fall. It is transmitted by airborne droplets, so outbreaks of epidemics in kindergartens and schools are not uncommon.

The more parents are aware of this unusual illness, the more reliably they can protect their kids from it.

The main cause is paramycovirus. If we talk about how mumps is transmitted, it is the familiar airborne route, that is, during a conversation, sneezing or coughing.

You can become infected from a child who does not even have any signs of the disease yet. The fact is that a person is the source of paramycovirus already 9 days before the appearance of his first symptoms and then another 9 days after their manifestation (i.e., on average, 18 days of active infection are obtained).

During an epidemic, up to 70% of the children's team becomes infected. Why is the pig so selective? Firstly, after suffering a disease, a stable, lifelong immunity to it is formed. Re-infection is very rare. Secondly, 20% of children are not attacked by paramycovirus due to some individual characteristics.

Based on this, doctors suggest that there are a number of factors contributing to infection. These include:

problems with immunity;
avitaminosis;
seasonal weakening of the body in winter and early spring;
lack of vaccination.

So if a mumps epidemic begins in a kindergarten or school, it is very difficult to protect the child from infection. The risk of infection is reduced if he has been vaccinated and has good immunity. And, of course, those who have already suffered from the disease should not worry.

Medical terminology. Glandula parotidea is the Latin word for the parotid salivary gland, which is why its inflammation is called mumps.

Classification

Depending on the state of immunity and the activity of paramycovirus, mumps in children can occur in different ways. Based on this, there are several classifications in pediatrics.

Manifest mumps

Uncomplicated: only the salivary glands (one or more) are affected.
Complicated: not only the salivary glands are affected, but also other organs, so that along with mumps, meningoencephalitis, orchitis, mastitis, pancreatitis, myocarditis, and arthritis are diagnosed.

According to severity

Mild form (erased or atypical): mild symptoms, no consequences.
Moderate severity: pronounced signs of intoxication, enlargement of the salivary glands.
Severe: severe symptoms.

There is also inapparent parotitis, i.e. asymptomatic. On the one hand, the child is sick, but does not feel any particular discomfort, feels as usual - and this cannot but please the parents. On the other hand, he is a source of infection, infecting others, while remaining in the shadows. After all, it is very difficult to diagnose this form of mumps in children.

Interesting fact. Animals do not get mumps.

Symptoms

The disease has a fairly long incubation period, which largely depends on the state of the child’s immune system. Usually, the first symptoms of mumps in children after infection begin to appear on days 11-13 (after 2 weeks), less often - on days 19-23 (i.e., only after 3 weeks).

To prevent the epidemic from spreading, if there are 2-3 sick people in a children's group, a quarantine is declared for a period of 21 days.

About a day before the swelling of the parotid glands, characteristic of the disease, prodromal phenomena can be observed - these are the first signs of mumps:

weakness, broken state;
malaise;
headaches and muscle pain;
slight chills;
lack of appetite;
insomnia.

The very next day, all these signs intensify and are complemented by a whole series of symptoms. It will be useful for parents to know how mumps manifests itself in children, so as not to confuse it with other diseases.

Intoxication:

arthralgia;
chills;
myalgia;
headache;
at severe forms asthenia, tachycardia, low blood pressure, anorexia, and prolonged insomnia may be observed.

Temperature:

in mild forms of mumps it can be low-grade (up to 38°C);
with moderate severity - already febrile (38-39°C);
in severe cases - high (40°C), and can remain at this level for 2 weeks or more;
The duration of fever is from 4 to 7 days, the peak occurs on the first and second days.

Damage to the salivary glands:

dry mouth;
pain in the ears;
Filatov's symptom: the most painful points are in front and behind the earlobe, as well as near the mastoid process;
when chewing and talking, the pain radiates to the ears;
tumor of the tonsils;
the most striking symptom of mumps in children is a significant (visually detectable) enlargement of the salivary glands, most often on both sides, and the swelling usually extends to the neck;
Mursu's symptom - inflammation of the mucous membrane in the area excretory duct parotid gland affected by a virus: the skin in this place is tense and shiny;
the swelling increases over 3 days, remains at the achieved volume for another 2-3 days, and then slowly decreases (this takes another week or even more);
parallel swelling of the sublingual and submandibular glands is possible.

Damage to the male genital organs:

in 20% of boys, damage to the spermatogenic epithelium of the testicles is observed, which provokes infertility in the future;
inflammation of the testicles occurs in a complicated form of mumps;
the child will constantly complain of pain in the gonad;
alternating increase in testicle size, swelling and redness.

In addition, you need to keep in mind how mumps occurs in children of different ages. The older they are, the more severe the disease is. The period of puberty is considered especially dangerous, when the organs of this area can come under attack from the virus.

In adults, the disease is treated mainly in a hospital, because it is most often impossible to avoid complications. At the first suspicion of mumps, the child should be immediately shown to a doctor.

About the name of the disease. When the parotid spaces and neck swell, the face of a child suffering from mumps becomes puffy and takes on characteristic shapes. Therefore, for a long time, people have used this name for the infection - mumps. It is also sometimes called a temple.

Diagnostics

Sometimes, to confirm the diagnosis, only an external examination and the results of routine tests - blood and urine - are sufficient. But sometimes the symptoms of mumps are disguised as other diseases, and the doctor has to prescribe a number of additional tests.

In addition, during the course of the illness, the child will have to undergo regular tests to identify complications.

Laboratory methods:

blood and urine tests;
pharyngeal rinses;
examination of the secretion of the parotid salivary gland;
collection of cerebrospinal fluid (required only if concomitant meningitis and other central nervous system lesions are suspected).

Immunofluorescent methods:

the study of cellular structures allows you to get faster results.

Serological methods:

enzyme-linked immunosorbent assay;
simple reactions (RSK and RNGA);
intradermal allergen test.

Diagnosing mumps in children is usually not difficult. All additional research are prescribed extremely rarely in the presence of complications. The examination is carried out either by a pediatrician or a therapist. He also prescribes treatment.

Educational program. If a child with mumps has been prescribed tests for RSK (complement fixation reaction) or IRHA (indirect hemagglutination reaction), he will need to be prepared in advance for blood sampling from a vein.

Treatment

After confirming the diagnosis based on tests, the doctor will determine the severity of the disease and prescribe how to treat mumps in children - at home (in 90% of cases) or in a hospital (if there is a risk of complications).

Therapeutic course, the main task which - to prevent complications, comes down to the following measures:

Isolation for 9 days after the first symptoms appear.
Bed rest for 10 days.
Prednisolone for a week: dosages start at 40-60 mg, but are reduced by 5 mg daily.
Other corticosteroids may be an alternative to prednisolone.
If there is a risk of further development of meningitis, a spinal puncture is prescribed to extract cerebrospinal fluid.
Dehydration therapy in moderation.
Antipyretics (paracetamol, ibuprofen), and at very high temperatures, analgin with papaverine is injected.
Plenty of warm drinks.
Antiviral/immunostimulating drugs (eg, groprinosin).
Apply dry heat to the swollen area.
Antispasmodics (drotaverine, no-spa) for pain relief.
Enzyme preparations for the prevention of pancreatitis (Mezim, Creon).

Therapeutic diet

Children with mumps are prescribed a therapeutic diet to avoid pancreatitis, which is a common complication after this disease. Its main principles:

do not overeat;
limit consumption White bread, pasta, fats, cabbage;
the basis of the diet should be dairy and plant products;
Rice, potatoes, and brown bread are recommended.

Typically, treatment for mumps in children comes down to complete rest, isolation and improvement of general condition. If complications and concomitant diseases occur, the therapeutic course changes direction towards them.

Avoiding the dangerous consequences of mumps by any means is the main task of doctors at this stage. Despite the fact that they are rare, their danger to the future life of the child is very great.

According to statistics. Boys who contracted mumps and did not comply with bed rest were subsequently diagnosed with orchitis 3 times more often than those who strictly followed all the doctors' recommendations.

Complications

Mumps is famous not so much for its symptoms or course, but for its consequences, and especially for boys. Indeed, infection of the testes by the virus may subsequently affect their ability to become fathers. Among the most common complications of this disease, doctors name the following:

orchitis, aspermia, infertility and testicular atrophy are the most common and most dangerous consequences of mumps in boys, the risk of which increases with age;
damage to the middle ear, which can result in deafness;
serious disturbances in the functioning of the central nervous system;
serous meningitis;
meningoencephalitis;
inflammation of the thyroid gland;
pancreatitis;
disruption of the pancreas.

If a child has had mumps, the prognosis is favorable if vaccinated. Dangerous consequences Although they are diagnosed, they are not so often. Fatalities- very rare: approximately 1 case per 100,000. But in order to minimize all risks, it is better to vaccinate on time and no longer be afraid of the mumps epidemic.

Prevention

The vaccine is a safe and guaranteed means of preventing mumps in children. According to the vaccination calendar, two injections are required:

at the age of 1-1.5 years;
in the period from 2 to 6 years.

The mumps vaccine is safe, and side effects are rare and mild. The administration of the drug causes moderate pain, slight fever, and swelling in the injection area.

There is no evidence that there is any connection between mumps vaccination and neurological complications. The drug is being developed from chicken cells, but is approved for use in children with egg allergies.

Despite regular vaccinations, mumps epidemics constantly break out in children's groups. Without an appropriate injection at 1 year of age, children suffer the disease very seriously, and boys in this case cannot avoid serious complications that will subsequently affect their entire lives.

Parents should keep this in mind before writing a refusal to receive another vaccination. Mumps is precisely a disease that is much more difficult to treat than to prevent.

Many people in childhood suffered from a disease such as mumps (disease), the symptoms of which are quite vivid.

This disease is also known as mumps. This disease has infectious nature. The disease belongs to the group of other childhood diseases (for example, measles, rubella, chickenpox, etc.). This disease affects the salivary glands, which are located near the ears. This causes the person's face to begin to swell and expand. Hence the name - mumps, the symptoms of which really make a person's face look like this animal.

Most often, this disease can be contracted between the ages of 3 and 7 years. By the way, according to statistics, girls get sick less often than boys. In childhood, the disease passes much easier, but in adult patients it not only has a severe course, but also has consequences for other organs and systems. However, now, thanks to vaccination, most children are unaware of this disease.

Causes of mumps development

Some people are aware of a disease called mumps, the symptoms of which are caused by a certain mumps virus. By the way, this pathogen is part of the same group as the virus that causes measles. This virus cannot mutate. It is not resistant to environmental conditions, so it quickly dies if you use ultraviolet radiation or various disinfectants. In addition, at temperatures above 70 degrees it also dies. But at temperatures up to 10 degrees it can live long enough.

The only source of the virus that causes mumps is the person who is infected and currently sick. By the way, this disease can go away without visible signs, so you cannot identify an infected person at first glance. Children who have mumps become contagious 2 days before mumps symptoms appear. Then he will be contagious for another 5 days from the time the first signs of mumps appeared. Human susceptibility to this virus is always high. But it can only be transmitted by airborne droplets.

Additionally, there are other factors that can cause the salivary glands near the ear to become enlarged. For example, this may be due to metabolic disorders. This happens with uremia, diabetes mellitus and other diseases. Secondly, mumps of a bacterial nature is also possible, and the formation of purulent masses. Thirdly, mumps can be viral. By the way, this also includes HIV mumps. In addition, these factors include Mikulicz syndrome, when inflammation of the salivary glands coincides with chronic mumps, which passes almost painlessly. Mumps disease, photos of which are easy to find in medical sources, can develop due to the formation of various neoplasms on the glands. Some medications can also cause swelling of the glands near the ear. For example, such medications include phenylbutane, propylthiouracil, various iodides and other substances. The virus enters through the mucous layers in the nasopharynx. Then he goes to circulatory system and affects various glandular tissues. It most often attacks the glands near the ear and under the jaw. The incubation stage can last from 11 to 21 days.

Symptoms of mumps in children appear within 3 weeks after infection. Although there are unusual cases, when the period of development of a viral infection takes only a couple of days. During this period, the patient is very dangerous for other people, so you need to be careful and not come into contact with an infected person.

In most cases, the signs of mumps are quite clear. When the incubation stage ends, a person’s body temperature rises. It can reach 39-40 degrees. The general state of health deteriorates sharply. The child will begin to be capricious. He is very excited, although many children, on the contrary, prefer to sleep more. If the disease develops in an adult, he becomes very weak and becomes irritable or nervous. Some people, on the contrary, become lethargic and apathetic. Constantly feels drowsy. There is no desire to do anything. The disease is characterized by headaches and dizziness. There are symptoms general intoxication body, so nausea and vomiting attacks are possible. Sometimes a person may be in a semi-fainting state in the most severe cases. There are disturbances in the coordination of movements.

The glands begin to swell and increase in size. This occurs approximately on the second day after the body temperature rises. And during the same period, pain appears in the ears, neck and cheeks. In most cases painful sensations occur only on one side, but if the disease becomes bilateral, then in the future both swelling and pain will spread to both sides of the face. If you press on glands that are swollen, the pain will only intensify.

By the way, they will feel like dough to the touch. When you need to chew, open your mouth or swallow food, the pain will also increase. In addition, there is one more sign that is characteristic only of mumps. Skin in the place where there is swelling, they will be smoother and shiny. Then the skin in this place begins to turn red. During the first 5 days, the tumor not only will not subside, but, on the contrary, tends to grow. Moreover, both cheeks can swell. Only after 5 days the swelling gradually begins to subside. It will completely disappear only after 10-14 days. Around the same period, the temperature will begin to decrease, and the patient’s general health will return to normal.

Consequences of mumps

Many people know this disease - mumps, the consequences of which can be very serious. Children survive this disease quite easily, although if treated incorrectly and untimely, the disease not only prolongs, but also causes severe side effects. But mumps in adult patients is very difficult.

The side effects and consequences of this disease are very varied. For example, an infection can spread to the gray matter and other membranes of the brain, causing inflammatory processes in them. In addition, they may develop pathological changes in the middle part of the ear.

In boys, changes in the genital organs may even occur, so infertility is possible. By the way, for some women this disease was the reason for their inability to conceive a child. The infection may spread to other glands. For example, during puberty it can affect the testicles, so that orchitis develops. In this case, the genitals become swollen, inflamed, red, and any touch causes severe pain. Most often, orchitis after mumps has one-sided treatment. Body temperature rises in the affected area. In some severe cases, the testicles will atrophy, but testosterone will still be produced so that reproductive abilities can be maintained. But in girls, oophoritis is considered a less painful disease. This is accompanied by inflammatory processes in the ovaries. This disease rarely occurs in the fairer sex, but it can lead to infertility.

The most serious side effect of mumps is encephalitis. This is a disease in which the membranes of the brain become inflamed. But this one by-effect very rarely appears. Sometimes complications affect the middle part of the hearing organ. However, after this the patient may remain deaf. The most common complication is meningitis. Although this disease is quite easy.

Treatment of epidemic mumps

In most situations, the disease is treated at home. A patient can be sent to a hospital department only if the disease is very severe. There are no special health measures for mumps. Medical therapy is aimed only at making the course of the disease easier.

He must remain in a lying position at all times. Moreover, you need to lie down for at least 10 days. This period can extend for more long time if the course of the disease is more severe. You definitely need to gargle and do various compresses and lotions on those areas that are swollen. For example, a regular solution is suitable for rinsing baking soda. In glass warm water you need to dissolve a spoonful of soda. This rinsing should be done as often as possible. You can also rinse with plain water in which sea salt has been dissolved. In addition, a solution of furatsilin or chlorophyllipt is perfect. If the child is very small and does not know how to rinse his mouth and throat, then you need to give him warm drinks as much and as often as possible.

To eliminate painful sensations, you need to apply a compress. Warms up first vegetable oil. Then you need to moisten the bandage in it. After this, the bandage is wrapped around the throat. After this, you need to additionally wrap your neck in a warm scarf.

To make it easier for the patient to tolerate the disease, medications are prescribed that relieve fever and eliminate pain. Physiotherapeutic procedures include UHF, ultraviolet irradiation and diathermy. Dry heat can be applied to the ear. For example, you can heat the salt and put it in a bag, which you then apply to your ear. A warm compress can be applied to other areas where the salivary glands are located. If you do not adhere to all these rules, the patient may develop infertility.

It is imperative to monitor the patient's diet. Swallowing and chewing can cause severe pain, so it is better to feed the patient liquid food or very soft ground foods. To prevent further development of the disease, you can switch to dairy products, vegetables, herbs, berries and fruits. It is best to avoid those foods that can irritate the mucous membranes. These include citrus fruits. It is also better to hold off on overly acidic drinks.

You should definitely drink tea with linden and mint. For a glass of boiling water you will only need a spoonful of raw materials. After the decoction has infused for 30 minutes, it is allowed to strain and drink. Such Herb tea you need to drink as often as possible. You can drop it on the lamp fir oil to breathe evaporation. A decoction of sage is suitable for rinsing.

Mumps is a fairly common disease in children. Although now every child is vaccinated, so many children do not know about this disease. If a person has not been vaccinated, then there is a risk of infection from an already infected patient. In this case, the disease will have a very severe course and serious consequences. It's better to spend preventive actions than to find out later what mumps is, the treatment of this disease and the side effects.

The content of the article

Viral mumps disease(synonyms for the disease: mumps, piggy) - spicy infectious disease, which is caused by the mumps virus, transmitted by airborne droplets, characterized by fever, damage to one or more (usually parotid) salivary glands; Other glands (genital, pancreas, thyroid) and the nervous system often experience damage, mainly in the form of serous meningoencephalitis.

Gilt historical data

The disease was first described by Hippocrates. Virus nature was brought to its attention in 1934 p. S. Johnson, E. Goodpasture. In the study of this disease, a great contribution was made by A. D. Romanovsky, N. F. Filatov, A. A. Smorodintsev, A. K. Shubladze, in Ukraine - I. V. Troitsky, who proved that the zone occurs with damage to many glands and nervous system.

Etiology of mumps

The causative agent of the viral mumps disease, Paramyxovirus parotitidis, belongs to the genus Paramuxovirus, family Paramyxoviridae. The virus has a single-stranded RNA, entwined with a shell of proteins and lipids, which includes hemagglutinins, hemolysin and neuraminidase. Only one serotype of the virus is known. It is very sensitive to unfavorable environmental factors - heating, drying, irradiation, disinfectant solutions, but is resistant to low temperatures. It reproduces well on chicken embryos when they are infected into the amniotic cavity.

Epidemiology of mumps

The source of infection is a sick person, who becomes infectious at the end of the incubation period, especially during the first 3-5 days of illness. From an epidemiological point of view, the most dangerous are patients with erased and asymptomatic forms of the disease, which account for 40% of cases. The presence of healthy virus carriers is assumed. The mechanism of infection is airborne through direct contact, and is also likely through objects contaminated with saliva.
Susceptibility to viral mumps disease is high. The contagiousness index is 20-40% and higher. It is observed in the form of sporadic diseases and epidemic outbreaks, at any age, but most often among children from 1 to 15 years. The maximum incidence is detected in preschoolers and primary schoolchildren. High susceptibility is also among young people aged 16-25 years.
Seasonality is observed - late winter and spring. The incidence rate increases every 2-3 years.
After an illness. Stable immunity is formed, although repeated cases of the disease are possible (0.4-3%). Maternal antibodies in the child's blood provide her with immunity during the first 6-8 months of life. Women who have had mumps a week before giving birth often give birth to children with clinical manifestations of the disease or it develops in the postnatal period.

Pathogenesis and pathomorphology of mumps

The entry point for infection is the mucous membranes of the mouth, nose, and larynx, in the epithelial cells of which the virus multiplies and then enters the blood. It is hematogenous. spreads to all organs and tissues. Since the causative agent is epithelial, neuro- and viscerotropic, the pathological process covers organs with glandular tissue and the central nervous system. In the salivary glands, the virus adapts and replicates, after which it enters the blood again, which leads to increased viremia.
Morphological changes were studied by biopsy of affected salivary glands and a study of experimental viral mumps disease in monkeys. The gland tissue retains its acinar structure, but swelling and infiltration with lymphocytes develop around the salivary ducts, spreading to connective tissue. The main changes are localized in the ducts of the salivary glands - from minor swelling of the epithelium to its complete desquamation and obstruction of the ducts with cellular detritus. Histological changes in the testicles are also varied: from minor interstitial edema without signs of impaired spermatogenesis to the formation of areas of epithelial necrosis and hemorrhages. Various degrees of damage are found in the pancreas, up to necrotizing pancreatitis. With mumps meningitis, hyperemia, cerebral edema, serous-fibrinous exudate in its grooves, hyperemia and perivascular infiltration of the meninges are observed.

Mumps clinic

. There are typical and atypical forms of the disease (according to N.I. Nisevich, 1967). TO typical forms include: glandular - lesions of other glandular organs, occurring both in isolation and in various combinations (parotid, submandibular, genital, mammary, pancreas, etc.); nervous - isolated damage to the central nervous system (serous meningitis, meningoencephalitis); combined - a combination of damage to the glandular organs and the central nervous system. Atypical forms: erased and asymptomatic.
The incubation period lasts 11-23 days, on average 15-18. Prodrome symptoms sometimes include malaise, weakness, headache and pain in the neck. neck muscles, feverish condition. The disease usually begins acutely with an increase in body temperature to 38-39 ° C, swelling and tenderness of the parotid salivary glands. Pain is felt in this area when opening the mouth, which may be the first sign of illness, sometimes even before the salivary glands become enlarged. The pain intensifies when drinking acidic liquid ( lemon juice, a weak vinegar solution), which increases salivation. The swelling begins to fill the space between the posterior edge of the lower jaw and the mastoid process. Soft fabrics around the gland swell and thicken, which makes it difficult to palpate to determine its contours. The affected gland reaches its maximum size within 1-3 days. The swelling “hides” the ascending branch and the angle of the lower jaw, the earlobe is slightly raised and directed forward. Its consistency is doughy or elastic-dense. The damage to the parotid glands is usually bilateral, first one, and after 1-2 days the second. Possible unilateral parotitis. Over the next 3-7 days, the swelling gradually decreases and finally disappears.
The area of swelling is moderately painful. The skin over it is of normal color, tense, shiny. Pain is felt when pressing behind the earlobe and in the area of the apex of the mastoid process (Filatov's symptom). Other painful points are also typical: in front of the earlobe, above the notch of the lower jaw submandibular gland. their presence helps in diagnosis if enlargement of the salivary glands is doubtful. If the parotid salivary glands are affected, characteristic hyperemia and swelling of the mucous membrane in the area of the mouth of the parotid gland duct is observed - Moores sign. Sometimes there is swelling of the mucous membrane of the pharynx, tonsils and subcutaneous tissue neck.
In addition to the parotid glands, other salivary glands may also be affected - submandibular, sublingual. In case of enlargement of the submandibular salivary gland, the swelling extends forward and downward from the angle of the lower jaw and has an oval shape. The pain is weaker, but the involution of the process occurs more slowly than in the case of an enlarged parotid gland. The sublingual salivary gland, as a rule, enlarges along with the submandibular gland; isolated damage to it is rarely observed. Damage to the salivary glands is accompanied by a decrease in saliva secretion by 3-4 times. Their functional ability is restored only after 3-4 weeks, that is, much later than the manifestations of the disease disappear.
Damage to the pancreas may precede enlargement of the salivary glands, occur simultaneously or with an interval of several days. The main symptoms are abdominal pain (mainly around the navel), often paroxysmal, sometimes of a shingles nature, nausea and repeated vomiting. Increased level amylase in the blood is typical for most patients with viral mumps, regardless of the presence of pancreatitis. Mild and subclinical forms of pancreatitis develop more often than they are detected. The course of pancreatitis is favorable, symptoms disappear after 5-10 days.
Orchitis and epididymitis are observed more often in adolescents and adults and can develop either separately or simultaneously. Orchitis appears mainly 6-8 days after the onset of the disease, sometimes later and may not be accompanied by noticeable damage to the salivary glands. Usually a one-sided process is observed. The onset is sudden, with chills and increased body temperature. The affected testicle sometimes increases in size by 2-3 times, hardens, and the skin over it swells and turns red. There is sharp pain on palpation. Testicular atrophy is possible. In 10-15% of patients, spermatogenesis is impaired, but complete sterility is rarely observed.
Thyroiditis of mumps etiology develops extremely rarely. There are cases of damage to the lacrimal gland (dacryoadenitis), very rarely isolated (mumps of the lacrimal gland of Hirschberg). Damage to the central nervous system in viral mumps disease is detected in 50-80% of cases and occurs in the form of serous meningitis, often meningoencephalitis, less often - neuritis of the cranial nerves , polyradiculoneuritis.
Mumps meningitis begins 3-6 days after the development of mumps symptoms, less often precedes them or develops simultaneously with swelling of the salivary glands. Isolated development of meningitis without involvement of the glands in the process is possible. Damage to the membranes of the brain is manifested by increased body temperature, headache, repeated vomiting, and meningeal symptoms. It has been established that the meninges are affected more often than meningitis is clinically diagnosed, since inflammatory changes in the cerebrospinal fluid are possible in the absence of meningeal symptoms.
The cerebrospinal fluid is transparent, pleocytosis is up to 300-500, sometimes up to 2000 cells per 1 μl, lymphocytes predominate. The amount of protein is within normal limits or slightly increased, the glucose level is normal. Meningitis of mumps etiology has a benign course.
Meningoencephalitis belongs to severe lesions of the nervous system, but its course is favorable. In some cases, neuritis is isolated.
Polyradiculoneuritis of mumps etiology without prior enlargement of the salivary glands is not observed. The development of symmetrical paresis or paralysis of the limbs in combination with pain and loss of sensitivity against the background of normal or subfebrile body temperature is typical. The course is benign.
A blood test in patients with viral mumps reveals leukopenia with relative lymphocytosis. In the case of meningitis and orchitis, an increase in the number of polymorphonuclear cells is possible.
Complications are observed rarely, in late periods. As a result, damage to the nervous system is possible hypertension syndrome, peripheral paresis of the facial, trigeminal and auditory nerves, deafness. In young children, due to the addition of a bacterial infection, complications may include pneumonia, stomatitis, or otitis media.
The prognosis is favorable.

Diagnosis of viral mumps disease

The main symptoms for diagnosing viral mumps disease are fever, swelling and moderate tenderness of the salivary glands (usually the parotid glands) with almost unchanged skin over them, Moores' sign. Enlargement of the salivary glands in combination with pancreatitis, serous meningitis or orchitis facilitates the diagnosis of mumps.
Recognition of isolated lesions of the submandibular salivary glands, as well as primary meningitis, pancreatitis or orchitis of mumps etiology causes significant difficulties. It is important to take into account the epidemiological history.

Specific diagnosis of mumps

Isolation of the virus from blood, saliva and cerebrospinal fluid is time-consuming and labor-intensive, which is not used in practice. Widely put into practice serological diagnostics using RTGA, the diagnostic titer of which is 1: 80. More informative is the fourfold increase in antibody titer in the dynamics of the disease. RSK is also used.
For retrospective diagnosis of viral mumps disease, an intradermal allergy test is used. An inactivated extract of a chicken embryo infected with the mumps virus is used as a diagnosticum.

Differential diagnosis of mumps

Viral mumps disease is differentiated from purulent and toxic mumps, mumps disease, tumors, lymphadenitis, and toxic diphtheria of the pharynx.
Purulent parotitis develops mainly against the background of a serious illness (septicemia, typhoid fever), characterized by septic fever, local hyperemia of the skin, severe pain and hardness of the gland, accompanied by leakage of pus from the opening of the gland duct. A blood test reveals neutrophilic leukocytosis.
Toxic mumps is observed in adults with acute and chronic poisoning with mercury and lead. It develops slowly, in parallel with other symptoms typical of poisoning.
Stones obstruct the ducts of the salivary glands, periodically causing their swelling at normal body temperature, the process is usually one-sided, the swelling is intermittent, the submandibular glands are more often affected than the parotid glands. The diagnosis is clarified using sialography. Tumors of the salivary glands are always a one-sided process, with gradual development, without common symptoms diseases.
At differential diagnosis with lymphadenitis, toxic diphtheria of the pharynx, the presence and characteristics the primary focus of inflammation.

Treatment of mumps

Patients with mild and moderate forms are treated at home. Only persons with a severe form of the disease with damage to the nervous system and gonads are subject to mandatory hospitalization. In the acute period of the disease, bed rest is recommended. Oral care includes brushing your teeth, rinsing your mouth after eating with boiled water, 2% sodium bicarbonate solution, potassium permanganate solution 1: 1000, furatsilin 1: 5000. For all forms of the disease, antipyretic, anti-inflammatory, and analgesics are recommended. Mefenamic acid is also used 0.25-0.5 g three times a day, which, in addition to the listed pharmacodynamic effects, is an interferon inducer.
Patients with pancreatitis are prescribed a diet with limited fat and protein; in case of severe pain - antispasmodics, significant intoxication and frequent vomiting - intravenous drip administration of glucose-salt solutions, proteolysis inhibitors (trasylol, contrical, gordox, pantripin, antagosan).
Patients with orchitis are prescribed strict bed rest until signs of the disease disappear, suspensions, prednisolone (2 mg/kg per day) as a drug with anti-inflammatory, immunosuppressive and desensitizing effects. Thermal procedures and compresses are contraindicated. To reduce swelling and pain of the inflamed testicle in the first 2-4 days, it is advisable to use cold.
For meningitis, a spinal puncture is indicated not only for diagnostic purposes, but also as a remedy to reduce intracranial pressure. Detoxification and dehydration treatments are carried out. Effectively used in complex treatment ribonuclease and human leukocyte interferon, which is administered intramuscularly twice a day for 5-7 days. In severe cases, glycocorticosteroids are prescribed for 6-8 days. Antibiotics are usually not used. Bed rest lasts 12-14 days.

Prevention of mumps

The patient is isolated until disappearance clinical manifestations illness, but not less than 9 days. Final disinfection is not carried out. In the children's institution where the patient is found, a quarantine is established for 21 days. Children under 10 years of age who have been in contact with a sick person are subject to separation from the 11th to the 21st day from the date of last contact. If the patient remains at home, children under 10 years of age are not allowed into the children's group for 21 days, which are counted from the 9th day of illness.
Active prevention involves the use of live atenujovar vaccine. It is administered once intramuscularly in a dose of 0.1 ml or subcutaneously in a dose of 0.5 ml to children aged 15-18 months.
After vaccination, specific antibodies are detected in 96% of children, but their titer is 5 times lower compared to those who have recovered from the disease. The long-term protective effect of the vaccine is observed in 97% of vaccinated people.

Mumps or mumps is a disease of viral etiology that leads to inflammation of the salivary glands. Children aged 3 to 15 years are most susceptible to this disease, the most dangerous period is from 3 to 7 years.

Most of the patients are boys, and for them this disease carries a great danger in the form of complications. In some cases, adults also become ill.

The mumps disease is transmitted by airborne droplets, but household infection is also possible.

The incubation period includes 9 days before the first signs of the disease appear and 9 days of the onset of the disease, i.e. 18 days a person is contagious.

Causes

The main cause of mumps infection is paramyxoviruses (Paramyxoviridae - a family of viruses from the order Mononegavirales).

You can become infected from a child who has not yet developed any signs or symptoms of the disease. During an epidemic, 70% of children are infected.

After suffering from mumps, lasting immunity is developed for life, reinfection is extremely rare.

20% of the child population is not susceptible to mumps infection due to the individual characteristics of the body.

Factors provoking the occurrence of the disease

Experts believe there are several factors that may contribute to infection. These include:

weakened immune system;
lack of vitamins and minerals in the body;
seasonal weakening of the body's protective functions in spring and winter;
lack of mumps vaccinations.

In the event of an epidemic in preschool institution or at school, it is extremely difficult to protect a child from infection. It is very important to maintain normal immunity of the child and carry out preventive vaccinations on time.

People who have been ill should not be afraid.

Symptoms

Mumps disease has the same symptoms in both children and adults.

The first stage of the disease has no symptoms. It lasts from 11 to 23 days, during this period the person does not experience any signs of the disease, but 7-9 days before the symptoms appear, the sick person is already dangerous to others.

After this stage, the disease progresses to acute form and has the following characteristics:

temperature rise to high levels ( this symptom lasts for a week);
severe headaches;
weakness and fatigue;
decreased appetite;
a feeling that doesn't stop;
pain when swallowing and moving the mouth;
pain in the ears, which increases during conversation.

But most a clear sign and a distinctive feature of mumps is the appearance of specific swelling in the ear area (see photo above). Such swellings appear due to inflammation of the salivary glands located near the ears - this is a common localization of the mumps virus.

The glands increase to their maximum size within 7 days, after which they gradually decrease. The patient appears pain syndrome, this is especially noticeable during physical contact, and in adult people it is also characteristic severe pain in muscles and joints.

In people who become ill as adults, mumps occurs in a severe form, and intoxication of the body is more severe. high level. Symptoms in adults are more pronounced.

The disease also leads to complications of the main part of the nervous system and.

Classification

Depending on the level of immunity in pediatrics, mumps has several classifications:

Manifest mumps:

uncomplicated: the disease affects only the salivary glands.
complicated: the disease affects not only the salivary glands, but also other organs, therefore, along with mumps, other diseases are diagnosed, for example, meningitis, etc.

According to severity:

Mild degree. The symptoms are mild, there are no complications.
Moderate severity. The symptoms are pronounced, severe intoxication, and the salivary glands enlarge.
Severe degree. The symptoms are very pronounced. Most often, this degree is diagnosed in older people, since the symptoms in adults are more pronounced and severe.

In addition, there is such a classification as asymptomatic mumps. When the disease progresses to this extent, the child feels well and has no symptoms, but he can infect others.

Diagnostics

Mumps in children is often diagnosed based on visual examination. But since swelling of the ear area can be caused not only by this disease, but also by a number of others, a number of studies will be required to make an accurate diagnosis.

In addition, mumps in children sometimes occurs in a sluggish form or without any symptoms at all, which makes it difficult to identify the disease.

To make a diagnosis, studies such as:

collecting anamnesis and clarifying the possibility of contact with patients;
, but it will only reveal the presence of infection in the body, for this reason it is not informative;
a bacteriological method for examining saliva and urine, but this analysis is informative only in the last days before the onset of symptoms and 4 days after their onset;
immunofluorescent analysis, which is the most informative.

As additional research methods, we use instrumental methods identifying affected organs.

Treatment

Symptoms and treatment for mumps are directly related.

After determining the exact diagnosis, the doctor identifies the severity of mumps in children and decides on the method of treatment.

No special therapy is provided; it is mainly aimed at alleviating the symptoms of the disease.

First of all, the patient must be isolated to prevent infection of others. Treatment takes place at home.

Hospitalization is provided for severe disease that occurs with complications.

Drug treatment

To treat mumps, symptomatic therapy is used:

To reduce the temperature, antipyretics are prescribed, for example, Ibuprofen or Paracetamol. The use of Aspirin is highly discouraged, as it affects the gastrointestinal tract and can cause additional problems;
anti-inflammatory drugs are prescribed ( Viferon, Kapferon), since there is no special medicine to combat mumps;
a diet is prescribed - preference is given to boiled and stewed foods, spicy and sweet foods are completely excluded, as well as alcohol (if we talk about adults), carbonated drinks and coffee;
drinking plenty of water at least 2 liters per day is prescribed;
complete bed rest is prescribed for 5-7 days;
with strong pain Painkillers may be prescribed;
antihistamines, to prevent allergic reactions;
to prevent infertility in men, hormone therapy is prescribed;
in case of severe intoxication, they are administered within the hospital sodium chloride and glucose.

Surgery

For the treatment of mumps surgical intervention not provided.

Additional treatments at home

To treat mumps, additional treatment methods can be used at home, but it is worth remembering that self-medication is not allowed.

Before using any methods, you need to consult a specialist.

Nutrition

In addition to doctor's prescriptions, you can use:

natural fruit drinks that help strengthen the immune system and maintain general tone in the body;
use compresses to reduce fever (vinegar);
drink vitamin complexes;
crush food for easier swallowing.

Herbs and infusions

To treat mumps, it is possible to use herbal infusions, but this should be done with caution and only after consulting a doctor.

You will need 1 tbsp. spoon of linden flowers, which should be poured with 1 glass of boiling water and left to infuse for 30 minutes. Take 0.5 cups 3 times a day.
You can use sage to rinse your mouth. To finish this you need to take 1 teaspoon of sage, pour 1 glass of boiling water and leave for half an hour. Then the infusion needs to be filtered.
You will need 1 tablespoon of primrose herb. Pour 200 ml of boiling water and leave for 30 minutes, then strain the infusion. Take a quarter glass 3 times a day, 30 minutes before meals, as an additional source of vitamins.

Complications

Mumps is a fairly well-known disease, but not only due to its highly pronounced symptoms and signs, but also to its complications, which sometimes lead to serious consequences for human health. And first of all, mumps poses a danger to boys and members of the male population.

Experts highlight the following possible complications diseases:

infertility caused by testicular atrophy. The risk of this complication increases with age;
deafness, which may occur due to damage to the middle ear;
disturbances in the functioning of the central nervous system;
serous meningitis;
thyroid diseases;
dysfunction of the pancreas.

Prevention

To prevent infection of other children or adults, the patient is isolated for 10 days.

Prevention of mumps, first of all, involves vaccination. To do this, I use a live or attenuated vaccine, which is injected under the skin in the area of the shoulder blade or the outer part of the shoulder once using a dose of 0.5 ml.

Vaccination is given to children aged 1 year. The vaccine includes antibodies against and.

At 6 years of age, revaccination is carried out, after which stable immunity to the disease is developed and infection is excluded almost 100%.

If, for medical reasons or because of refusal to vaccinate, the vaccination schedule has been disrupted, then you can get vaccinated at any age, and revaccination at least after 4 years.

Several types of vaccines are used for vaccinations:

Monovaccine is a vaccine against mumps in live form.
Vaccine – against measles and mumps in live form.
The three-component vaccine includes Priorix, Ervevax, and Trimovax.

Forecast

In most cases, the prognosis for mumps is favorable and ends with complete recovery. The proportion of cases of the disease with serious complications is not large. If you consult a doctor in a timely manner and follow all prescriptions, complications are virtually eliminated.

If a child has a complication in the form of serous meningitis, he should be monitored by a neurologist for 2 years, as this may occur.

May lead to infertility.

In order to avoid this disease, you should not refuse to vaccinate your child, since this is an almost 100% guarantee of the resistance of immunity to the causative agent of the virus.

If an infection with mumps does occur, you should not self-medicate, but consult a doctor at the first symptoms, since timely diagnosis and treatment are the key to a successful recovery.

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