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Section 3. Summaries of Infectious Diseases
Mumps
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Mumps is a systemic disease characterized by swelling of one or more of the salivary glands, usually the parotid glands. Approximately one third of infections do not cause clinically apparent salivary gland swelling. More than 50% of people with mumps have cerebrospinal fluid pleocytosis, but fewer than 10% have symptoms of central nervous system infection. Orchitis is a common complication after puberty, but sterility rarely occurs. Other rare complications include arthritis, thyroiditis, mastitis, glomerulonephritis, myocarditis, endocardial fibroelastosis, thrombocytopenia, cerebellar ataxia, transverse myelitis, ascending polyradiculitis, pancreatitis, oophoritis, and hearing impairment.
ETIOLOGY: Mumps is caused by an RNA virus classified as a Rubulavirus in the Paramyxoviridae family. Other causes of parotitis include infection with cytomegalovirus, parainfluenza virus types 1 and 3, influenza A virus, coxsackieviruses, lymphocytic choriomeningitis virus, enteroviruses, human immunodeficiency virus (HIV), Staphylococcus aureus, and nontuberculous mycobacterium; starch ingestion; drug reactions (eg, phenylbutazone, thiouracil, iodides); and metabolic disorders (diabetes mellitus, cirrhosis, and malnutrition).
EPIDEMIOLOGY: Humans are the only known natural hosts. The virus is spread by contact with infected respiratory tract secretions. Infection can occur throughout childhood. During adulthood, infection is likely to produce more severe disease, including orchitis. Death attributable to mumps is rare; the estimated case fatality rate is 1.6 to 3.8 per 10 000. More than half of the fatalities occur in people older than 19 years of age. Mumps infection during the first trimester of pregnancy is associated with an increased rate of spontaneous abortion. Although mumps virus can cross the placenta, no evidence exists that mumps infection during pregnancy causes congenital malformations. Historically, the peak incidence was between January and May; however, seasonality no longer . . . [Go to Full Text]
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- Perez, E. E., Bokszczanin, A., McDonald-McGinn, D., Zackai, E. H., Sullivan, K. E.
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- Pool, V., Braun, M. M., Kelso, J. M., Mootrey, G., Chen, R. T., Yunginger, J. W., Jacobson, R. M., Gargiullo, P. M.
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(2002). MMR--Separate Administration--Has It Been Done?. Pediatrics
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- Piedra, P. A., Gaglani, M. J., Riggs, M., Herschler, G., Fewlass, C., Watts, M., Kozinetz, C., Hessel, C., Glezen, W. P.
(2005). Live Attenuated Influenza Vaccine, Trivalent, Is Safe in Healthy Children 18 Months to 4 Years, 5 to 9 Years, and 10 to 18 Years of Age in a Community-Based, Nonrandomized, Open-Label Trial. Pediatrics
116: e397-e407
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- Miller, L. C., Comfort, K., Kelly, N.
(2001). Immunization Status of Internationally Adopted Children. Pediatrics
108: 1050-1051
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- Rosenthal, J., Rodewald, L., McCauley, M., Berman, S., Irigoyen, M., Sawyer, M., Yusuf, H., Davis, R., Kalton, G.
(2004). Immunization Coverage Levels Among 19- to 35-Month-Old Children in 4 Diverse, Medically Underserved Areas of the United States. Pediatrics
113: e296-e302
[Abstract]
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- Posfay-Barbe, K. M., Heininger, U., Aebi, C., Desgrandchamps, D., Vaudaux, B., Siegrist, C.-A.
(2005). How Do Physicians Immunize Their Own Children? Differences Among Pediatricians and Nonpediatricians. Pediatrics
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- Virtanen, M., Peltola, H., Paunio, M., Heinonen, O. P.
(2000). Day-to-Day Reactogenicity and the Healthy Vaccinee Effect of Measles-Mumps-Rubella Vaccination. Pediatrics
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- Nilsson, A., De Milito, A., Engstrom, P., Nordin, M., Narita, M., Grillner, L., Chiodi, F., Bjork, O.
(2002). Current Chemotherapy Protocols for Childhood Acute Lymphoblastic Leukemia Induce Loss of Humoral Immunity to Viral Vaccination Antigens. Pediatrics
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- Patja, A., Mäkinen-Kiljunen, S., Davidkin, I., Paunio, M., Peltola, H.
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