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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
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.
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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).
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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
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