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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 and may manifest
primarily as respiratory tract infection. 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.
In the absence of immunization, mumps typically occurs during
childhood. Infection occurring among adults is more likely to
be severe, and death resulting from mumps and its complications,
although rare, occurs most often in adults. Mumps during the
first trimester of pregnancy is associated with an increased
rate of spontaneous abortion. Although mumps can cross the placenta,
no evidence exists that this results in congenital malformation.
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 and other enteroviruses,
lymphocytic choriomeningitis virus, human immunodeficiency virus
(HIV),
Staphylococcus aureus, nontuberculous mycobacterium,
and less often, other gram-positive and gram-negative bacteria;
salivary duct calculi; starch ingestion; drug reactions (eg,
phenylbutazone, thiouracil, iodides); and metabolic disorders
(diabetes mellitus, cirrhosis, and malnutrition).
EPIDEMIOLOGY: Mumps occurs worldwide, and humans are the only
known natural hosts. The virus is spread by contact with infected
respiratory tract secretions. Historically, the peak incidence
was between January and May; however, seasonality no longer
is evident
. . . [Go to Full Text]
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