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Section 3. Summaries of Infectious Diseases
Mumps
Clinical ManifestationsEtiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
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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 an immunization program, 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 virus can cross the placenta, no evidence exists that this results in congenital malformation.
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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 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).
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EPIDEMIOLOGY
Mumps occurs worldwide, and humans are the only known natural hosts. The virus is spread by contact with infected respiratory tract secretions. Mumps virus is the only cause of epidemic parotitis. Historically, the peak
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