Mumps

Topic Overview

What is mumps?

Mumps is a contagious viral infection that can cause painful swelling of the salivary glands, especially the parotid glands (between the ear and the jaw). About 1 out of 3 people with mumps will not have gland swelling. They may have an upper respiratory tract infection instead.

What causes mumps?

Mumps is spread when an infected person coughs or sneezes near you or shares food or drinks.

What are the symptoms?

Mumps can affect many body systems and cause flu-like symptoms, belly pain, swollen cheeks, and swollen and painful testicles. But some people who are infected with the mumps virus do not have any symptoms.

The incubation period—the time from when a person is first infected with the virus until the first symptoms are noticed—is usually 16 to 18 days, although it can be as long as 25 days. Infected people can spread the virus 1 to 2 days before symptoms start and for 5 to 9 days after symptoms start.

How is mumps diagnosed?

Mumps is most often diagnosed by a history of exposure to the disease, the presence of swelling and tenderness of the parotid glands, and other symptoms, including neck stiffness, headache, and painful testicles.

If needed, a test, such as an enzyme-linked immunosorbent assay (ELISA, EIA), can be done to confirm the diagnosis and rule out the possibility that another illness is causing the symptoms.

The mumps virus itself can be identified with a viral culture of samples of urine, saliva, or cerebrospinal fluid obtained by a lumbar puncture. These tests are rarely done.

How is it treated?

In most cases, people recover from mumps with rest and care at home. In complicated cases, a hospital stay may be required.

Can mumps be prevented?

Mumps can almost always be prevented by getting a series of shots with the combination measles-mumps-rubella (MMR) vaccine. Two shots provide lifelong protection (immunity) against getting mumps: one at 12 to 15 months of age, the other at 4 to 6 years of age. Or your child could get the MMRV vaccine, which protects against chickenpox (varicella) as well as mumps. MMRV can be substituted for MMR in children age 12 and younger. Talk to your child's doctor about the pros and cons of the MMRV shot.

Most babies do not become infected with mumps during their first year of life because of the short-term immunity they received before birth from their mothers. Before the mumps vaccine existed, mumps was a common childhood disease in the United States.

Frequently Asked Questions

Learning about mumps:	What is mumps? What are the symptoms? When are mumps immunizations given?(What is a PDF document?)
Being diagnosed:	What kinds of exams and tests are used?
Getting treatment:	What is the treatment? What can I do at home? What should I know about giving over-the-counter medicines to my child?
Ongoing concerns:	Are there complications? Can the vaccine for mumps cause autism? Is it safe to travel to countries where mumps is common?

Symptoms

The mumps virus enters your body through the nose and throat. You may start to feel symptoms as the virus multiplies and spreads to the brain and the membranes that cover it, to the glands (usually the salivary glands), pancreas, testicles, ovaries, and to other areas of the body.

Symptoms usually last about 10 days and may include:

• Swelling and pain in one or more of the salivary glands. One or both cheeks may look swollen. Many people consider swollen parotid glands to be a classic sign of mumps, but this symptom can also occur with other illnesses.
• Fever of 101°F (38°C) to 104°F (40°C).
• Headache, earache, sore throat, and pain when swallowing or opening the mouth.
• Pain when eating sour foods or drinking sour liquids, such as citrus fruit or juice.
• Tiredness, with aching in the muscles and joints.
• Poor appetite and vomiting.

Up to one-third of people who are infected with the mumps virus do not have any symptoms, especially children younger than 2 years.

Infected people can spread the virus 1 to 2 days before symptoms start and for 5 to 9 days after symptoms start.

The incubation period—the time from when a person is first infected with the virus until the first symptoms are noticed—is usually 16 to 18 days, although it can be as long as 25 days.

Contact your doctor immediately if you have symptoms of complications, such as a stiff neck or severe headache (related to meningitis), painful, tender testicles (from orchitis), and upper or lower belly pain (caused by pancreatitis or oophoritis).

Exams and Tests

Mumps is most often diagnosed by a history of exposure to the disease and the presence of symptoms. Swelling and tenderness of the salivary glands, especially the parotid glands, is a common symptom to spot.

If needed, a test can be done to confirm the diagnosis and rule out other illnesses. For example, a blood test can check the level of antibodies the body has developed against the mumps virus.

The mumps virus itself can be identified with a viral culture of a sample of urine, saliva, or cerebrospinal fluid obtained by a lumbar puncture. These tests are rarely done.

Treatment Overview

In cases without complications, mumps is treated with bed rest and care at home. Home treatment includes medicines you can buy without a prescription to relieve pain and reduce fever.

Complications may require treatment in the hospital. Medicines to relieve pain associated with orchitis, meningitis, pancreatitis, and other complications may be given. Treatment with other medicines, such as interferon for severe orchitis, is experimental. Antibiotics are not given to treat mumps or other viral infections.

Home Treatment

Children who have mumps should not go to school, day care, or public places until 5 days after the salivary glands first start to swell.¹

In general, it is not necessary to separate a child from the family, because by the time mumps is diagnosed, most household members have already been exposed.

If you or your child has mumps:

• Use acetaminophen for fever or headache. Follow all instructions on the label. If you give medicine to your baby, follow your doctor’s advice about what amount to give. Do not give aspirin to anyone younger than 20 because of its link to a rare but serious illness called Reye syndrome.
• Place an ice or a heat pack, whichever feels better, on the swollen jaw if there is pain from the swelling. Place a light towel between the jaw and the ice pack or heat pack to protect the skin. Remove the pack after 20 minutes.
• Place an ice pack intermittently on tender testicles. Gentle support may also be comforting and reduce swelling. See how to make and use an ice pack.
• Suck on ice chips or flavored ice treats, such as Popsicles. Eat soft foods that do not require chewing.
• Do not eat sour foods or sour liquids. Because infected salivary glands are extremely sensitive, it may be hard to eat sour foods.
• Drink extra fluids or suck on Popsicles. This can help reduce fever and prevent dehydration.

If you or your child has mumps, call your local health department. The health department needs to record all cases of this illness. If you visit your doctor, he or she will report it for you.

Prevention

Before the mumps vaccine existed, mumps was a common childhood disease in the United States. The mumps vaccine is now routinely given as part of the measles, mumps, and rubella (MMR) shot(What is a PDF document?). The mumps vaccine is also included in the MMRV shot(What is a PDF document?), which also protects against chickenpox (varicella). Talk to your child's doctor about the pros and cons of the MMRV shot. It can be given to children ages 12 and younger. For more information, see the topic Immunizations.

The benefits of the MMR and MMRV vaccines far outweigh the risks. But you may have concerns, such as:

• Whether your child is at risk for autism after receiving the MMR vaccine. Numerous studies show there is no evidence that the MMR vaccine causes or is related to autism.^{2, 3}
• Whether your child will have an allergic reaction from the MMR vaccine or MMRV vaccine. The risk of allergic reaction from these vaccines is very low.

Check your immunization status before you travel to countries where mumps is common.

Other Places To Get Help

Organizations

HealthyChildren.org
141 Northwest Point Boulevard
Elk Grove Village, IL 60007
Phone:	(847) 434-4000
Web Address:	www.healthychildren.org
This American Academy of Pediatrics website has information for parents about childhood issues, from before the child is born to young adulthood. You'll find information on child growth and development, immunizations, safety, health issues, behavior, and much more.
American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL  60007-1098
Phone:	(847) 434-4000
Fax:	(847) 434-8000
Email:	kidsdocs@aap.org
Web Address:	www.aap.org
The American Academy of Pediatrics (AAP) offers a variety of educational materials, such as links to publications about parenting and general growth and development. Immunization information, safety and prevention tips, AAP guidelines for various conditions, and links to other organizations are also available.
Centers for Disease Control and Prevention (CDC): Vaccines and Immunizations
1600 Clifton Road
Atlanta, GA  30333
Phone:	1-800-CDC-INFO (1-800-232-4636)
TDD:	1-888-232-6348
Email:	cdcinfo@cdc.gov
Web Address:	www.cdc.gov/vaccines
This CDC Web site has information about vaccines and the diseases that can be prevented by immunization. The Web site includes the recommended immunization schedules for children, teens, and adults. There is also information about vaccine side effects and safety, school and state requirements, and immunization records. Interactive schedules are also available.
KidsHealth for Parents, Children, and Teens
10140 Centurion Parkway North
Jacksonville, FL  32256
Phone:	(904) 697-4100
Fax:	(904) 697-4125
Web Address:	www.kidshealth.org
This Web site is sponsored by the Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This Web site offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly e-mails about your area of interest.
National Network for Immunization Information
301 University Boulevard
Galveston, TX  77555
Phone:	(409) 772-0199
Fax:	(409) 772-5208
Email:	nnii@i4ph.org
Web Address:	www.immunizationinfo.org
The National Network for Immunization Information provides information on immunizations, including each of the recommended childhood vaccines, the recommended childhood immunization schedule, tips on using the World Wide Web as a source of immunization and health information, and links to other helpful sites. You can also search for the vaccines that each state requires before entry into school or day care.

Related Information

• Hand-Washing
• Immunizations
• Immunizations: Questions Parents Ask
• Swollen Glands and Other Lumps Under the Skin
• Travel Health
• Vaccine Information Statements

References

Citations

1. Centers for Disease Control and Prevention (2008). Updated recommendations for isolation of persons with mumps. MMWR, 57(40): 1103–1105. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5740a3.htm?s_cid=mm5740a3_e.

2. Peacock G, Yeargin-Allsopp M (2009). Autism spectrum disorders: Prevalence and vaccines. Pediatric Annals, 38(1): 22–25.

3. Elliman D, et al. (2009). Measles, mumps, and rubella: Prevention, search date July 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

Other Works Consulted

• American Academy of Pediatrics (2009). Mumps. In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp. 468–472. Elk Grove Village, IL: American Academy of Pediatrics.

• Centers for Disease Control and Prevention (2010). Use of combination measles, mumps, rubella, and varicella vaccine. MMWR, 59(03): 1–12. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm?s_cid=rr5903a1_e.

• Gnann JW (2008). Mumps. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., pp. 2480–2482. Philadelphia: Saunders.

• Levin MJ, Weinberg A (2011). Mumps section of Infections: Viral and rickettsial. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 1142–1143. New York: McGraw-Hill.

• Litman N, Baum SG (2010). Mumps virus. In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 2, pp. 2201–2206. Philadelphia: Churchill Livingstone Elsevier.

• Mason WH (2007). Mumps. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 1341–1344. Philadelphia: Saunders Elsevier.

Credits

By	Healthwise Staff
Primary Medical Reviewer	John Pope, MD - Pediatrics
Specialist Medical Reviewer	Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
Last Revised	March 17, 2011

By:	Healthwise Staff	Last Revised: March 17, 2011
Medical Review:	John Pope, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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