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Mumps

Author
Mary A Albrecht, MD
Section Editors
Martin S Hirsch, MD
Sheldon L Kaplan, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

The mumps virus causes an acute, self-limited viral syndrome. Prior to the widespread use of an effective vaccine, mumps primarily occurred in young children attending primary grade school; mumps was also a leading cause of viral meningitis and the most common cause of unilateral-acquired sensorineural deafness in children [1]. Sporadic outbreaks have occurred in the United States and Europe; some of these patients have required hospitalizations due to complications of infection.

The epidemiology, clinical manifestations, diagnosis, treatment, and prevention of mumps are discussed here. Issues related to vaccination for prevention of mumps are discussed separately. (See "Measles, mumps, and rubella immunization in adults".)

EPIDEMIOLOGY

Mumps occurs worldwide. The peak incidence is typically in the late winter to early spring, although sporadic outbreaks occur.

In the United States, after development of the mumps vaccine in 1967 and introduction of a policy for administration of one dose of mumps vaccine in 1977, reported mumps cases dropped by 98 percent [2,3]. Routine mumps immunization was recommended by the American College of Pediatrics until 1982, leaving a cohort of young adults (born after 1956 but before 1982) at risk. A second dose of vaccine was recommended in 1989; this led to historically low rates of mumps, prompting a goal of mumps elimination [4,5].

In 1987, there was a resurgence of mumps (13,000 cases) among individuals born between 1967 and 1977 who did not receive mandatory mumps vaccine for school entry. These outbreaks led to a change in the demographic of peak incidence, from 5 to 9 years to 10 to 19 years of age [6]. Adults also remained susceptible to mumps; more than 10 percent of cases in 1987 occurred in individuals >20 years of age.

                           

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Literature review current through: Nov 2016. | This topic last updated: Mon Nov 28 00:00:00 GMT+00:00 2016.
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References
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  1. Dayan GH, Rubin S. Mumps outbreaks in vaccinated populations: are available mumps vaccines effective enough to prevent outbreaks? Clin Infect Dis 2008; 47:1458.
  2. Dayan GH, Quinlisk MP, Parker AA, et al. Recent resurgence of mumps in the United States. N Engl J Med 2008; 358:1580.
  3. Mumps vaccine. MMWR Morb Mortal Wkly Rep 1977; 26:393.
  4. USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus: a summary. MMWR Recomm Rep 1995; 44:1.
  5. Anderson LJ, Seward JF. Mumps epidemiology and immunity: the anatomy of a modern epidemic. Pediatr Infect Dis J 2008; 27:S75.
  6. van Loon FP, Holmes SJ, Sirotkin BI, et al. Mumps surveillance--United States, 1988-1993. MMWR CDC Surveill Summ 1995; 44:1.
  7. Watson JC, Hadler SC, Dykewicz CA, et al. Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 1998; 47:1.
  8. Gupta RK, Best J, MacMahon E. Mumps and the UK epidemic 2005. BMJ 2005; 330:1132.
  9. Centers for Disease Control and Prevention (CDC). Exposure to mumps during air travel--United States, April 2006. MMWR Morb Mortal Wkly Rep 2006; 55:401.
  10. Centers for Disease Control and Prevention (CDC). Updated recommendations for isolation of persons with mumps. MMWR Morb Mortal Wkly Rep 2008; 57:1103.
  11. Arday DR, Kanjarpane DD, Kelley PW. Mumps in the US Army 1980-86: should recruits be immunized? Am J Public Health 1989; 79:471.
  12. Briss PA, Fehrs LJ, Parker RA, et al. Sustained transmission of mumps in a highly vaccinated population: assessment of primary vaccine failure and waning vaccine-induced immunity. J Infect Dis 1994; 169:77.
  13. Hersh BS, Fine PE, Kent WK, et al. Mumps outbreak in a highly vaccinated population. J Pediatr 1991; 119:187.
  14. Wharton M, Cochi SL, Hutcheson RH, et al. A large outbreak of mumps in the postvaccine era. J Infect Dis 1988; 158:1253.
  15. Sosin DM, Cochi SL, Gunn RA, et al. Changing epidemiology of mumps and its impact on university campuses. Pediatrics 1989; 84:779.
  16. Centers for Disease Control (CDC). Mumps outbreaks on university campuses--Illinois, Wisconsin, South Dakota. MMWR Morb Mortal Wkly Rep 1987; 36:496.
  17. Albertson JP, Clegg WJ, Reid HD, et al. Mumps Outbreak at a University and Recommendation for a Third Dose of Measles-Mumps-Rubella Vaccine - Illinois, 2015-2016. MMWR Morb Mortal Wkly Rep 2016; 65:731.
  18. Centers for Disease Control and Prevention (CDC). Mumps epidemic--United kingdom, 2004-2005. MMWR Morb Mortal Wkly Rep 2006; 55:173.
  19. Centers for Disease Control and Prevention (CDC). Update: mumps outbreak - New York and New Jersey, June 2009-January 2010. MMWR Morb Mortal Wkly Rep 2010; 59:125.
  20. Wharton M, Cochi SL, Hutcheson RH, Schaffner W. Mumps transmission in hospitals. Arch Intern Med 1990; 150:47.
  21. Brunell PA, Brickman A, O'Hare D, Steinberg S. Ineffectiveness of isolation of patients as a method of preventing the spread of mumps. Failure of the mumps skin-test antigen to predict immune status. N Engl J Med 1968; 279:1357.
  22. Harris RW, Kehrer AF, Isacson P. Relationship of occupations to risk of clinical mumps in adults. Am J Epidemiol 1969; 89:264.
  23. Kaplan KM, Marder DC, Cochi SL, Preblud SR. Mumps in the workplace. Further evidence of the changing epidemiology of a childhood vaccine-preventable disease. JAMA 1988; 260:1434.
  24. Beard CM, Benson RC Jr, Kelalis PP, et al. The incidence and outcome of mumps orchitis in Rochester, Minnesota, 1935 to 1974. Mayo Clin Proc 1977; 52:3.
  25. CDC. Mumps surveillance, January 1977-December 1982. Atlanta, US Department of Health and Human Services, US Public Health Service, 1984.
  26. 2014 Community Mumps Outbreak in Central Ohio. http://www.odh.ohio.gov/features/odh features/Mumps.aspx (Accessed on May 30, 2014).
  27. Centers for Disease Control and Prevention (CDC). Mumps outbreak on a university campus--California, 2011. MMWR Morb Mortal Wkly Rep 2012; 61:986.
  28. Barskey AE, Schulte C, Rosen JB, et al. Mumps outbreak in Orthodox Jewish communities in the United States. N Engl J Med 2012; 367:1704.
  29. Centers for Disease Control and Prevention (CDC). Brief report: update: mumps activity--United States, January 1-October 7, 2006. MMWR Morb Mortal Wkly Rep 2006; 55:1152.
  30. Centers for Disease Control and Prevention (CDC). Mumps epidemic--Iowa, 2006. MMWR Morb Mortal Wkly Rep 2006; 55:366.
  31. Peltola H, Kulkarni PS, Kapre SV, et al. Mumps outbreaks in Canada and the United States: time for new thinking on mumps vaccines. Clin Infect Dis 2007; 45:459.
  32. Bitsko RH, Cortese MM, Dayan GH, et al. Detection of RNA of mumps virus during an outbreak in a population with a high level of measles, mumps, and rubella vaccine coverage. J Clin Microbiol 2008; 46:1101.
  33. Wharton M, Cochi SL, Williams WW. Measles, mumps, and rubella vaccines. Infect Dis Clin North Am 1990; 4:47.
  34. Hviid A, Rubin S, Mühlemann K. Mumps. Lancet 2008; 371:932.
  35. Foy HM, Cooney MK, Hall CE, et al. Isolation of mumps virus from children with acute lower respiratory tract disease. Am J Epidemiol 1971; 94:467.
  36. Falk WA, Buchan K, Dow M, et al. The epidemiology of mumps in southern Alberta 1980-1982. Am J Epidemiol 1989; 130:736.
  37. PHILIP RN, REINHARD KR, LACKMAN DB. Observations on a mumps epidemic in a virgin population. Am J Hyg 1959; 69:91.
  38. McGuinness AC, Gall EA. Mumps at army camps in 1943. War Med 1944; 5:95.
  39. Manson AL. Mumps orchitis. Urology 1990; 36:355.
  40. Ternavasio-de la Vega HG, Boronat M, Ojeda A, et al. Mumps orchitis in the post-vaccine era (1967-2009): a single-center series of 67 patients and review of clinical outcome and trends. Medicine (Baltimore) 2010; 89:96.
  41. Casella R, Leibundgut B, Lehmann K, Gasser TC. Mumps orchitis: report of a mini-epidemic. J Urol 1997; 158:2158.
  42. Phillips CF. Mumps. In: Nelson's Textbook of Pediatrics, Vaughn VC, McKay RJ, Nelson WE (Eds), WB Saunders Co., Philadelphia 1987. p.673.
  43. Dejucq N, Jégou B. Viruses in the mammalian male genital tract and their effects on the reproductive system. Microbiol Mol Biol Rev 2001; 65:208.
  44. Ehrengut W, Schwartau M. Mumps orchitis and testicular tumours. Br Med J 1977; 2:191.
  45. Azimi PH, Cramblett HG, Haynes RE. Mumps meningoencephalitis in children. JAMA 1969; 207:509.
  46. Bang HO, Bang J. Involvement of the central nervous system in mumps. Acta Med Scand 1943; 113:487.
  47. Litman N, Baum SG. Mumps Virus. In: Principles and Practice of Infectious Diseases, Bennett JE, Dolin R, Blaser MJ (Eds), Churchill Livingstone, New York 2015.
  48. RUSSELL RR, DONALD JC. The neurological complications of mumps. Br Med J 1958; 2:27.
  49. Reed D, Brown G, Merrick R, et al. A mumps epidemic on St. George Island, Alaska. JAMA 1967; 199:113.
  50. Johnstone JA, Ross CA, Dunn M. Meningitis and encephalitis associated with mumps infection. A 10-year survey. Arch Dis Child 1972; 47:647.
  51. Levitt LP, Rich TA, Kinde SW, et al. Central nervous system mumps. A review of 64 cases. Neurology 1970; 20:829.
  52. MCLEAN DM, BACH RD, LARKE RP, MCNAUGHTON GA. MUMPS MENINGOENCEPHALITIS, TORONTO, 1963. Can Med Assoc J 1964; 90:458.
  53. RITTER BS. Mumps meningoencephalitis in children. J Pediatr 1958; 52:424.
  54. Connolly KJ, Hammer SM. The acute aseptic meningitis syndrome. Infect Dis Clin North Am 1990; 4:599.
  55. Nussinovitch M, Volovitz B, Varsano I. Complications of mumps requiring hospitalization in children. Eur J Pediatr 1995; 154:732.
  56. Koskiniemi M, Vaheri A. Effect of measles, mumps, rubella vaccination on pattern of encephalitis in children. Lancet 1989; 1:31.
  57. Koskiniemi M, Donner M, Pettay O. Clinical appearance and outcome in mumps encephalitis in children. Acta Paediatr Scand 1983; 72:603.
  58. Wilfert CM. Mumps meningoencephalitis with low cerebrospinal-fluid glucose, prolonged pleocytosis and elevation of protein. N Engl J Med 1969; 280:855.
  59. Cohen HA, Ashkenazi A, Nussinovitch M, et al. Mumps-associated acute cerebellar ataxia. Am J Dis Child 1992; 146:930.
  60. Oran B, Ceri A, Yilmaz H, et al. Hydrocephalus in mumps meningoencephalitis: case report. Pediatr Infect Dis J 1995; 14:724.
  61. Timmons GD, Johnson KP. Aqueductal stenosis and hydrocephalus after mumps encephalitis. N Engl J Med 1970; 283:1505.
  62. VUORI M, LAHIKAINEN EA, PELTONEN T. Perceptive deafness in connectionwith mumps. A study of 298 servicemen suffering from mumps. Acta Otolaryngol 1962; 55:231.
  63. Westmore GA, Pickard BH, Stern H. Isolation of mumps virus from the inner ear after sudden deafness. Br Med J 1979; 1:14.
  64. Hall R, Richards H. Hearing loss due to mumps. Arch Dis Child 1987; 62:189.
  65. Hydén D. Mumps labyrinthitis, endolymphatic hydrops and sudden deafness in succession in the same ear. ORL J Otorhinolaryngol Relat Spec 1996; 58:338.
  66. Comacchio F, D'Eredità R, Marchiori C. MRI evidence of labyrinthine and eighth-nerve bundle involvement in mumps virus sudden deafness and vertigo. ORL J Otorhinolaryngol Relat Spec 1996; 58:295.
  67. Duncan S, Will RG, Catnach J. Mumps and Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry 1990; 53:709.
  68. Pollack S, Bar-On E, Enat R. Guillain-Barré syndrome; association with mumps. N Y State J Med 1981; 81:795.
  69. Tulloch A. Polyneuritis--an unusual complication of mumps. Med J Aust 1973; 1:844.
  70. Venketasubramanian N. Transverse myelitis following mumps in an adult -- a case report with MRI correlation. Acta Neurol Scand 1997; 96:328.
  71. Anand R, Anand R, Gupta M, et al. Mumps hemiplegia. Indian J Pediatr 1997; 64:119.
  72. Nussinovitch M, Brand N, Frydman M, Varsano I. Transverse myelitis following mumps in children. Acta Paediatr 1992; 81:183.
  73. Benady S, Zvi AB, Szabo G. Transverse myelitis following mumps. Acta Paediatr Scand 1973; 62:205.
  74. Beardwell A. Facial palsy due to the mumps virus. Br J Clin Pract 1969; 23:37.
  75. Morgan M, Nathwani D. Facial palsy and infection: the unfolding story. Clin Infect Dis 1992; 14:263.
  76. Djupesland G, Berdal P, Johannessen TA, et al. Viral infection as a cause of acute peripheral facial palsy. Arch Otolaryngol 1976; 102:403.
  77. Hung W. Mumps thyroiditis and hypothyroidism. J Pediatr 1969; 74:611.
  78. Lyon E. [Subacute mumpsthyroiditis and its management]. Med Klin 1967; 62:208.
  79. Sheba C, Bank H. Prevention of mumps thyroiditis. N Engl J Med 1968; 279:108.
  80. Kabakuş N, Aydinoğlu H, Bakkaloğlu SA, Yekeler H. Mumps interstitial nephritis: a case report. Pediatr Nephrol 1999; 13:930.
  81. Lin CY, Chen WP, Chiang H. Mumps associated with nephritis. Child Nephrol Urol 1990; 10:68.
  82. Monteiro GE, Lillicrap CA. Case of mumps nephritis. Br Med J 1967; 4:721.
  83. Masson AM, Nickerson GH. Mumps with nephritis. Can Med Assoc J 1967; 97:866.
  84. Hughes WT, Steigman AJ, Delong HF. Some implications of fatal nephritis associated with mumps. Am J Dis Child 1966; 111:297.
  85. Harel L, Amir J, Reish O, et al. Mumps arthritis in children. Pediatr Infect Dis J 1990; 9:928.
  86. Gordon SC, Lauter CB. Mumps arthritis: a review of the literature. Rev Infect Dis 1984; 6:338.
  87. Susković T, Vukicević-Baudoin D, Vucicević Z, Holjevac I. Severe pancreatitis as first symptom of mumps complicated with pseudocyst and abscess of pancreas. Infection 1997; 25:39.
  88. Haddock G, Coupar G, Youngson GG, et al. Acute pancreatitis in children: a 15-year review. J Pediatr Surg 1994; 29:719.
  89. Parenti DM, Steinberg W, Kang P. Infectious causes of acute pancreatitis. Pancreas 1996; 13:356.
  90. Kussy JC. Fatal mumps myocarditis. Minn Med 1974; 57:285.
  91. Roberts WC, Fox SM 3rd. Mumps of the heart. Clinical and pathologic features. Circulation 1965; 32:342.
  92. Ozkutlu S, Soylemezoglu O, Calikoglu AS, et al. Fatal mumps myocarditis. Jpn Heart J 1989; 30:109.
  93. Baandrup U, Mortensen SA. Fatal mumps myocarditis. Acta Med Scand 1984; 216:331.
  94. Ward SC, Wiselka MJ, Nicholson KG. Still's disease and myocarditis associated with recent mumps infection. Postgrad Med J 1988; 64:693.
  95. Watanabe A, Namura M, Kanaya H, et al. [A case of mumps myocarditis associated with coronary artery involvements]. Nihon Naika Gakkai Zasshi 1987; 76:1409.
  96. Chaudary S, Jaski BE. Fulminant mumps myocarditis. Ann Intern Med 1989; 110:569.
  97. Kabakuş N, Aydinoğlu H, Yekeler H, Arslan IN. Fatal mumps nephritis and myocarditis. J Trop Pediatr 1999; 45:358.
  98. Siegel M, Fuerst HT. Low birth weight and maternal virus diseases. A prospective study of rubella, measles, mumps, chickenpox, and hepatitis. JAMA 1966; 197:680.
  99. http://www.cdc.gov/mumps/lab/qa-lab-test-infect.html#st3 (Accessed on August 22, 2011).
  100. Boston Public Health Commission. Health Alert: Mumps Outbreak. April 2006.
  101. UTZ JP, HOUK VN, ALLING DW. CLINICAL AND LABORATORY STUDIES OF MUMPS. N Engl J Med 1964; 270:1283.
  102. Glikmann G, Pedersen M, Mordhorst CH. Detection of specific immunoglobulin M to mumps virus in serum and cerebrospinal fluid samples from patients with acute mumps infection, using an antibody-capture enzyme immunoassay. Acta Pathol Microbiol Immunol Scand C 1986; 94:145.
  103. Poggio GP, Rodriguez C, Cisterna D, et al. Nested PCR for rapid detection of mumps virus in cerebrospinal fluid from patients with neurological diseases. J Clin Microbiol 2000; 38:274.
  104. Hosoya M, Honzumi K, Sato M, et al. Application of PCR for various neurotropic viruses on the diagnosis of viral meningitis. J Clin Virol 1998; 11:117.
  105. Jeffery KJ, Read SJ, Peto TE, et al. Diagnosis of viral infections of the central nervous system: clinical interpretation of PCR results. Lancet 1997; 349:313.
  106. Cusi MG, Bianchi S, Valassina M, et al. Rapid detection and typing of circulating mumps virus by reverse transcription/polymerase chain reaction. Res Virol 1996; 147:227.
  107. Afzal MA, Buchanan J, Dias JA, et al. RT-PCR based diagnosis and molecular characterisation of mumps viruses derived from clinical specimens collected during the 1996 mumps outbreak in Portugal. J Med Virol 1997; 52:349.
  108. Kashiwagi Y, Kawashima H, Takekuma K, et al. Detection of mumps virus genome directly from clinical samples and a simple method for genetic differentiation of the Hoshino vaccine strain from wild strains of mumps virus. J Med Virol 1997; 52:195.
  109. Davidkin I, Jokinen S, Paananen A, et al. Etiology of mumps-like illnesses in children and adolescents vaccinated for measles, mumps, and rubella. J Infect Dis 2005; 191:719.