or '''epidemic Parotitis ''' is a Viral Disease of Human s. Prior to the development of Vaccination and the introduction of MMR Vaccine , it was a common Childhood Disease worldwide, and is still a significant threat to health in the Third World .1
Painful swelling of the Salivary Gland s (classically the Parotid Gland ) and fever is the most typical presentation.2 Painful Testicular Swelling and Rash may also occur. While symptoms are generally not severe in children, in teenagers and adults, the symptoms can be more severe and complications such as Infertility or subfertility are relatively common, although still rare in absolute terms.3 }},4 }},5 }} The disease is generally self-limiting, and there is no specific treatment apart from controlling the symptoms with Painkiller s.
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Mumps
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The mumps are caused by a Paramyxovirus , and are spread from person to person by Saliva Droplet s or direct contact with articles that have been contaminated with infected saliva. The Parotid Glands (the salivary glands between the ear and the jaw) are usually involved. Unvaccinated children between the ages of 2 and 12 are most commonly infected, but the infection can occur in other age groups. Orchitis (swelling of the Testes ) occurs in 10–20% of infected males, but sterility only rarely ensues; a Viral Meningitis occurs in about 5% of those infected. In older people, the Central Nervous System , the Pancreas , the Prostate , the Breast s, and other organs may be involved.
The Incubation Period is usually 18 to 21 days, but may range from as few as 12 to as many as 35 days. Mumps is generally a mild illness in children in developed countries. After adolescence, mumps tends to affect the ovary, causing Oophoritis , and the testes, causing Orchitis . The mature testis is particularly susceptible to damage from mumps which can lead to infertility. Adults infected with mumps are more likely to develop severe symptoms and complications. [http://www.webmd.com/hw/health_guide_atoz/ue5367.asp?navbar=hw180631
The more common symptoms of mumps are:
- Swelling of the parotid gland (or Parotitis ) in >90% of patients, and pain behind the lower jaw when chewing.
- Fever
- Headache
- Sore Throat
- Orchitis , referring to painful inflammation of the testicle.6 }}
A physical examination confirms the presence of the swollen glands. Usually the disease is diagnosed on clinical grounds and no confirmatory laboratory testing is needed. If there is uncertainty about the diagnosis, Serology or a saliva test for the virus may be carried out.
There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck area and by Acetaminophen (paracetamol) for pain relief ( Aspirin is discouraged in children with a viral illness because of the risk of Reye's Syndrome ). Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.
Patients are advised to avoid fruit juice or any acidic foods, since these stimulate the salivary glands, which can be painful.
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The disease is self-limiting, and general outcome is good, even if other organs are involved. Sterility in men from involvement of the testes is very rare. After the illness, life-long
Immunity to mumps generally occurs.
Known complications of mumps include:
- Infection of other organ systems
- Sterility in men (this is quite rare, and mostly occurs in older men)
- Mild forms of Meningitis (rare, 40% of cases occur without parotid swelling)
- Encephalitis (very rare, rarely fatal)
- Profound (91 dB or more) but rare sensorineural Hearing Loss , uni- or bilateral
The most common preventative measure against mumps is the depends on the strain of the vaccine, but is usually around 80%.
11 }}
,12
Some
Anti-vaccine Activists protest against the administration of a vaccine against mumps, claiming that the attenuated vaccine strain is harmful, and/or that the wild disease is beneficial. Disagreeing, the
WHO , the
American Academy Of Pediatrics , the
Advisory Committee On Immunization Practices Of The Centers For Disease Control And Prevention , the
American Academy Of Family Physicians , the
British Medical Association and the
Royal Pharmaceutical Society of Great Britain currently recommend routine vaccination of children against mumps. The
British Medical Association and
Royal Pharmaceutical Society Of Great Britain had previously recommended against general mumps vaccination, changing that recommendation in 1987. In 1988 it became United Kingdom government policy to introduce mass child mumps vaccination programmes with the MMR vaccine, and MMR vaccine is now routinely administered in the UK.
Before the introduction of the mumps vaccine, the mumps virus was the leading cause of viral meningoencephalitis in the United States. However, encephalitis occurs rarely (less than 2 per 100,000).
13 In one of the largest studies in the literature, the most common symptoms of mumps meningoencephalitis were found to be fever (97%), vomiting (94%) and headache (88.8%).
14 }} The mumps vaccine was introduced into the United States in December 1967: since its introduction there has been a steady decrease in the incidence of mumps and mumps virus infection. There were 151,209 cases of mumps reported in 1968; in 1998 there were only 666 cases reported.
In the United Kingdom over the last two years, a mumps outbreak
BMJ Mumps epidemic in UK 2005 has involved more than 70,000 patients.[http://www.voanews.com/english/2006-04-19-voa74.cfm]
15 }} The cause of the outbreak is low immunity in those too young to have received MMR, but old enough to have not had Mumps as children. A catch-up programme of immunisation of under 25 year olds, particularly in university towns such as
Exeter was implemented.
Doctors are attributing the rise in mumps case frequency to low vaccination rates in Iowa's youth, coupled with the close quarters in dormitories, classrooms and cafeterias.
Still more cases are being reported from this outbreak, the majority of them in
Dubuque County .
According to Canadian media reports
{Link without Title} , there may be something novel about this mumps strain which indicates a standard MMR-series vaccination is not 95% effective, as was thought.
- 18 April 2006: 815 cases have been reported {Link without Title} in Iowa alone, representing a caseload reporting increase of 200 in the last week.
- 25 April 2006: There are over 1,120 confirmed {Link without Title} , probable and suspected cases of mumps. Over 1000 of the cases are confirmed.
- 19 April 2006: There are 14 confirmed cases in Wisconsin, and half of these are at the University Of Wisconsin-Milwaukee campus. A vaccination clinic is being held at UWM in response to this as questions rise as about the cause of the outbreak.
- 21 April 2006: Ten (10) cases are confirmed at the University Of Wisconsin-Milwaukee campus, and the number of people in contact with this group has expanded to 1000. 3 more vaccination clinics have been scheduled.
There have been three confirmed cases of the mumps at
Southern Illinois University-Carbondale , and has spread to three other neighboring counties in the
Southern Illinois area.
- 20 April 2006: A woman in and Delta County were previously confirmed, and results in neighboring Bay County came back negative.
- 2 May 2006: With 340 mumps cases now reported in Kansas, state health officials have asked the U.S. Centers for Disease Control and Prevention to help. {Link without Title}
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