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Condition
Mumps

Class
Immune system

Description
Mumps is a highly infectious viral disease. Although it is usually dismissed as a mild disease that most people will get and recover from quickly as a child, mumps can cause serious complications. It can affect the nervous system causing permanent deafness, headaches, meningitis and encephalitis and, in adults, it can cause swelling of the testicles and ovaries which, in rare cases, can lead to sterility, and painful swelling of the breasts.

The number of cases of mumps in the UK has fallen dramatically since the introduction of the mumps, measles and rubella (MMR) vaccine in 1988. However, the disease still occurs in the UK, and since 1999 there has been an increase of confirmed cases in adolescents and young adults who were too old to be offered vaccination when the vaccine was introduced, and who have not picked up natural immunity when they were young children. There was an epidemic in 2005, with 43,378 confirmed cases of mumps, and in 2010 there were around 3,800 cases.

Causes
Mumps is caused by a virus that belongs to a group of viruses called the paramyxoviruses. It is spread through droplets from coughing and sneezing by someone infected with the virus. It can also be spread indirectly by contact with objects and surfaces that have been previously touched by someone with the mumps virus who has not washed their hands thoroughly after sneezing or coughing into their hands. The incubation period, that is the time taken for the disease to develop after being infected with the virus, is about 17 days. Individuals are most infectious from 1 or 2 days before the parotid glands (salivary glands in the side of the neck) swell to approximately 5 days later.

Symptoms
The symptoms of mumps start like a bad cold with a high temperature, headache, muscle pain, loss of appetite and a general feeling of being unwell, followed by the characteristic swelling of the glands at the side of the neck. Swelling normally occurs on both sides of the neck, but sometimes it may affect only one side. Swallowing can be painful. In some children with a very mild form of the disease, symptoms may go unnoticed.

Treatment
In the UK, most children are routinely vaccinated against mumps with a vaccine known as MMR which also protects against measles and rubella. Children are given the vaccine between 12 and 18 months of age and then given a booster between 4 and 5 years. Infants from 6 months of age travelling to countries where mumps is still a problem should also be vaccinated with MMR. As the vaccine is less effective when given early, these children will need two further doses of the vaccine at the recommended ages to ensure that they are adequately protected.

It is common for children to develop a mild fever and rash after the immunisation and generally feel a bit grizzly. The recommended dose of paracetamol is advised if the child develops a temperature.

When to see your doctor
If you think you or your child have the symptoms of mumps you should consult your doctor. After MMR vaccination, your child may feel grizzly but if crying is prolonged or there is a persistent rash or fever, you should see your doctor. Swelling might occur at the injection site but is not normally any larger than the surface area of a 10p coin, any larger swelling should be checked by your doctor.

When to see your pharmacist
You can obtain paracetamol from your local pharmacy without the need for a prescription to help reduce your child’s temperature following immunisation. Always check the label of medicines to make sure that you are not giving your child too much paracetamol. Aspirin should not be used in children under 16 years of age to lower high temperatures or for pain relief.

Protecting your child, your family and others against mumps
The most effective way of protecting your child and others against mumps is to have your child vaccinated with the MMR vaccine. The childhood immunisation programme provides direct protection against mumps, measles, rubella, diphtheria, whopping cough and the risks of bacterial meningitis caused by pneumococcal bacteria, meningococcal type C and Hib. By providing immunity against mumps and measles, the immunisation programme also helps provide protection against viral meningitis. The risks of all of the diseases covered by the immunisation programme are far, far greater than any risks associated with the vaccines themselves. It is essential that all children are vaccinated at the appropriate times. Vaccination of children also helps reduce the spread of infection to adults.

There has been much publicity about giving a single vaccine for each disease separately, rather than giving the combined triple vaccine (MMR) to protect against all three diseases, because of a misunderstanding that MMR may cause bowel disease or autism. The conclusion of experts from all over the world, including the World Health Organization, is that there is no link between the MMR vaccine and bowel disease or autism. The World Health Organization advises against using separate vaccines for the simple reason that doing so would leave children at risk and offer no benefits. No country in the world recommends giving MMR as three separate vaccines. Giving the vaccines separately may be harmful because it leaves children open to the risk of catching measles, mumps or rubella. By having them all at once, your child is protected against all three diseases as soon as they have had the MMR injection.

Living with mumps
If someone in your family does develop mumps try to keep them apart from others for at least 5 days after the symptoms of swollen glands in the neck first appear. This means keeping young children off from school for 5 days, or staying away for 5 days from work or other places where there is close contact with other people. The practice of holding ‘mumps parties’, deliberately to infect others to build their immunity without vaccination, is positively discouraged by the health authorities as it can pose a serious health risk.

To reduce the spread of the virus, encourage all members of the family to use disposable tissues when sneezing or coughing, and to wash their hands regularly throughout the day, not just after going to the toilet.

To ease symptoms, drink plenty of water and eat soft foods that are easy to swallow. A cold flannel applied to the neck, or to the breasts or testicles if these too are sore, will help ease discomfort. Do not overdo things but try and get as much sleep and rest as possible to help the body recover.

Useful Tips
  • If your child develops a fever after childhood immunisation for MMR, sponging with cool water can help get reduce their temperature

  • Make sure your baby or child drinks lots of fluids



Reviewed on 12 April 2011



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