Mumps is characterized by the following features.

Prodromal phase: Initially, there is a prodromal phase in which the patient suffers from malaise and low-grade fever.

Parotitis: After the prodromal feature, the classical, tender enlargement of the parotid gland starts developing. In around 75% of the cases, the enlargement is bilateral. Usually, there is swelling of only one gland in the initial stage and the second gland enlarges after one to three days. Sometimes, the second gland may enlarge after the recovery of the first gland.

Complications: The common complications of mumps include orchitis, oophoritis, meningitis and pancreatitis. If meningitis or orchitis develop as complications of mumps, high grade fever may also be seen [4].

• Orchitis: Orchitis is a known complication of mumps [5]. It occurs in around 25 to 40% of the postpubertal men suffering from mumps. Bilateral orchitis is present in 33% of the cases. Orchitis typically develops 7 to 10 days after the onset of parotitis. Rarely, the patient may become sterile.
• Oophoritis: Inflammation of the ovaries is a common complication of mumps and is suggested by lower abdominal pain and enlargement of the ovaries.
• Meningitis: Meningitis is also a frequent complication of mumps infection [6]. It develops in around 30% of the patients suffering from mumps. It presents with headache, neck stiffness, fever and lethargy.
• Pancreatitis: Mumps is responsible for up to 5% of the cases of pancreatitis; however it is not yet clear whether or not it is actually caused by mumps virus. It presents with upper abdominal pain, nausea and vomiting.
• Other rare complications of mumps include neuritis of the vestibulocochlear nerve (causing transient hearing loss and labrynthitis), encephalitis, Guillain-Barre syndrome, thyroiditis, hepatitis, myocarditis, nephritis and thrombocytopenia.

• Fever

  A-13-year-old girl presented with diabetic ketoacidosis with convincing clinical signs of parotitis (fever, drooling of saliva, inability to swallow with development of bilateral parotid swelling) and pancreatitis (fever, abdominal pain and vomiting), [ncbi.nlm.nih.gov]

  For example mumps meningitis may present as headache, sensitivity to light, neck stiffness, fever and/or vomiting. On average, fever usually lasts one to six days, but salivary gland swelling can last for more than 10 days. [immune.org.nz]

  Symptoms of viral meningitis include: high temperature (fever) of 38ºC (100ºF) or above sensitivity to light (photophobia) headache nausea vomiting The symptoms of viral meningitis usually pass within 14 days. [hse.ie]

• Fatigue

  A 56-year-old Japanese man had suffered from nausea and generalized fatigue for two days before being transferred to our hospital in a confused state. [ncbi.nlm.nih.gov]

  It typically starts with a few days of fever, headache, fatigue, and loss of appetite, followed by swollen salivary glands. For more information, go to: CDC Mumps Information or CDC Mumps Cases & Outbreaks. [wkyt.com]

  Symptoms include fatigue, fever, swollen salivary glands, rash, and jaw pain and can last a few weeks. Once exposed, it can take between 12 to 25 days for symptoms to appear. [abc17news.com]

  The illness starts with the general malaise and discomfort common to other childhood viral illnesses: headache, fever, body aches, poor appetite, and fatigue. [jamanetwork.com]

  Symptoms Mumps symptoms include: fever swelling of the face headache fatigue aches and pains loss of appetite painful chewing or swallowing. Symptoms usually start about 12 to 25 days after catching mumps. [health.gov.au]

• Malaise

  A previously healthy 22-year-old woman presented with acute, unilateral facial and neck swelling, associated with fever and malaise. [ncbi.nlm.nih.gov]

  Other symptoms include low-grade fever, malaise, headache, and possible swelling of other salivary glands. The diagnosis of mumps is largely based on clinical findings. [amboss.com]

  Patients often present with nonspecific viral symptoms of fever, myalgias, and malaise. More specific features include facial swelling (parotitis) in 95% and/or testicular pain (orchitis). [radiopaedia.org]

  Initial symptoms are typically non-specific, such as headache, malaise and fever, followed within a day by the characteristic swelling of the parotid (salivary) glands. [who.int]

  The illness starts with the general malaise and discomfort common to other childhood viral illnesses: headache, fever, body aches, poor appetite, and fatigue. [jamanetwork.com]

• Chills

  […] vomiting weakness Orchitis inflammation of the testes symptoms may include: fever chills headaches nausea and vomiting stomach pains painful swelling of one or both testes Oophoritis inflammation of the ovaries in females symptoms may include: fever [childrenshospital.org]

  This will include pain, swelling, loss of appetite, headache, sore throat, fever and chills. The frustrating part of living with mumps is not being able to get out and see people. [familydoctor.org]

  Most children develop chills, headache, poor appetite, a general feeling of illness (malaise), and a low to moderate fever. [merckmanuals.com]

• Pediatric Disease

  The mumps virus does share various epidemiologic characteristics with other well-known viral pediatric diseases, such as measles (RNA virus, of the genus Morbillivirus, in the Paramyxoviridae family) and rubella (RNA virus, of the genus Rubivirus, in [emedicine.com]

• Cough

  Whooping Cough: Background and Key Findings The FDA is studying whooping cough because rates have been rising steadily over the last 20 years. Also called pertussis, this serious and contagious disease is caused by a bacterium. [fda.gov]

  Cover your mouth with a tissue when coughing or sneezing; use your upper sleeve to cover your cough, not your hand. Avoid sharing food, drinks, and items such as eating utensils, cigarettes or vaping devices. [scdhec.gov]

  It is spread through mucus or saliva when an infected person coughs or sneezes. [adolescentvaccination.org]

  COVER mouth and nose with a tissue when coughing or sneezing. If a tissue isn’t available, cough or sneeze into an upper sleeve or elbow, not hands. PROTECT others. [shelbytnhealth.com]

  Cover your mouth and nose with a tissue when you cough or sneeze, and put your used tissue in the trash. If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands. [healthyhorns.utexas.edu]

• Sneezing

  COVER mouth and nose with a tissue when coughing or sneezing. If a tissue isn’t available, cough or sneeze into an upper sleeve or elbow, not hands. PROTECT others. [shelbytnhealth.com]

  It is spread through mucus or saliva when an infected person coughs or sneezes. [adolescentvaccination.org]

  Cover your mouth and nose with a tissue when you cough or sneeze, and put your used tissue in the trash. If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands. [healthyhorns.utexas.edu]

  Mouth and nose should be covered during any sneezing or coughing and hands should be washed frequently. [fox6now.com]

• Vomiting

  Symptoms of viral meningitis include: high temperature (fever) of 38ºC (100ºF) or above sensitivity to light (photophobia) headache nausea vomiting The symptoms of viral meningitis usually pass within 14 days. [hse.ie]

  vomiting stomach pains painful swelling of one or both testes Oophoritis inflammation of the ovaries in females symptoms may include: fever stomach pain and tenderness nausea and vomiting pain on one side of the pelvic area or both Can you prevent the [childrenshospital.org]

  A-13-year-old girl presented with diabetic ketoacidosis with convincing clinical signs of parotitis (fever, drooling of saliva, inability to swallow with development of bilateral parotid swelling) and pancreatitis (fever, abdominal pain and vomiting), [ncbi.nlm.nih.gov]

• Abdominal Pain

  A-13-year-old girl presented with diabetic ketoacidosis with convincing clinical signs of parotitis (fever, drooling of saliva, inability to swallow with development of bilateral parotid swelling) and pancreatitis (fever, abdominal pain and vomiting), [ncbi.nlm.nih.gov]

  If you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite or nausea A blood sample taken from a vein in the arm Amylase is an enzyme made mainly by the pancreas. [labtestsonline.org.uk]

  It presents with upper abdominal pain, nausea and vomiting. [symptoma.com]

• Nausea

  Mumps can lead to sever complications, including: Meningitis swelling of tissue around the brain and the spinal cord symptoms may include: headaches neck stiffness nausea and vomiting changes in behavior eyes sensitive to light Pancreatitis inflammation [childrenshospital.org]

  Symptoms of viral meningitis include: high temperature (fever) of 38ºC (100ºF) or above sensitivity to light (photophobia) headache nausea vomiting The symptoms of viral meningitis usually pass within 14 days. [hse.ie]

  Salient clinical indicators of CNS involvement include headache, fever, nausea, vomiting, and nuchal rigidity. [emedicine.com]

  If you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite or nausea A blood sample taken from a vein in the arm Amylase is an enzyme made mainly by the pancreas. [labtestsonline.org.uk]

• Epigastric Pain

  Pancreatitis, typically with sudden severe nausea, vomiting, and epigastric pain, may occur toward the end of the first week. These symptoms disappear in about 1 week, leading to complete recovery. [merckmanuals.com]

• Parotid Swelling

  Case 2 was an eight-year-old girl with bilateral parotid swelling. A cochlear implant enabled her to improve hearing perception. [ncbi.nlm.nih.gov]

  Ordinarily, the parotid glands are not palpable; but in patients with mumps, parotid swelling increases rapidly over several days. [emedicine.com]

• Jaw Pain

  Symptoms include fatigue, fever, swollen salivary glands, rash, and jaw pain and can last a few weeks. Once exposed, it can take between 12 to 25 days for symptoms to appear. [abc17news.com]

  DPH has instructed doctors to consider mumps as a diagnostic possibility “regardless of vaccination history,” and to isolate patients for five days after the onset of symptoms — swollen neck glands, headache, jaw pain and fever. [bostonherald.com]

  In addition to swollen glands in the neck, symptoms of mumps include fever, headache, earache, jaw pain, fatigue, and loss of appetite. People who previously had mumps are considered immune from a second infection. [bostonglobe.com]

  Others may feel extremely ill and be unable to eat because of jaw pain, and a few will develop serious complications. Men and adolescent boys can develop pain or swelling in their testicles, which rarely results in sterility. [access.tarrantcounty.com]

• Angioedema

  Mucoepidermoid carcinoma Sclerosing polycystic adenosis Sialadenitis Parotitis Chronic sclerosing sialadenitis Sialectasis Sialocele Sialodochitis Sialosis Sialolithiasis Sjögren's syndrome Orofacial soft tissues – Soft tissues around the mouth Actinomycosis Angioedema [en.wikipedia.org]

• Otalgia

  Tenderness of the parotid glands and otalgia often precede parotitis, which is bilateral in 95% of cases. 8 The swelling can be extensive enough to interfere with speech and chewing, and can even cause trismus. 13 The intraoral entry point to the duct [web.archive.org]

• Myalgia

  Patients often present with nonspecific viral symptoms of fever, myalgias, and malaise. More specific features include facial swelling (parotitis) in 95% and/or testicular pain (orchitis). [radiopaedia.org]

  Nonspecific symptoms lasting a few days, such as fever, headache, malaise, myalgia and anorexia, can precede parotitis. Parotitis is usually bilateral although it can be unilateral. Typically, there is pain at or near the angle of the jaw. [patient.info]

  Mumps is characterized by a non-specific prodrome including myalgia, anorexia, malaise, headache, and low-grade fever with an acute onset of unilateral or bilateral tender swelling of the parotid or salivary gland lasting 2 days without other apparent [health.state.mn.us]

  Headaches, malaise, myalgia, high fever, and anorexia are nonspecific symptoms that may occur. Fetal Consequences Mumps during pregnancy may be understandably more worrying than when it occurs in the general population. [news-medical.net]

• Arthritis

  Less common complications include inflammation of the ovaries (oophoritis), breast tissue (mastitis), pancreas (pancreatitis), heart (myocarditis), and joints (arthritis). [jamanetwork.com]

  Mumps can cause pain and swelling of the testicles, deafness and arthritis. It can cause central nervous system disorders such as encephalitis (inflammation of the brain) and meningitis (inflammation of the covering of the brain and spinal column). [dph.illinois.gov]

  Mumps arthritis: a review of the literature. Rev. Infect. Dis. 1984 May-Jun;6(3):338-44. [PubMed: 6377441] 22. Hung W. Mumps thyroiditis and hypothyroidism. J. Pediatr. 1969 Apr;74(4):611-3. [PubMed: 5767349] 23. UTZ JP, HOUK VN, ALLING DW. [ncbi.nlm.nih.gov]

  Neuritis, arthritis, nephritis, thyroiditis and pericarditis have all been reported. Transient and mild mastitis (uncommon - can occur in either sex). [patient.info]

• Suggestibility

  This case suggests an association between fulminant type 1 diabetes and mumps virus infection. [ncbi.nlm.nih.gov]

• Facial Swelling

  More specific features include facial swelling (parotitis) in 95% and/or testicular pain (orchitis). Serum IgM antibody testing can be used to confirm a case of mumps, if necessary. Mumps is a single-stranded RNA paramyxovirus 2. [radiopaedia.org]

  Mumps is caused by a paramyxovirus and is characterized by facial swelling. Until the mumps vaccine was introduced in 1967, most individuals in the United States had mumps during childhood. [jamanetwork.com]

  Individuals with facial swelling (swollen neck or cheek) should consult their health care provider or SCHD at (901)222-9243 and stay in isolation for five days after onset or until testing negative. [shelbytnhealth.com]

  Normally, mumps can be diagnosed by its symptoms alone, especially by examining the facial swelling. [medicalnewstoday.com]

• Neck Swelling

  A previously healthy 22-year-old woman presented with acute, unilateral facial and neck swelling, associated with fever and malaise. [ncbi.nlm.nih.gov]

  Submandibular gland involvement causes neck swelling beneath the jaw, and suprasternal edema may develop, perhaps because of lymphatic obstruction by enlarged salivary glands. When sublingual glands are involved, the tongue may swell. [merckmanuals.com]

• Testicular Pain

  More specific features include facial swelling (parotitis) in 95% and/or testicular pain (orchitis). Serum IgM antibody testing can be used to confirm a case of mumps, if necessary. Mumps is a single-stranded RNA paramyxovirus 2. [radiopaedia.org]

  In males who have gone through puberty, two or three of every 10 will experience testicular pain and swelling. Not everyone will have the typical symptoms; many infected people will just have respiratory symptoms without any swollen glands. [adultvaccination.org]

  This can sometimes lead to the diagnosis being missed. [ 4 ] Orchitis presents with chills, sweats, headache and backache with swinging temperature and severe local testicular pain and tenderness. [patient.info]

  Other symptoms may include testicular pain (in males), abdominal pain, seizures, stiff neck, and difficulty swallowing. Orchitis (inflammation of one or both testicles) is the most feared complication of mumps. [emedicinehealth.com]

• Headache

  Most children develop chills, headache, poor appetite, a general feeling of illness (malaise), and a low to moderate fever. [merckmanuals.com]

  The most common symptoms include: In an early phase of the disease fever headache decrease in appetite not feeling well Within 24 hours of the above symptoms earache or face pain pain is worse with chewing pain is worse with foods that cause an increase [childrenshospital.org]

  Mumps may also infect the: Central nervous system Pancreas Testes Symptoms of mumps may include: Face pain Fever Headache Sore throat Loss of appetite Swelling of the parotid glands (the largest salivary glands, located between the ear and the jaw) Swelling [nlm.nih.gov]

• Guillain-Barré Syndrome

  Complications A list of potential complications from mumps infection is cited below: Aseptic meningitis/encephalitis Sensorineural hearing loss/deafness [8] Transverse myelitis Polyneuritis Guillain-Barré syndrome Cerebellar ataxia (with encephalitis) [emedicine.com]

  "IVIG Treatment and Prognosis in Guillain–Barré Syndrome". Journal of Clinical Immunology. 30 (S1): 74–78. doi:10.1007/s10875-010-9407-4. PMC 2883091. [en.wikipedia.org]

• Cerebellar Ataxia

  Postinfectious encephalitis, acute cerebellar ataxia, transverse myelitis, and polyneuritis occur rarely. Supportive care Treatment of mumps and its complications is supportive. The patient is isolated until glandular swelling subsides. [merckmanuals.com]

  Complications A list of potential complications from mumps infection is cited below: Aseptic meningitis/encephalitis Sensorineural hearing loss/deafness [8] Transverse myelitis Polyneuritis Guillain-Barré syndrome Cerebellar ataxia (with encephalitis) [emedicine.com]

Mumps is easily diagnosed on clinical grounds. However, the following investigations are helpful in confirming the diagnosis.

• Blood tests demonstrate a relative lymphocytosis is seen in case of mumps infection.
• Serum amylase is commonly elevated with or without pancreatitis because of salivary gland involvement [7].
• Examination of the cerebrospinal fluid (CSF) shows lymphocytic pleocytosis along with normal to low glucose in case of meningitis [8] [9].
• Mumps is confirmed by isolation of the virus from the saliva or cerebrospinal fluid; or by the demonstration of a fourfold rise in complement fixing antibodies.

• Hyperglycemia

  Pancreatitis is infrequent, but occasionally occurs without parotitis; the hyperglycemia is transient and is reversible. [cdc.gov]

• Lymphocytosis

  Blood tests demonstrate a relative lymphocytosis is seen in case of mumps infection. Serum amylase is commonly elevated with or without pancreatitis because of salivary gland involvement. [symptoma.com]

  The WBC count is usually low or within the normal range with a relative lymphocytosis. Serum amylase may be elevated during the first week of illness. [clinicaladvisor.com]

• Hypoglycemia

  Decreased glucose levels can indicate fungal, tuberculous or pyogenic infections; lymphomas; leukemia spreading to the meninges; meningoencephalitic mumps; or hypoglycemia. [fi.bab.la]

The treatment of mumps is supportive and symptomatic. Mumps does not require any specific antiviral therapy as the illness is self-limiting.

Isolation: The patient suffering from mumps should be isolated until the swelling of the parotid gland(s) subsides.

Bed rest: During the febrile period of the disease, the patient should be advised to have bed rest.

Painkillers: Non-steroidal anti-inflammatory drugs (NSAIDs) such as paracetamol and ibuprofen are used to treat the pain of parotitis. Application of warm or cold compresses topically over the parotid gland may soothe the pain.

The complications of mumps are treated as follows.

Orchitis: In case of orchitis, the scrotum should be suspended with support and ice bags should be applied to keep their temperature from rising to dangerously high levels. Analgesics are given for pain. Injection of 1% procaine solution in the spermatic cord at the external inguinal ring also reduces pain. Injection of hydrocortisone followed by oral prednisolone is also helpful in reducing the pain and inflammation [10].

Meningitis: In case of meningitis, cerebral edema is treated by the use of mannitol and steroids. If the patient is experiencing fits, antiseizure medication may also be given.

Pancreatitis: The treatment of pancreatitis is symptomatic.

In the patients with uncomplicated disease, the prognosis is excellent. Patients who develop complications may have chronic morbidity but fatality is still extremely rare. Even if the patients develop meningitis or encephalitis, the prognosis remains favorable, although there may be sensorineural deafness. Even then, the hearing loss is rarely permanent. Similarly, total loss of fertility in patients with orchitis is extremely rare and no loss of fertility is seen in case of oophoritis.

Mumps infection is also linked to the development of type 1 diabetes mellitus [2] [3].

Mumps is caused by a paramyxovirus. The virus spreads by respiratory droplets and its infection is facilitated by lack of immunization against mumps and compromised immunity in the patient [1].

Mumps was a very common disease several decades ago but nowadays, with the advent of MMR vaccine, the prevalence has greatly reduced in the developed countries. The incidence is highly variable from country to country depending upon the efficiency of their immunization programs.

Most of the patients of mumps are children of school age. Males and females are equally affected. However, the complications of the central nervous system are up to 3 times more common in males.

Once the virus enters the body via respiratory droplets, it disseminates through the bloodstream into the parotid glands and several other sites such as the nervous system, the testes, ovaries etc. There is active inflammation and cellular infiltration that causes enlargement and pain of the parotid glands.

Mumps can be prevented by proper immunization in children. Currently, the vaccine of choice is MMR (that covers mumps, measles and rubella) [11]. It should be given at the age of 12 months and then followed up with a second dose after another 12 months. Avoidance of contact with any active case of mumps is also helpful in prevention.

Mumps is a common viral disease of children that produces tender inflammation and enlargement of the parotid gland(s). The causal agent is a paramyxovirus and infectivity occurs by respiratory droplets, saliva and urine. The disease is self-limiting and the treatment is symptomatic and supportive unless there are complications.

Mumps is a viral disease of children in which the parotid salivary glands become enlarged and painful. It is a highly contagious disease and spreads through respiratory droplets. The disease is usually not dangerous and the patient is treated only with painkillers unless there are complications. Mumps can be prevented by proper vaccination.

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2. Ratzmann KP. Does mumps infection play a role in the etiology and pathogenesis of insulin-dependent diabetes mellitus? Medecine interne. Oct-Dec 1986;24(4):245-252.
3. Hyoty H, Leinikki P, Reunanen A, et al. Mumps infections in the etiology of type 1 (insulin-dependent) diabetes. Diabetes research. Nov 1988;9(3):111-116.
4. Rodriguez-Vidigal F, Redondo L, Aguilar FJ, Vera A, Munoz-Sanz A. [Lymphocytic meningitis by mumps virus: epidemiologic, clinical, serologic and evolutive analysis of 28 cases]. Enfermedades infecciosas y microbiologia clinica. Apr 1999;17(4):176-179.
5. Manson AL. Mumps orchitis. Urology. Oct 1990;36(4):355-358.
6. Behar M. [Mumps meningitis]. La Semana medica. Apr 7 1960;116:435-443.
7. Lagunilla Martinez FL. [Amylase in the blood and infantile mumps infections]. Acta pediatrica espanola. Dec 1962;20:737-750.
8. Tashima CK. CSF pleocytosis after mumps. The New England journal of medicine. Jun 12 1969;280(24):1362.
9. Wilfert CM. Low CSF sugar in mumps. The New England journal of medicine. Jul 10 1969;281(2):106.
10. Martynkin AS, Timchenko VN, Ignat'eva Iu D. [Post-mumps orchitis: sequelae, treatment and prevention]. Pediatriia. 1987(6):95-98.
11. Elliman D, Sengupta N, El Bashir H, Bedford H. Measles, mumps, and rubella: prevention. Clinical evidence. 2007;2007.