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MUMPS XIE QIFENG Dept. of Infectious Disease

MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

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Page 1: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

MUMPSXIE QIFENG

Dept. of Infectious Disease

Page 2: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Introduction Mumps is an acute respiratory tract in

fectious disease caused by mumps virus, it occurs primarily in school-aged children and adolescents.The most prominent manif

estation is nonsuppurative swelling and tenderness of the salivary glands with

one or both parotid glands involved in most cases.

Page 3: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Introduction

Meningitis, meningoencephalitis, epididymo-orchitis, oophoritis and pancreatitis are the common extrasalivary gland manefestations of mumps.

Page 4: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Etiology

• Mumps virus (Paramyxovirus parotitis) belongs to Paramyxoviridae family. RNA virus.

• 6 major proteins. nucleocapsid associated

(S antigen) for diagnosis. Hemagglutinin-neuraminidase(V antigen) for protection.

Page 5: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Etiology

• Sensitive to ether,ultraviolet and high temperature

• Humans are the only natural host

Page 6: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Epidemiology

• Sources of infection:

Patients in early course of the disease, hosts under covert infection.

The period of peak contagion before or at the onset of parotitis.

• Route of transmission :

Via droplet nuclei or direct contact,fomites

Page 7: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

• Epidemic features:

Endemic throughout the world.

The peak incidence in winter and spring.

School-aged children at high risk.

Post-infection immunity is stable and long-lasting.

Page 8: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Pathogenesis and Pathology

The virus usually infecting glandular tissue such as parotid, orchis or oophoron.

The main pathologic findings are nonsuppurative inflammatory reactions.

The meningoencephalitis may involve

the Fusion protein.

Page 9: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Clinical Manifestations• Incubation period: averages 16 to 18 days

with a range of 2 to 4 weeks.

• Prodromal symptoms include low- grade fever, anorexia,malaise and headache.

• Parotid tenderness and ipsilateral earache within 1 or 2 days after the illness onset,then

parotid is visibly enlarged and go to maximum

Page 10: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

size over next 2 to 3 days accompanied severe

pain and normal or high temperature. One parotid enlarges after the other. The orifice of Stensen’s duct is edematous and erythematous. Parotid returns to normal size within a week.

Patients with parotitis have difficulty with

pronunciation and mastication. Citrus fruits and juices exacerbates the pain.

Other salivary glands involved include submandibular adenitis and sublingual adenitis.

Page 11: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

• Clinical meningitis occurs in 15% of patients with mumps. Its onset averages 4-5 days after parotitis but may before, after or in the absence of parotitis. Clinical features are headache, vomiting, fever and nuchal rigidity.

CSF pleocytosis. Prognosis is benign.

• The onset of orchitis is abrupt with high temperature, chills , testicular pain and swelling. Impaired fertility is rare.

Page 12: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

• Oophoritis develops in 5% postpubertal women with mumps. Impaired fertility is

rare.

• Pancreatitis is manifested by severe epigastric pain and tenderness,fever,nausea,and vomiting.

Page 13: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Diagnosis• In most instances, the diagnosis of mumps is

made on the basis of a exposure history and of parotid swelling and tenderness accompanied

other symptoms.

• Laboratory confirmation is unnecessary in typical cases, exception the absence or recurrence of parotitis and extrasalivary glands

involved. Serologic tests,viral isolation. Amylase and lipase.

Page 14: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Differential Diagnosis

• Suppurative parotitis

• Other viral parotitis: caused by parainfluenza

virus, coxsackievirus and influenza A virus.

---serologic tests or viral culture

• Parotid enlargement caused by other reasons

Page 15: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Prognosis

Benign and self-limited

Major death causes are severe mumps

encephalitis

Page 16: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Treatment• Supportive and symptomatic treatment

• Anti-viral therapy: ribavirin and interferon

• Dexamethason for meningoencephalitis

• Diethylstilbestrol for orchitis

Page 17: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

Prenvention

• Patients should be isolated.

• Attenuated mumps virus vaccine has been available. More than 90% vaccine recipients produced protective antibody.

Aseptic meningitis associated with vaccine virus occurred in 0.025% recipients.

Mumps vaccine should not be administered to pregnant women or persons with immunodeficiencies.

Page 18: MUMPS XIE QIFENG Dept. of Infectious Disease. Introduction Mumps is an acute respiratory tract infectious disease caused by mumps virus, it occurs primarily

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