Symptoms and Causative Agent
Mumps is caused by a virus from the genus Rubulavirus. Its symptoms include low-grade fever, respiratory problems, and most notably swelling of the salivary glands below the ear. The affected glands are called the parotid glands, and the swelling is known as parotitis. Although parotitis is the most easily recognized symptom of mumps, it occurs only in about 30-40% of cases. Other patients may have non-specific symptoms. Up to 20% of infected individuals may experience no symptoms at all.
Symptoms typically occur two to three weeks after exposure to the virus.
The virus is spread by respiratory droplets. These can become airborne when an infected person coughs, sneezes, and talks. Additionally, a person can contract the virus by touching surfaces that are contaminated with infected droplets. Infected individuals are considered most contagious during a period starting several days before the appearance of parotitis (if it occurs), and running through the fifth day after it first appears. To keep a patient from spreading the virus to others, isolation is recommended for five days after parotitis begins.
In the United States, cases of mumps have dropped by 99% since the introduction of a vaccine in 1967. Unlike measles and rubella, however, mumps has not yet been eliminated in the United States. Recent large outbreaks have occurred among college students (2006, more than 6,500 cases) and in a tradition-observant Jewish community, sparked by a boy who returned from a trip to the United Kingdom and began showing mumps symptoms while at a summer camp (2009-2010, more than 3,400 cases).
Mumps cases typically peak in late winter or early spring.
Treatment and Care
There is no direct treatment for mumps. Supportive care may be provided, including efforts to lower fever.
Complications and Mortality Rate
Mumps can be a mild disease, but it is often quite uncomfortable and complications are not rare. These include meningitis; testicular inflammation in males who have reached puberty, among whom about half experience some degree of testicular atrophy; inflammation of the ovaries or breasts in females who have reached puberty; and permanent deafness in one or both ears. Before the development of a mumps vaccine, the disease was one of the major causes of deafness in children.
Some research also suggests an increase in miscarriages among pregnant women who are infected with mumps during their first trimester.
Available Vaccines and Vaccination Campaigns
The live, attenuated mumps vaccine used today in the United States was licensed in 1967. It was developed by the prolific vaccine researcher Maurice Hilleman, using mumps virus that he isolated from his daughter, Jeryl Lynn, when she was ill with mumps at age 5. (The vaccine virus strain is referred to as the “Jeryl Lynn strain.”) Hilleman’s mumps vaccine was then used in the combination measles-mumps-rubella (MMR) vaccine, which was licensed in 1971. The rubella component of the vaccine was changed in 1979, but the mumps and measles components have remained the same since 1971.
Most industrialized countries, and some developing countries, include mumps-containing vaccine as part of their national immunization program. The World Health Organization’s position on mumps immunization is that “Routine mumps vaccination is recommended in countries with a well established, effective childhood vaccination programme and the capacity to maintain high-level vaccination coverage with measles and rubella vaccination (that is, coverage that is >80%) and where the reduction of mumps incidence is a public health priority. Based on mortality and disease burden, WHO considers measles control and the prevention of congenital rubella syndrome to be higher priorities than the control of mumps.” WHO recommends that mumps immunization be accomplished via the MMR vaccine, rather than a single component mumps vaccine.
U.S. Vaccination Recommendations
Mumps vaccination is included on the U.S. childhood immunization schedule as part of the combined MMR vaccine. This vaccine is given in two doses, the first at 12-15 months of age and the second between 4-6 years of age. Alternatively, mumps vaccination is available as part of the newer MMRV (measles, mumps, rubella, and varicella) combination vaccine, which also protects against chickenpox.
Certain adults are considered to be at higher risk for mumps, including college students and health care personnel. It is recommended that these groups verify that they received two doses of mumps-containing vaccine, or demonstrate proof of mumps immunity.
During recent outbreaks, mumps cases have occurred even in individuals who have received two doses of the vaccine, as a result of waning vaccine immunity. In response, third doses have been given during outbreaks, with good booster responses to the vaccine.
Sources and Additional Reading
Centers for Disease Control and Prevention. Mumps. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Wolfe S, Hamborsky J, eds. 12th ed. Washington DC: Public Health Foundation, 2011. Accessed 2/4/2014.
Centers for Disease Control and Prevention. Mumps. http://www.cdc.gov/mumps/index.html. Accessed 2/4/2014.
Centers for Disease Control and Prevention. Vaccines: Mumps Vaccination. http://www.cdc.gov/vaccines/vpd-vac/mumps/default.htm. Accessed 2/4/2014.
Immunization Action Coalition. Mumps: Questions and Answers. Available at: www.immunize.org/catg.d/p4211.pdf. (111 KB). Accessed 2/4/2014.
Plotkin SA, Orenstein WA, Offit PA, eds. Vaccines, 5th ed. Philadelphia: Saunders; 2008.
World Health Organization. Mumps virus vaccines: WHO position paper. Weekly Epidemiological Record. 2007, 82, 49-60. http://www.who.int/immunization/wer8207mumps_Feb07_position_paper.pdf (321 KB). Accessed 2/5/2014.
More information about the history of mumps and the development of mumps vaccines can be found in our Disease Timelines.
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Last update 5 Feb 2014