Mariel A. Marlow, Nakia S. Clemmons
An enveloped, single-stranded, negative-sense RNA virus of the family Paramyxoviridae, genus Rubulavirus.
By respiratory droplets, saliva, or contact with contaminated fomites; requires close contact for spread. Transmission is most likely to occur 2 days before through 5 days after parotitis onset.
Endemic to many countries throughout the world. By the end of 2016, mumps-containing vaccine was being used routinely in 121 countries worldwide. Recently, there has been an increase in mumps outbreaks among highly vaccinated populations in industrialized nations. The risk of exposure among travelers is high in many countries.
Average incubation period is 16–18 days (range, 12–25 days). Mumps is an acute systemic illness that classically presents with parotitis (acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary glands), lasting 2–10 days. Nonspecific prodromal symptoms of low-grade fever, headache, malaise, myalgias, and anorexia may occur several days before parotitis onset. Infections may also be limited to nonspecific respiratory symptoms or asymptomatic. Complications, including orchitis, oophoritis, mastitis, hearing loss, aseptic meningitis, encephalitis, and pancreatitis may occur in the absence of parotitis.
Usually clinically defined as acute parotitis or other salivary gland swelling lasting ≥2 days or orchitis or oophoritis, without other apparent cause. Laboratory confirmation of mumps involves detecting mumps virus by real-time RT-PCR or virus isolation by culture. Laboratory confirmation of mumps can be challenging; therefore, mumps cases should not be ruled out by negative laboratory results. For further information on laboratory testing, see www.cdc.gov/mumps/lab/index.html. Mumps is a nationally notifiable disease.
Supportive care is the mainstay of treatment.
Before departure from the United States, travelers aged ≥12 months who do not have acceptable evidence of mumps immunity (as documented by 2 doses of a mumps virus–containing vaccine, laboratory evidence of immunity, laboratory confirmation of disease, or birth before 1957) should be vaccinated with 2 doses of measles-mumps-rubella (MMR) vaccine ≥28 days apart (or 1 dose of MMR if previously administered 1 dose of MMR). Measles-mumps-rubella-varicella (MMRV) vaccine is licensed for children aged 12 months through 12 years and may be used if vaccination for measles, mumps, rubella, and varicella is indicated for this age group. There is no recommendation for vaccination against mumps for infants aged <12 months before international travel; however, infants aged 6–11 months should receive 1 dose of MMR vaccine before departure to protect against measles.
CDC website: www.cdc.gov/mumps
- CDC. Manual for the surveillance of vaccine-preventable diseases. Atlanta: CDC; 2018 [updated Dec 2017; cited 2018 Jan 29]. Available from: www.cdc.gov/vaccines/pubs/surv-manual/chpt09-mumps.pdf.
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- World Health Organization. Immunization, vaccines and biologicals: mumps. 2016 [updated August 9, 2017; cited 2018 Jan]. Available from: www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/passive/mumps/en.