Mumps ( parotitis )

mumps ( parotitis )

   Inflammation of the salivary glands.—  Mainly the parotid glands are affected.
— There are three pairs of salivary glands.
— Two parotid glands, the largest, one in each cheek, over the angle of the jaw , in front of the ear.
—  Two sub mandibular glands at the back of the mouth.
—  Two sub-lingual glands, under the floor of the mouth.

  Salivary glands

Definition

—  Inflammation of the parotid gland

Viral etiology

—  Caused by mumps virus.

—  Family: paramyxoviridae.

—  Genus: parainfluenza virus.

—  The viral genome isxx-smallA, with  negative  polarity.

— 

The  fusion protein enables the virus to form multinucleated giant cell by fusing infected cells together

Transmission

—  By inhalation of respiratory droplets, during sneezing and coughing.

—  The virus sheds in saliva.

—  Also, the virus can be transmitted by direct contact with saliva.

Phathophysiology

Clinical features

—  Mumps is a highly infectious child-hood disease.

—  IP, 14 to 18 days.

—  Mumps starts with moderate fever, malaise, pain on chewing or swallowing, particularly acidic liquids.

—  Followed by inflammation of the salivary glands, particularly the parotid glands.

—  The swelling appears in front of the ear.

Parotitis

Complications

—  Aseptic meningitis.

—  Encephalitis.

—  Orchitis, after puberty. Inflammation of one or both testicles. Usually unilateral , rarely  leads to sterility .

—  Pancreatitis.

—  Oophoritis.

—  Thyroiditis.

—  Deafness

—  Death

Prognosis & lab diagnosis

—  In the absence of complications recovery is usual.

—  Lab. Diagnosis, by detection of IgM antibody to mumps virus.

—  Serologic testing

¡  By detection of IgM antibody to mumps virus.

¡  Significant increase in IgG antibody between acute and convalescent specimens

Prevention

—  A live attenuated vaccine is available (MMR).

—  It contains mumps, measles and rubella attenuated virus strains.

—  Administered in one dose, intramuscularly or subcutaneously.

—  The vaccine is protective.

Mumps Vaccine Information

—  Composition                      Live virus (Jeryl Lynn strain)

—  Efficacy                                 95% (Range, 90%-97%)

—  Duration of
Immunity                            Lifelong

—  Schedule                                        1 Dose

—  Should be administered with measles and rubella (MMR)

Treatment

—  There is no specific anti-viral drug therapy.

—  Treatment is supportive by treating symptoms, using antipyretics and analgesics.

Nursing Management

—  The child must rest in bed until the fever goes away.

—  Isolate the child, to prevent spreading the disease to other.

—  Use analgesics and anti-pyretic to ease symptoms.

—  Avoid food that require chewing.

—  Avoid sour foods that stimulate saliva production.

—  Drink plenty of water.

—  Use cold compress to ease the pain of swelling glands.