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Mumps: An Emergency Medicine-Focused Update
Chelsea Bockelman1, Thomas C Frawley1, Brit Long1
1Department of Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas.
Background:
Mumps is a Paramyxoviridae virus. This disease was rampant prior to introduction of the measles, mumps, and rubella vaccine, resulting in decreased incidence. This disease has demonstrated several outbreaks.
Objective:
This review provides a focused evaluation of mumps, an update on outbreaks, management recommendations, and ways to decrease transmission.
Discussion:
Clusters of mumps outbreaks continue to occur. The virus is a paramyxovirus, a single-stranded RNA virus. The vaccine can provide lifelong immunity if administered properly, though prior to 1967 and introduction of the vaccine, the virus was common. In the past decade, there have been several notable outbreaks. Humans are the only known hosts, with disease spread through exposure to droplets and saliva. Factors affecting transmission include age, compromised immunity, time of year, travel, and vaccination status. Upper respiratory symptoms, fever, and headache are common, with unilateral or bilateral parotitis, and the virus may spread to other systems. Diagnosis is clinical, though polymerase chain reaction and immunoglobulin testing are available. This review provides several recommendations for vaccine in pregnancy, patients living in close quarters, health care personnel, and those immunocompromised. Treatment is generally supportive, with emphasis on proper isolation to prevent widespread outbreaks. Although reporting regulations and procedures vary by state, mumps is reportable in most states.
Conclusions:
Mumps is an easily spread virus. Although vaccination is the most effective way to prevent transmission, early recognition of the disease is crucial. As an emergency physician, it is important to recognize the clinical presentation, recommended testing, treatment, and isolation procedures.
Insights
Mumps outbreaks continue to occur despite vaccination. Early recognition of symptoms, proper testing, and isolation are crucial for controlling this easily spread paramyxovirus.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Mumps is caused by a Paramyxoviridae virus, a single-stranded RNA virus.
- The measles, mumps, and rubella vaccine significantly decreased mumps incidence, but outbreaks persist.
- Humans are the sole known hosts, with transmission via respiratory droplets and saliva.
Purpose of the Study:
- To provide an updated evaluation of mumps.
- To review current outbreak trends and management strategies.
- To outline methods for reducing mumps transmission.
Main Methods:
- Review of existing literature on mumps epidemiology and clinical presentation.
- Analysis of factors influencing mumps transmission.
- Compilation of diagnostic and treatment recommendations.
Main Results:
- Mumps outbreaks continue to occur, influenced by factors like age, immunity, and vaccination status.
- Common symptoms include upper respiratory issues, fever, headache, and parotitis.
- Diagnosis is primarily clinical, supported by PCR and immunoglobulin tests.
Conclusions:
- Vaccination offers lifelong immunity but is not 100% effective in preventing all outbreaks.
- Early recognition, appropriate testing, and isolation are vital for managing mumps.
- Recommendations are provided for specific populations, including pregnant individuals and healthcare personnel.
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