Internal Medicine

0521779407-14 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:16

Mumps 1019

➣Reportable in certain areas

➣Immunize susceptible pts

➣Respiratory isolation for 9 days after onset parotid swelling

specific therapy

n/a

follow-up

n/a

complications and prognosis

Complications

■Orchitis: around 30–40% postpubertal males

➣Usually unilateral

➣Sterility not common

■Oophoritis (inflammation of ovaries);∼7% of postpubertal females

➣Usually unilateral

➣Pelvic pain, lower abdominal tenderness

➣Risk of sterility very low

■Mastitis: 30% postpubertal females

■Senso-neural hearing loss; 5/100,000 cases

➣Central Nervous System

up to 15% of cases have signs of meningeal inflammation

Encephalitis; more common in patients >15 years

2.6 encephalitis/1000 cases mumps

➣Pancreatitis: often mild,∼4% of cases

1st trimester; spontaneous abortions, no congenital malfor-

mations

other complications: arthritis, renal involvement, thyroiditis

Diabetes mellitus: association has been suggested, unproven

Prevention

■For active cases;

➣Exclude child from school/day care center

➣Droplet precautions until 9 days after parotid swelling

Mumps vaccine does not prevent infection when given to indi-

viduals incubating mumps.

■General:

➣vaccine is live-virus vaccine

➣Vaccine – lasting immunity

➣Vaccine recommended to all children during 2nd year of life and

booster at 4–6 years