Causative agent
Mumps virus
Clinical description
Mumps is an acute viral disease resulting from infection with mumps
virus. Clinical features include fever, headache swelling of one or
both cheeks or sides of the jaw and swollen glands. The fever usually
lasts for 1 to 6 days and the parotitis for up to 10 days, or more.
Mumps can have serious complications, including aseptic meningitis (4-6
% cases), encephalitis (1 in 1000 cases), inflammation of the testes
(orchitis), pancreatitis, oophoritis and permanent deafness. Neurological
involvement occurs in 10-20% of cases and may precede or follow parotitis,
and can also occur in its absence. Orchitis is the most common complication
of mumps in adult males (4 out of 10 cases). Fulminant encephalitis
is rare, but a potentially fatal complication of mumps.
Transmission
Respiratory transmission from infected individuals. The incubation
period ranges from 12-25 days, and is usually about 18 days. A mumps
case is infectious from about 6-7 days before onset of parotitis until
9 days after, although clinical inapparent cases can also be communicable.
Surveillance in Scotland
Immunisation against mumps began in Scotland in October 1988, with the introduction of MMR vaccine. The introduction of a routine second dose of MMR followed in 1996. Mumps is a notifiable disease. A salivary surveillance scheme exists for mumps, in which notifying GPs are requested to submit an Oral Fluid sample using a standard kit, from all notified cases for laboratory confirmation. Genotyping to determine the possible origin of the virus may also be attempted.
- Statutory notification of mumps by clinical diagnosis
- Laboratory reports for mumps virus
- Laboratory confirmation of notified cases by oral fluid testing
Clinical Case Definition
Acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary gland, lasting two or more days and without other apparent cause.
(Source: WHO)
Laboratory criteria for diagnosis
- Isolation of mumps virus from a clinical specimen
- Detection of mumps virus nucleic acid in a clinical specimen
- Mumps virus specific antibody response in serum or saliva
- Detection of mumps virus antigen by direct fluorescent antibody (DFA) in a clinical specimen using mumps specific monoclonal antibodies
Incidence
In the years following MMR introduction the number of notifications and laboratory confirmed cases fell. However, since 2004 there has been increased incidence of mumps in Scotland, with peaks of cases in 2005 and 2009. The majority of confirmed cases have been in adolescents and young adults. Many in this age group have not had the opportunity to be protected against mumps by two doses of MMR vaccine, as scheduled for younger children; they will have received only one dose or none at all. At the same time, the likelihood of this cohort being exposed to mumps infection was also reduced. Therefore many in this age group remained susceptible and outbreaks have occurred when they reach older ages.
Mumps Notifications and Laboratory Confirmed Cases
Scotland 2000-2011
Year |
Notifications |
Laboratory
Confirmed |
2000 |
199 |
9 |
2001 |
155 |
6 |
2002 |
259 |
63 |
2003 |
181 |
47 |
2004 |
3595 |
1887 |
2005 |
5698 |
2586 |
2006 |
2917 |
1322 |
2007 |
2741 |
1207 |
2008 |
720 |
171 |
2009 |
1129 |
709 |
2010 |
727 |
466 |
2011 |
609 |
235 |
Prevention
Two doses of MMR vaccine are recommended. The first offered at the routine immunisation appointment between 12 and 13 months; and the second offered at the pre-school booster appointment at around three and a half years.
Any older individuals, particularly those in high risk adolescent and young adult age groups, who have not yet received two doses of MMR vaccine, are encouraged to do so.
More information about MMR immunisation is available at the Immunisation Scotland website.
MMR vaccine uptake is collated by Information Services Division, which is part of the NHS. Uptake is reported for vaccinations given as part of the routine childhood programme. Whole year vaccine uptake rates are published in the March of the following year.
For further details of vaccine uptake visit the Information Services Division website.
Further Information
Historic data
European Centre for Disease Prevention and Control (ECDC)
ECDC is the public health surveillance network for vaccine preventable infectious diseases in Europe. Previously this work was carried out by EUVAC.NET.
Images of Mumps Infection
General information about mumps
The Green Book provides background information and vaccination details about all vaccine preventable diseases. This is regularly updated. It is written and maintained by the UK Department of Health, but is used throughout the UK.
NHS Inform provides information about mumps including symptoms, causes, complications and prevention.
Last reviewed: 25th May 2012
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