The article will discuss one of the controlled infections - mumps or mumps disease. Since the 60s of the last century, when mass prophylactic vaccination began, infection has declined significantly. What are the symptoms of mumps disease in children and adults, what are its consequences and how effective vaccination is - we will answer these and other questions in the article.
general information
This disease is caused by the pathogen paramyxovirus (paramyxovirus parotidis), the reservoir of which is only an infected person. People are highly susceptible to this pathogen, more often the disease is recorded in children. In this case, mumps suffer more often from boys (1.5 times more often than girls). Infants receive from the mother immunity to the disease, which lasts up to five years. Most often, preschool children are sick, but adult infection is also found. Moreover, the older the patient, the course of the disease is accompanied by more severe clinical symptoms and an increased risk of complications. The transferred disease gives a lasting lifetime immunity to infection. In connection with pronounced external symptoms, mumps is called mumps or mumps disease.
Highly contagious disease
Ever since the time of Hippocrates, this disease has been known to mankind, and its name is due to the fact that a sick person externally becomes like a piglet (shown in the photo). Mumps disease primarily affects the salivary parotid glands, the glandular tissue of which becomes inflamed and swollen. The disease is transmitted only from the patient by airborne droplets. A household way of transmitting mumps disease is completely ruled out. Seasonality of the incidence is associated with the ability of the pathogen to maintain contagiousness in the cold and wet seasons of the year. In this case, the virus is easily deactivated by drying, exposure to ultraviolet light and disinfectant solutions.
Mumps features
The disease can occur in three manifest forms:
- Inapparatnaya - the disease proceeds without visible and tangible symptoms.
- Uncomplicated - paramyxovirus affects only the glandular tissue of the salivary glands.
- Complicated - in addition to the salivary glands, the virus penetrates the glands of other organs (sex glands, pancreas and nervous system).
Depending on the severity of the symptoms, mumps disease can occur in mild, moderate and severe forms. Mumps is dangerous for its complications. The consequences of mumps disease can be deafness, testicular atrophy in men, infertility, and diabetes.
Mumps development stages
During the disease, the following periods are distinguished:
- Incubation. Duration 10 to 25 days. In this case, the patient is contagious on the 4th-5th day.
- An acute period or the height of the disease. Duration - up to 10 days. It is characterized by an increase in symptoms with a peak on the 3-5th day.
- Reconvalescence. The full recovery period lasts from 10 days to a month.
Symptoms of mumps disease
The acute period of mumps is accompanied by fever, chills, weakness and headache, tinnitus, pain when swallowing and opening the mouth. A visible sign of the disease is an increase in the salivary parotid glands, sometimes involving the submandibular and sublingual glands in the inflammatory process. Their palpation is painful, inflammation begins as one-sided, but by the 2-3rd day of the disease passes into the bilateral phase. Swelling begins to go away on the 4th-5th day, and only in adults the disease of mumps can save puffiness for up to 2 weeks. With an uncomplicated course, after a week the symptoms go away and the patient can be considered recovered.
Complicated form of the disease
On the 5-7th day of the disease in 10% of cases other organs are involved in the inflammation.
With damage to the pancreas, symptoms of acute pancreatitis appear - pain in the upper abdomen, dyspepsia, vomiting, nausea. This complication is more typical for adult patients and occurs in a ratio of 1 to 14 patients.
Paramyxovirus can affect the inner ear. The patient has a constant tinnitus, dizziness, impaired coordination and balance. Most often, this is a one-sided lesion, which can lead to a decrease or loss of hearing.
A rare complication - involvement in thyroid inflammation - can lead to tissue degeneration, atrophy and oncology.
In severe cases, inflammation spreads to the lining of the brain, causing swelling and the appearance of meningeal symptoms (temperature above 39 degrees, photophobia, vomiting, convulsions). In 10% of cases, the disease leads to the development of serous meningitis.
The consequences of mumps disease in the genital area
When the genitals are involved, boys may develop orchitis - swelling of the testicles 2-3 times, accompanied by their compaction and pain in the groin. The consequences of mumps disease for 12 year old boys are especially serious. Their sex cells are irreversibly affected, which leads to irreversible infertility. In other cases, testicular edema occurs on day 7, but with inadequate treatment of mumps disease in men, testicular atrophy, impaired spermatogenesis, and secondary infertility may develop in men from 1 to 3 months. In some cases, post-infertility infertility in men can be treated, which requires considerable effort and material cost.
In women, in rare cases (every twentieth), the development of ovarian inflammation is possible, proceeding almost asymptomatically. There is a risk of infertility.
Registration of the disease in a pregnant woman in the first trimester is an indication for termination of pregnancy.
Mumps diagnosis
Diagnosing mumps with severe clinical symptoms is usually straightforward. But the final diagnosis is made on the basis of confirmed laboratory tests. A modern arsenal of diagnostic methods includes:
- Serological tests. Isolation of the virus from the secretion of the salivary gland, urine, pharynx. Enzyme-linked immunosorbent assay (ELISA), complement fixation reaction (CSC) and hemagglutination inhibition reaction (RTGA) are used. These tests may not be reliable due to cross-reaction with parainfluenza viruses.
- Polymerase chain reaction is one of the newest and most accurate methods for determining viral infection. This method gives an idea of the stage of the disease and the sensitivity of the pathogen.
Differentiating the diagnosis of mumps is very important, since completely different diseases can hide under external symptoms. For example, sometimes swelling of the mucous salivary glands and lymph nodes near the pharyngeal is accompanied by no less dangerous diseases - lymphadenitis in toxic diphtheria. Infectious mononucleosis and herpes virus infections may be associated with such symptoms.
Mumps treatment
If acute symptoms appear in a child, a pediatrician should be called to the house. The onset of symptoms of mumps disease in adults often leads them to dentists or ENT doctors.
Most patients do not require hospitalization. It is carried out only in case of severe complications of mumps disease. The treatment is aimed at preventing the development of complications, reducing and alleviating the symptoms. Patients are prescribed bed rest, a milk and vegetable diet, antipyretic and anti-inflammatory drugs. With severe intoxication of the body, intravenous administration of detoxification drugs (saline, 5% glucose solution) is possible. Multivitamin complexes are prescribed.
Treatment at home involves quarantine up to 10 days. In child care facilities, mumps are quarantined for up to 3 weeks.
Preventive actions
There is no specific prevention of mumps. Since paramyxovirus is similar to the influenza virus, the general preventive measures are the same as for the spread of viral infections of a general nature. General strengthening of the body, elimination of contact with patients significantly reduce the risk of the disease.
The most reliable way to prevent mumps in children is vaccination. It is carried out for the first time at the age of 1 year with a complex vaccine for mumps, measles and rubella. The second immunization is indicated for children 6-7 years old who have not had mumps.
Immunization: Pros and Cons
The opinion of specialists in this matter is ambiguous. There is an opinion that only boys of the puberty period (the beginning of puberty) who did not get mumps in childhood should be vaccinated. The rationale for this point of view is the immunity acquired by the boy after mumps at an early age, intravitally, while the vaccine will ensure its availability for several years.
Supporters of the mandatory immunization of all young children appeal to the fact that no one is immune from the complications of the course of mumps. And if it is possible to avoid even the small probability of a child developing diabetes, deafness or testicular atrophy, then you should use it.
Contraindications to vaccination
Modern vaccines contain attenuated paramyxoviruses and a protein component based on chicken or quail eggs or cattle protein. Features of vaccines are taken into account in the presence of allergies in the child. There are mono-vaccines and multivaccines. Complex vaccines have long been a priority in Western countries.
Vaccinations in Russia are carried out in accordance with the immunization calendar - in 1 year of life and in 6-7 years. Vaccination is effective even in the first 2 days after contact with the patient, in which case the risk of developing complications and a severe course of the disease is reduced.
The effectiveness of immunization with modern means is quite high - immunity lasts several years, sometimes for life. But there are still contraindications for children:
- Blood diseases and oncological diseases.
- Allergy to both eggs and beef.
- Immunodeficiency conditions.
- Intolerance to certain antibiotics of the aminoglycoside group.
- Acute infectious conditions.
- Allergic reactions to previous vaccinations and exacerbations of chronic pathologies.
All side effects of the vaccine are associated with the features of the course of mumps (fever, respiratory and catarrhal manifestations, swelling of the glands). These manifestations may appear on the 10-12th day after vaccination, hold on for 1-2 days and pass on their own.
What to do to parents
Today, vaccinating children against mumps is not mandatory, and parents have the right to refuse vaccination of their child. One has only to responsibly approach this issue, given the following facts:
- About 1.5 million children die every year in the world, whose death could be prevented by timely vaccination.
- About 17 children out of 100 under the age of 5 could live with vaccination against dangerous viral diseases.
- The development of meningoencephalitis, although not fatal, but leads to irreversible damage to the auditory nerves and deafness.
- Mortality in the case of mumps is small, but is 1 case per 100 thousand patients.
- About 25% of cases of male infertility are associated with childhood mumps.
- Severe pancreatic lesions can lead to various forms of diabetes.
The distrustful attitude to vaccination in modern society has long become a global global problem. It is formed under the influence of the following aspects: distrust of the vaccine as such (its effectiveness or its supplier), arrogance of the average person (underestimation of the risks of the disease), inconvenience of vaccination (geographical remoteness, stress or high cost). Which of the following factors affects the decision of a particular parent, and are you ready to say that you made a decision without basing on false conclusions?
From doubt to confidence
Distrust of vaccines in humans has existed since their invention. According to surveys, 1/5 of the population is ready to admit the existence of a medical conspiracy, according to which immunization is supported by government health authorities, despite the presence of side effects. You can argue about this for a long time, but each parent will have to take responsibility for the health of their child. We only recall that in the world today, thanks to vaccines, diseases of cholera, rabies, smallpox, one of the forms of meningoencephalitis and even more than 10 diseases are in the category of completely disappeared dangerous infections. Vaccine production is a very complex process, and modern certification methods are very strict. In any case, the choice remains an individual matter.