Let's move from measles to mumps.
Mumps, again, starting at the
upper respiratory tract,
progressing this time to the parotid glands,
and then a secondary viremia after that,
hich can label the rest of the
body including and especially
the testes in men, ovaries in women,
thyroid, pancreas, central nervous system,
even the gut, etc.
The incubation period here is a little bit
longer than it was for measles, so up
to 3 weeks, 2-3 weeks.
The mumps virus manifestations,
the mumps manifestations
frequently, and thankfully, are
The patients are still contagious, but
they may not have any symptoms.
When they do, however, they'll have
from low to high grade fever,
and they will classically have
bilateral swelling of the parotid glands,
as well as swelling of the Stensen's duct
ostium, the opening into the
back of the throat.
That means that
any ingestion of sour foods, like a lemon
or even sometimes salty foods,
will cause exquisite
pain as the parotid glands try to contract
nd they go through that very densely
swollen Stensen's duct.
Importantly, mumps virus, as mentioned,
can travel to the testes and the ovaries.
And there, it can cause a localized
inflammation called orchitis or oophoritis.
Along with that pancreatitis, there can be
central nervous system manifestations,
severe headache, confusion,
The aseptic meningitis, a frank
encephalitis and meningitis,
thankfully, is rare.
It's only about 5% of cases, and all
this resolves spontaneously,
but there may be secondary complications
in hospital: aspiration during a seizure,
The orchitis, especially in
males, and this is
perhaps an important thing to
remember for testing,
orchitis from mumps can cause
sterility in males,
and that is a big complication, which --
well, it's not preventable.
Again, a clinical diagnosis with bilateral
swollen glands or swollen parotid glands,
that should be screaming the diagnosis.
There are other things which
but one should think first of mumps
to exclude that possibility.
And in doing so, one can obtain
specimens from saliva, urine, spinal fluid,
and ask the pathologist to look for those
multinucleated cells that I showed
you earlier in this talk.
But what else can do?
A hemagglutination assay, one can do an
RT-PCR, one can do screening by
the enzyme-linked immunosorbent
assay, the ELISA.
So there are multiple ways to look
for the mumps virus.
Transmission, again, prior to
the onset of symptoms, that 2-3
week incubation period,
patients can be contagious through
and very classically close contact
with other people
and even fomites.
So, you are likely to see clusters
or an outbreak of mumps
on college campuses.
In fact, that is what has happened
in the last 10 years or so.
But also, in close areas, so
just like measles and Disneyland for
those of you who have traveled
to a Disneyland Park,
can be close contact there and
transmission of this virus.
That same virus we just talked about,
the triple vaccine, the measles
mumps rubella shot.