Mumps Virus – Paramyxoviruses

00:01 Okay.

00:02 Let's move from measles to mumps.

00:05 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.

00:24 The incubation period here is a little bit longer than it was for measles, so up to 3 weeks, 2-3 weeks.

00:32 The mumps virus manifestations, the mumps manifestations frequently, and thankfully, are often asymptomatic.

00:40 The patients are still contagious, but they may not have any symptoms.

00:44 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.

00:57 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 and they go through that very densely swollen Stensen's duct.

01:13 Importantly, mumps virus, as mentioned, can travel to the testes and the ovaries.

01:20 And there, it can cause a localized inflammation called orchitis or oophoritis.

01:25 Along with that pancreatitis, there can be central nervous system manifestations, severe headache, confusion, occasionally seizures.

01:33 The aseptic meningitis, a frank encephalitis and meningitis, thankfully, is rare.

01:40 It's only about 5% of cases, and all this resolves spontaneously, but there may be secondary complications in hospital: aspiration during a seizure, hypoxia, etc.

01:52 The orchitis is perhaps an important thing to remember for testing, orchitis from mumps can cause sterility in males.

02:01 So, diagnosis.

02:03 Again, a clinical diagnosis with bilateral swollen glands or swollen parotid glands, that should be screaming the diagnosis.

02:10 There are other things which cause parotitis, but one should think first of mumps to exclude that possibility.

02:17 And in doing so, one can obtain specimens from saliva, urine, spinal fluid, But what else can do? One can do an RT-PCR, one can do screening by the enzyme-linked immunosorbent assay, the ELISA.

02:30 So there are multiple ways to look for the mumps virus.

02:33 Transmission, again, prior to the onset of symptoms, that 2-3 week incubation period, patients can be contagious through respiratory droplets and very classically close contact with other people and even fomites.

02:49 So, you are likely to see clusters or an outbreak of mumps on college campuses.

02:54 In fact, that is what has happened in the last 10 years or so.

02:57 But also, in closed 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.

03:09 Prevention.

03:09 That same virus we just talked about, the triple vaccine, the measles mumps rubella shot.