- Published on Sunday, 19 August 2012 02:26
- Written by Dr. Ali Mzige
- Hits: 1154
Mumps (matubwitubwi in Kiswahili) is a contagious viral infection that causes painful enlargement of the salivary glands; the infection may also affect the testes, brain and pancreas (kongosho) especially in adults.
Children become infected with mumps by breathing in small airborne droplets of moisture coughed out by an infected person or by having direct contact with objects contaminated by infected saliva.
Mumps is less contagious than measles (surua) or chickenpox (tetekuwanga). In heavily populated areas, it occurs year round but most frequent during cold seasons. Epidemics may occur when people without immunity are crowded together. It is discouraged to let a child go to school if the child has mumps, for fear of infecting other children.
Although the infection may occur at any age, most cases occur in children 5 to 15 years old. The infection is unusual in children younger than 2 years. One infection with mumps virus usually provides lifelong immunity.
The disease has an incubation period of 14 to 24 days after infection. Most children develop chills, headache, poor appetite, a general feeling of illness (malaise) and low moderate fever. These symptoms are followed in 12 to 24 hours by a swelling of the salivary glands, which is most prominent on the second day. Some children simply have swelling of the salivary glands without the other symptoms.
There is pain on swallowing or chewing especially when swallowing acidic liquids like oranges. The glands are tender when touched. At this stage, the temperature usually rises to 39 or 40 degrees centigrade.
About 20% of men who become infected after the puberty develop inflammation of one or both testes (orchitis). Inflammation of the testes produces severe pain. On healing, the affected testis may be smaller. If both testes are damaged, sterility may result.
Mumps leads to viral inflammation of the brain or its covering (meningoencephalitis) in 10% of people. The disease process affecting the brain causes headache, stiff neck, drowsiness, coma, or seizures. Most people recover completely, but some have permanent nerve or brain damage, such as nerve deafness or paralysis of the facial muscles, usually affecting only one side of the body.
The pancreas (kongosho) may also be affected and this may occur towards the end of the first week of infection. This disorder causes abdominal pain, nausea and vomiting, which varies from mild to severe. These symptoms disappear within a week, and the person recovers completely. Those people who take excessive alcohol on weekends may as well end up with pancreatitis (due to alcohol) and present with similar features like those caused by mumps pancreatitis.
Doctors diagnose mumps clinically based on the typical symptoms, particularly when they occur during an outbreak of mumps. Laboratory testes to identify the mumps virus and its antibodies are rarely needed to make the diagnosis.
It is good to suffer mumps if you are a kid because recovery is usually uneventful, but in rare cases symptoms may worsen again after about two weeks. The mumps virus vaccine is not available in Tanzania as one of the EPI vaccines, but in certain countries like in the UK and USA they are given in a combination of Measles Mumps Rubella vaccine (MMR), beginning at 12 to 15 months single dose vaccine. Children going to the USA are required to have MMR vaccine which could be provided in some of the private hospitals in Dar es Salaam at a cost.
Once mumps infection has started, it just has to run its course. To minimize discomfort, children should avoid foods that require much chewing or are acidic. Analgesics may be used for headache and discomfort.
Boys or men with inflammation of the testes need bed rest. The scrotum may be supported by an adhesive tape bridge connected between the thighs. Ice packs may be applied to relieve pain. Those who have not suffered from mumps orchitis should pray to almighty god not to suffer from the disease.
If pancreatitis causes severe nausea and vomiting, intravenous fluids may be given, and intake by mouth should be avoided for few days. Children with inflammation of the coverings of the brain and spinal cord may need intravenous fluids and pain killer for headache and fever. If seizures (convulsions) develop, anticonvulsant drugs may be needed.
Please note that, ideally all HIV-infected should receive the routine childhood vaccinations, except usually the Measles-Mumps-Rubella. MMR contain live viruses and can cause a severe or fatal illness in the most immunologically compromised children with HIV, but they are recommended for children with HIV infection whose immune system is not compromised. However, the effectiveness of any vaccination will be less in children with HIV infection.