Mumps classically causes swelling and inflammation of one or both of the parotid glands (parotitis).
More serious complications of mumps, such as meningitis, encephalitis, and orchitis, can occur in the absence of parotitis, potentially delaying the accurate diagnosis of the disease.
Diagnosis can usually be made based on the characteristic clinical features of parotitis and prodrome alone. Laboratory diagnosis is based on serological or salivary confirmation, detection of viral nucleic acid, or isolation of the virus from body fluids.
Treatment is symptomatic, and the disease can be prevented largely by routine vaccination.
The mumps vaccine is used almost universally in developed countries, as part of MMR (measles, mumps, and rubella) vaccine. Sporadic outbreaks have occurred in highly vaccinated populations, leading to suggestions that the vaccine’s efficacy may not be as high as originally thought and that vaccination policy should be reviewed, perhaps to include 3 doses.
Mumps is an acute systemic infectious disease caused by an RNA paramyxovirus. It is spread by respiratory droplets, and, before the advent of the mumps vaccine, it commonly affected school-aged children. Classically, mumps causes swelling of the parotid glands; the involvement of other salivary glands, meninges, gonads, and pancreas is also common.
History and exam
Key diagnostic factors
- presence of risk factors
- history of missed or no vaccination or possible vaccine failure (primary or secondary)
Other diagnostic factors
- constitutional symptoms
- aseptic meningitis
- unvaccinated status
- healthcare worker
- international traveller
- close-contact living (college students, prisoners, military)
- vaccine failure
1st investigations to order
- salivary mumps IgM
Investigations to consider
- FBC and differential
- serum mumps IgM
- serum mumps IgG
- reverse transcriptase PCR
- serum amylase
- viral culture (CSF, saliva, or urine)
- lumbar puncture
- CT head
David Elliman, MB BS, FRCPCH, FRCP, FFPH, DCH, BA (Open)
Consultant in Community Child Health
Great Ormond Street Hospital
DE is involved in expert legal work where those with parental responsibility disagree as to whether a child should be immunised.
Helen Bedford, PhD, FFPH, FRCPCH
Professor of Children's Health
UCL Institute of Child Health
HB declares that she has no competing interests.
Dr David Elliman and Professor Helen Bedford would like to gratefully acknowledge Dr Kristin Furfari, a previous contributor to this topic. KF declares that she has no competing interests.
Ravi Ubriani, MD, FAAD
Assistant Professor of Clinical Dermatology
RU declares that he has no competing interests.
Christopher D. Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont College of Medicine
CDH declares that he has no competing interests.
Kristine Macartney, MBBS, BMedSci, MD, FRACP
National Centre for Immunisation Research and Surveillance
Department Of Microbiology and Infectious Diseases
The Children’s Hospital
New South Wales
KM declares that she has no competing interests.
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