What are the symptoms of mumps?

Symptoms of Mumps

Mumps is characterized primarily by parotid gland swelling, but can also present with fever, headache, malaise, and in up to 15% of cases, meningeal signs, with orchitis occurring in 20-30% of postpubertal males. 1, 2

Primary Symptoms

• Parotid gland swelling - The hallmark symptom of mumps infection 3

  • Can be unilateral or bilateral
  • Typically painful and tender
  • Usually develops 16-18 days after exposure
  • May last 7-10 days

• Prodromal symptoms (typically precede parotitis by 1-2 days):

  • Fever
  • Headache
  • Malaise
  • Myalgia
  • Upper respiratory symptoms 2, 4

Less Common Presentations

• Submandibular gland swelling (can occur with or without parotid involvement) 5
• Sublingual gland swelling
• Some patients may have non-specific respiratory symptoms without parotitis

Complications

Mumps can lead to several serious complications, particularly in adults:

• Aseptic meningitis - Occurs in up to 15% of cases 1, 2

  • Presents with headache, neck stiffness, photophobia
  • Generally self-limiting

• Orchitis (inflammation of testicles) 1, 2, 6

  • Affects 20-30% of postpubertal males
  • Usually unilateral
  • Presents with testicular pain, swelling, tenderness
  • Sterility is a rare sequela

• Other complications 2, 6:

  • Oophoritis (ovarian inflammation) in postpubertal females
  • Pancreatitis
  • Sensorineural hearing loss (approximately 1 per 20,000 cases)
  • Encephalitis (rare)
  • Conjunctivitis

Diagnostic Considerations

• Clinical diagnosis can be made based on classic parotid swelling, but laboratory confirmation is recommended 2
• Optimal specimens for laboratory diagnosis include 1, 2:
  • Buccal/oral swab from the parotid duct (Stensen's duct) - collect within 3 days of symptom onset
  • Serum for mumps IgM antibodies
  • Paired acute and convalescent serum samples to demonstrate 4-fold rise in mumps IgG

Important Clinical Pearls

• Mumps is highly contagious through respiratory droplets and direct contact with saliva 4
• Previously immunized patients may still develop mumps but often present with milder symptoms 3
• Patients are most infectious from 2 days before to 5 days after parotid swelling onset 2
• Mumps should be suspected in patients with parotitis even in vaccinated individuals, especially during outbreaks 6
• The disease is generally self-limiting with symptoms resolving within 7-10 days 2

Management

• Treatment is primarily supportive, focusing on symptom relief 2:
  • Analgesics for pain
  • Adequate hydration
  • Warm or cold compresses for parotid pain and swelling
• Isolation of infected individuals is recommended to prevent spread 2

Mumps remains an important infectious disease to recognize, especially given recent outbreaks in vaccinated populations 3, 4.