What is the correlation between viral illness and subsequent parotitis?

From the Guidelines

Correlation between Viral Illness and Subsequent Parotitis

There is a strong correlation between viral illness, specifically mumps, and subsequent parotitis, as mumps is a systemic illness that presents with swelling of one or more of the salivary glands, typically the parotid glands 1.

Key Points

• Mumps infection can lead to parotitis, with approximately 30%-40% of infections producing typical acute parotitis 2.
• The virus can be isolated from saliva from 7 days before through 8 days after onset of salivary gland swelling 1.
• Serious complications of mumps infection can occur without evidence of parotitis 2.
• The spectrum of illness ranges from subclinical infection to nonspecific respiratory illness, sialadenitis including classic parotitis, and other complications 3.
• Diagnosis of mumps infection can be supported by a positive serologic test for antimumps IgM antibodies and/or seroconversion or a 4-fold rise of mumps IgG antibody levels between acute and convalescent phase sera 4.

Clinical Implications

• Vaccination is effective in preventing mumps, with a protective rate of approximately 88% following administration of 2 doses 4.
• Early diagnosis is crucial, and healthcare professionals should consider mumps in patients presenting with parotitis or other symptoms, especially in outbreaks or areas with low vaccination rates.
• Laboratory testing, including serology and nucleic acid amplification tests (NAAT), can support diagnosis, but may have limitations, such as the need for specialized laboratories and the potential for false negatives in previously immunized individuals 4.

From the Research

Correlation between Viral Illness and Subsequent Parotitis

• The correlation between viral illness and subsequent parotitis is supported by several studies 5, 6, 7, 8.
• Viral parotitis can be caused by paramyxovirus (mumps), Epstein-Barr virus, coxsackievirus, and influenza A and parainfluenza viruses 5.
• A study conducted in 2017 found that 68.2% of parotitis cases were associated with influenza virus infection, with 93% being influenza A (H3N2) and 7% being influenza B 7.
• Another study found that mumps etiology was confirmed in 95 out of 100 consecutive patients with clinically typical parotitis, and a probable parainfluenza type 3 infection was diagnosed in one case 8.
• The role of parotitis virus in the development of insulin-dependent diabetes mellitus has been investigated, but the results are contradictory, and no conclusive relationship has been established 9.

Types of Viral Infections Associated with Parotitis

• Paramyxovirus (mumps) 5, 8
• Epstein-Barr virus 5
• Coxsackievirus 5
• Influenza A and parainfluenza viruses 5, 7
• Parainfluenza type 3 8

Clinical Characteristics of Parotitis Cases

• Swelling and pain in one or both salivary glands, submaxillary or submental 7
• Fever, headache, muscle ache, and/or fatigue 7
• Mild clinical signs, with an average swelling development of 5 days and no complications 7
• Influenza-like illness in tandem with parotitis in 74% of cases 7