Mumps

Mumps is a contagious viral infection that used to be common in children before the introduction of the MMR vaccine.

It’s most recognisable by the painful swellings at the side of the face under the ears (the parotid glands), giving a person with mumps a distinctive "hamster face" appearance.

Other symptoms of mumps include headaches, joint pain and a high temperature, which may develop a few days before the swelling of the parotid glands.

When to see your GP

It's important to contact your GP if you suspect mumps so a diagnosis can be made. While mumps isn't usually serious, the condition has similar symptoms to more serious types of infection, such as glandular fever and tonsillitis.

Your GP can usually make a diagnosis after seeing and feeling the swelling, looking at the position of the tonsils in the mouth and checking the person's temperature to see if it's higher than normal.

Let your GP know in advance if you're coming to the surgery, so they can take any necessary precautions to prevent the spread of infection.

If your GP suspects mumps, they should notify your local health protection unit (HPU). The HPU will arrange for a sample of saliva to be tested to confirm or rule out the diagnosis.

Who is affected

Most cases of mumps occur in people between 17 and 34 years of age who have not received 2 doses of the MMR vaccine. There were 534 confirmed mumps cases of mumps in Scotland between 1 January and 30 September 2019.

Once you've been infected by the mumps virus, you normally develop a life-long immunity to further infection.

How mumps is spread

Mumps is spread in the same way as colds and flu – through infected droplets of saliva that can be inhaled or picked up from surfaces and transferred into the mouth or nose.  

A person is most contagious a few days before the symptoms develop and for a few days afterwards.

During this time, it's important to prevent the infection spreading to others, particularly teenagers and young adults who haven't been vaccinated.

If you have mumps, you can help prevent it spreading by:

• regularly washing your hands with soap
• using and disposing of tissues when you sneeze
• avoiding school or work for at least five days after your symptoms first develop

Preventing mumps

You can protect your child against mumps by making sure they're given the combined MMR vaccine (for mumps, measles and rubella). The MMR vaccine is part of the routine NHS childhood immunisation schedule. 

Your child should be given one dose when they are around 12-13 months and a second booster dose before they start school. Your child needs to get 2 doses of the vaccine to provide the best protection against mumps.

Treatment for mumps

There's currently no cure for mumps, but the infection should pass within one or two weeks.

Treatment is used to relieve symptoms and includes:

• getting plenty of bed rest and fluids
• using painkillers, such as ibuprofen and paracetamol – aspirin shouldn't be given to children under 16
• applying a warm or cool compress to the swollen glands to help relieve pain

Read more about treating mumps

Complications

Mumps usually passes without causing serious damage to a person's health. Serious complications are rare.

However, mumps can lead to viral meningitis if the virus moves into the outer layer of the brain. Other complications include swelling of the testicles in males or the ovaries in females (if the affected male or female has gone through puberty).

Read more about the complications of mumps

The symptoms of mumps usually develop 14 to 25 days after becoming infected with the mumps virus (this delay is known as the incubation period). The average incubation period is around 17 days.

Swelling of the parotid glands is the most common symptom of mumps. The parotid glands are a pair of glands responsible for producing saliva. They're located in either side of your face, just below your ears.

Both glands are usually affected by the swelling, although only one gland can be affected. The swelling can cause pain, tenderness and difficulty with swallowing.

More general symptoms often develop a few days before the parotid glands swell. These can include:

• headache
• joint pain
• feeling sick
• dry mouth
• mild abdominal pain
• feeling tired
• loss of appetite
• a high temperature (fever) of 38C (100.4F), or above

In about one in three cases, mumps doesn't cause any noticeable symptoms.

When to seek medical advice

If you suspect mumps, it's important to call your GP.

While the infection isn't usually serious, mumps has similar symptoms to other, more serious types of infection, such as glandular fever and tonsillitis. It's always best to visit your GP so they can confirm (or rule out) a diagnosis of mumps.

It's also important to let your GP know in advance if you're coming to the surgery so they can take any necessary precautions to avoid the spread of infection.

Mumps is caused by the mumps virus, which belongs to a family of viruses known as paramyxoviruses. These viruses are a common source of infection, particularly in children.

When you get mumps, the virus moves from your respiratory tract (your nose, mouth and throat) into your parotid glands (saliva-producing glands found either side of your face), where it begins to reproduce. This causes the glands to swell.

The virus can also enter your cerebrospinal fluid (CSF), which is the fluid that surrounds and protects your brain and spine. Once the virus has entered the CSF, it can spread to other parts of your body, such as your brain, pancreas, testicles (in boys and men) and ovaries (in girls and women).

How mumps is spread

Mumps is an airborne virus and can be spread by:

• an infected person coughing or sneezing and releasing tiny droplets of contaminated saliva, which can then be breathed in by another person
• an infected person touching their nose or mouth, then transferring the virus onto an object, such as a door handle, or work surface; if someone else touches the object shortly afterwards, they can transfer the virus into their respiratory tract
• sharing utensils, such as cups, cutlery or plates with an infected person

People with mumps are usually most infectious from a few days before their parotid glands swell until a few days afterwards. For this reason, it's advisable to avoid work or school for five days after your symptoms first develop if you're diagnosed with mumps.

Mumps can also be passed on by people who are infected with the virus but don't have any obvious symptoms.

If you suspect that you or your child has mumps, it's important to see your GP for a diagnosis.

Let your GP know in advance of your surgery visit so any necessary precautions to prevent the spread of infection can be taken.

Mumps can usually be diagnosed from the symptoms, in particular the swelling of glands in the sides of your face (parotid glands).

If you have mumps, your GP can see and feel the swelling. By looking inside your mouth, they may be able to see that your tonsils have been pushed out of their usual position.

Your GP can also check your temperature to see if it is higher than normal.

If your GP suspects mumps, they should notify your local health protection unit (HPU). The HPU will arrange for a sample of your saliva to be tested to confirm or rule out the diagnosis.

Read about treating mumps.

Treatment for mumps is focused on relieving symptoms until your body’s immune system fights off the infection. There are currently no medications to treat the mumps virus.

The infection usually passes within a week or two.

In the meantime, the measures below may help.

• get plenty of bed rest until your symptoms have passed
• take over-the-counter painkillers, such as ibuprofen or paracetamol, to relieve any pain (children aged 16 or under should not be given aspirin)
• drink plenty of fluids, but avoid acidic drinks such as fruit juice as these can irritate your parotid glands; water is usually the best fluid to drink
• apply a warm or cool compress to your swollen glands to help reduce any pain
• eat foods that don't require a lot of chewing, such as soup, mashed potatoes and scrambled eggs

If your symptoms don’t improve after seven days, or suddenly worsen, contact your GP for advice.

Preventing the spread of infection

If you or your child has mumps, it’s important to prevent the infection spreading, particularly to younger people born between 1980 and 1990 (these people are unlikely to have immunity from a previous infection, and are also unlikely to have been vaccinated).

The best way to do this is to:

• stay away from school, college or work until five days after you first developed symptoms
• wash your hands regularly, using soap and water
• always use a tissue to cover your mouth and nose when you cough and sneeze, and throw the tissue in a bin immediately afterwards

There are several problems that often occur with mumps. These can be worrying, but they're rarely serious and usually improve as the infection passes.

Common complications

Swollen testicle

Pain and swelling of the testicle (orchitis) affects one in four males who get mumps after puberty. The swelling is usually sudden and affects only one testicle. The testicle may also feel warm and tender.

In affected boys and men, swelling of the testicle normally begins four to eight days after the swelling of the parotid gland. Occasionally, swelling can occur up to six weeks after the swelling of the glands.

Any testicle pain can be eased using over-the-counter painkillers such as paracetamol or ibuprofen. If the pain is particularly severe, contact your GP, who may prescribe a stronger painkiller for you.

Applying cold or warm compresses to your testicle and wearing supportive underwear may also reduce any pain.

Just under half of all males who get mumps-related orchitis notice some shrinkage of their testicles and an estimated 1 in 10 men experience a drop in their sperm count (the amount of healthy sperm their body can produce). However, this is very rarely large enough to cause infertility.

Swollen ovaries

One in 20 females who get mumps after puberty experience swelling of the ovaries (oophoritis), which can cause:

• lower abdominal pain
• high temperature
• being sick

The symptoms of oophoritis usually pass once the body has fought off the underlying mumps infection.

Viral meningitis

Viral meningitis can occur if the mumps virus spreads into the outer protective layer of the brain (the meninges). It occurs in about one in seven cases of mumps.

Unlike bacterial meningitis, which is regarded as a potentially life-threatening medical emergency, viral meningitis causes milder, flu-like symptoms, and the risk of serious complications is low.

Sensitivity to light, neck stiffness and headaches are common symptoms of viral meningitis. These usually pass within 14 days.

Pancreatitis

About 1 in 20 cases of mumps lead to short-term inflammation of the pancreas (acute pancreatitis). The most common symptom is sudden pain in the centre of your belly. Other symptoms of acute pancreatitis can include:

• feeling or being sick
• diarrhoea
• loss of appetite
• high temperature
• tenderness of the belly
• less commonly, yellowing of the skin and the whites of the eyes (jaundice)

Although pancreatitis associated with mumps is usually mild, you may be admitted to hospital so your body functions can be supported until your pancreas recovers.

Rare complications of mumps

Rare but potentially serious complications of mumps include an infection of the brain itself, known as encephalitis. This is thought to occur in around 1 in 1,000 people who develop viral meningitis from mumps. Encephalitis is a potentially fatal condition that requires admission to a hospital intensive care unit. About 1 in 20 people with mumps experience some temporary hearing loss, but permanent loss of hearing is rare. It's estimated this occurs in around 1 in 20,000 cases of mumps.