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Mumps
- Paramyxoviridae
- Paramyxovirus,
- ssRNA, -ve sense
- Pleomorphic
- 120-250nm
- enveloped
- natural reservoir in humans
- Age
- Pre-vaccine: 5-9
- Post-vaccine: teenager
- Subclinical infection in 30%
Transmission
Course
- Incubation 12-25 days (avg = 18 days)
- Prodromal illness 1-2 days
- Infectious period
- 1 week before to 9 days after illness
- peak infectivity 48 hours before onset
Pathogenesis
- Viral replication in upper respiratory tract
- Moves to lymph nodes
- Viraemia
- Spread to – parotid, CNS, GU, thymus, thyroid, pancreas, spleen, eyes,
heart
Complications
- Parotitis in 60-70%
- Submandibular or sublingual adenitis – 10%
- Meningitis
- Encephalitis
- 1:6000 – 1:400
- Early onset due to viral damage
- Late onset immune mediated
- Post infectious demyelinating / non-focal encephalitis
- Permanent sequelae
- Deafness
- Paresis
- Involuntary movements
- Aphasia
- Convulsions
- Altered consciousness
Differential (other viral causes of parotitis)
- Influenza
- Parainfluenza 1&3
- Coxsackie
- Lymphocytic choriomeningitis virus
Diagnosis
- Virus isolation from saliva, urine, CSF
- Ab responses (IgG, IgM)
Management
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