Clinical course, complications, immunization status and outcome of mumps in children
Keywords:Complications, Orchitis, Vaccination
Background: Mumps is a self-limiting viral disease in children which usually resolve within 10 days. It is characterized by fever, constitutional symptoms and swelling of the parotid gland(s) and may lead to serious complications. The most common complication is orchitis, followed by meningitis. Less common complications include pancreatitis, encephalitis, deafness, mastitis, oophoritis, and facial Bell palsy.
Methods: This is a hospital-based Prospective observational study where children age ≤18 years who presented with mumps were studied for immunization status, clinical course, complications and outcome.
Results: Fever was the most common presentation followed by parotid involvement. The mean duration of illness was 9±2 days. Constitutional symptoms like headache, myalgia or fatigue were seen in 90 patients (60%). The most common complication seen was orchitis and tonsilitis, 4 cases (2.7%) each followed by pancreatitis (2%), febrile seizures (2%) and meningitis (2%). The least common was myocarditis (0.7%). Only 10 (6.7%) of the patients were hospitalized and none died. All the patients were cured within 2 weeks and without any sequels. The average loss of school days (school absentee) were 8 days. These complications were seen only in non- immunized patients.
Conclusions: The benefits of vaccination against mumps in addition to rubella and measles would be a logical public health intervention that would have a significant clinical and economic benefits and to prevent complications of mumps.
Tae BS, Ham BK, Kim JH, Park JY, Bae JH. Clinical features of mumps orchitis in vaccinated post pubertal males: a single-center series of 62 patients. Korean J Urol. 2012;53:865-9.
Orlíková H, Malý M, Lexová P. Protective effect of vaccination against mumps complications, Czech Republic, 2007e2012. BMC Public Health. 2016;16(1):293.
Barbel P, Peterson K, Heavey E. Mumps makes a comeback: what nurses need to know. Nursing. 2017;47(1):15-7.
Yung C, Andrews N, Bukasa A, Brown K, Ramsay M. Mumps complications and effects of mumps vaccination, England and Wales, 2002e2006. Emerg Infect Dis. 2011;17(4):661-7.
Zhuo Y, Yu J, Wu Y. The potential dysfunction of otolith organs in patients after mumps infection. PloS One. 2017;12(7):e0181907.
Centers for Disease Control and Prevention. Mumps: For healthcare providers, 2016. Available at: https://www.cdc.gov/vaccines/vpd/mmr/public/index.html#what-is-mmr. Accessed on 5 January, 2023.
Tyor W, Harrison T. Chapter 28: Mumps and rubella in Handbook of Clinical Neurology. 2014;123:591-600
Rubin S, Eckhaus M, Rennick L, Bamford C, Duprex W. Molecular biology, pathogenesis and pathology of mumps virus. J Pathol. 2015;235:242-52.
Fiebelkorn A, Barskey A, Hickman C, Bellini W. Chapter 9: Mumps. VPD Surveillance Manual, 5th ed. 2012.
Vaccines. Available at: https://www.cdc.gov/ vaccines/pubs/surv-manual/chpt09-mumps.pdf. Accessed on 14 March 14, 2022.
Zamir C, Schroeder H, Shoob H, Abramson N, Zentner G. Characteristics of a large mumps outbreak: clinical severity, complications and association with vaccination status of mumps outbreak cases. Hum Vaccin Immunother. 2015;11(6):1413-7.
Reichmann ME. Animal virus. Access Science. 2014. Available at: https://www.accessscience. com/content/animal-virus/036100. Accessed on 1 December, 2022.
Latner DR, Hickman CJ. Remembering mumps: E1004791. PLoS Pathogens. 2015;11(5).
Fiebelkorn A, Coleman L, Belongia E. Measles and mumps antibody response in young adults after a third dose of measles- mumps-rubella vaccine. Open Forum Infect Dis. 2014;1(1): S58.
Arshad AS, Shamila H, Khan I, Syed MA. Patterns of mini-outbreaks of mumps at South Kashmir, Pulwama, India 2007-2011. Nitte University J Heal Sci. 2013;3:52-5.
Paul S, Mahajan PB, Sahoo J, Bhatia V, Subba SH. Investigating Mumps Outbreak in Odisha, India: An Opportunity to Assess the Health System by Utilizing the Essential Public Health Services Framework. Am J Trop Med Hyg. 2017;96(5):1215-21.
Moghe CS, Goel P, Singh J. Mumps outbreak investigation in Jaisalmer, Rajasthan, India, June-September 2016. J Med Virol. 2019;91(3):347-50.
Saha I, Haldar D, Paul B, Shrivastava P, Das DK, Pal M et al. An epidemiological investigation of mumps outbreak in a slum of Kolkata. J Commun Dis. 2012;44(1):29-36.
Gut JP, Lablache C, Behr S, Kirn A. Symptomatic mumps virus reinfections. J Med Virol. 1995;45:17-23.
Rima BK, Christie AB. Mumps: epidemic parotitis. In: Weatherall D, Leddingham JGG and Warrell DA (eds) The Oxford Textbook of Med. 1995;372-5.
Kanra G, Isik P, Kara A, Cengiz AB, Seçmeer G, Ceyhan M. Complementary findings in clinical and epidemiologic features of mumps and mumps meningoencephalitis in children without mumps vaccination. Pediatr Int. 2004;46(6):663-8.
Gustavo HD, Patricia Q, Amy AP, Albert EB. Recent Resurgence of Mumps in the United States. N Engl J Med. 2008;358:1580-89.
Vareil MO, Rouibi G, Kassab S, Soula V, Duffau P, Lafon ME et al. Epidemic of complicated mumps in previously vaccinated young adults in the South-West of France. Med Mal Infect. 2014;44(11-12):502-8.
López-Perea N, Masa-Calles J, Torres de Mier M de V, Fernández-García A, Echevarría JE, De Ory F et al. Shift within age- groups of mumps incidence, hospitalizations and severe complications in a highly vaccinated population Spain, 1998-2014. Vaccine. 2017;35:4339-45.
Takla A, Wichmann O, Klinc C, Hautmann W, Rieck T, Koch J. Mumps epidemiology in Germany 2007-11. Euro Surveill. 2013;18(33):pii=20557.
Mumps Vaccination, Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/ mumps/vaccination.html. Accessed on 26 December 2022.