Mumbs:

Mohsen Abd El Hameed Attiya

The word ”mumps” probably derives from the Britishverb to ”mump” which means ”to grimace or grin”. Thus thename of the disease likely refers to the marked parotidswelling which is the most common physical manifestationof infection with this virus.An outbreak of what was probably mumps or epidemicparotitis was described by Hipocrates in 5th century B.C.as an illness accompanied swelling near the ear and painfulenlargement of the testes, either unilaterally or bilaterally.In fact modern virologic and serologic methods showedthat mumps virus could cause illness without parotitis.During childhood, mumps is generally a selflimited febriledisease with manifestation that are frequently multisystemic.The disease is caused by a single strain of paramyxovirusmumps which is RNA virus and usually spherical andmay also be pleomorphic, filamentous form. During recentyears a number of studies have been reported on the proteincomposition of mumps virus. Like other paramyxovirusesmumps virus has been shown to contain two glycoproteinstructures: the larger one and smaller one. There are manydifferent strains of mumps virus and each strain has uniqueantigenic site. The virus produces hemolysis, hemagglutinin,complement fixing antigen and an antigen that elicits delayedhypersensitivity.Mumps infection are most common in childhood age group.Almost half of all children entering school had been infectedwith mumps. Infection is uncommon during the earlymonths of life. This may be due in part to infrequent opportunitiesfor exposure and to placental transfer of maternalantibody to the fetus.Infection is most common during the late winter andearly spring months.Mumps virus infection is spread by respiratory rout.Male and females are affected with equal frequencyparotid swelling is usually bilateral, although one glandmay begin swelling a day or two earlier than the ethergland; therefore the progress of parotitis may be asynchronous.Mumps virus produces a generalised infection. Althoughemphasis has focused on parotid involvement, it is clearthat mumps may occur in the absence of parotid swelling.Meningitis and renal involvement may be considered a partof the disease.It is unusual that mumps virus should be responsiblefor neonatal respiratory distress. For knowledge onlyone case has been described.One attack of mumps usually confers liflong immunity.As regard to the immunity against mumps both, the humeraland cell mediated immunity are encountered.A patient with mumps rarely has sever systemic manifestation.Temperatures are only moderately elevated.The classic illness begin with fever, headach, and malaise,followed within 24 hours by pain localized near the lobeof the ear and aggrevated by chewing movements, directpalpation. Anorexia is a common complaint. Central nervoussystem involvement is a common manifestation, occuringin about 10 percent of cases. Sometimes patients willcomplain of photophobia. Signs of maningeal irritationalso may be present. Evidence of encephalitis, such asconvulsions or disturbances of mentation are less common.Among adult the second most common manifestation ofmumps is orchitis which occur in 20 to 3S percent of cases.It is rarely in children before the age of puberty. Infemales, an oophoritis infrequently occurs with signs andsymptoms that may be indistinguishable from these of acuteappendicitis. Some patient may complain of abdominalpain, this may represents involvement of the pancrease,Pancreatitis may occur in 1% of cases; either alone orassociated with parotitis, the onset may be sudden withsevere epigastric pa1n, fevers, chills, nausia and vomiting.Nephritis may also occur during the first 14 days afterthe onset of parotitis. Other rarely manifestation include:Thyroiditis, mastitis, dacryoadenitis and bartholinitis.Since mumps is a self-limited infectious disease and1S unaffected by the use of antibiotics, treatment is symptomaticand supportive and is usually includes analgesicssuch as aspirin, propoxyphene or codien and parenteralfluids if anorexia and persistent vomiting occur.Mumps is a preventable disease by passive and activeimmunization. passive immunization (mumps immune globulin)is a 16.5% solution of y-globulin fraction of blood fromhealthy adults who have had mumps. Active immunization1S a mumps virus vaccines or, measles, mumps and rubellavaccine.