Mumps disease: signs, treatment and effects
Epidemic parotitis, known by the well-known common name of mumps, a disease whose consequences are deplorable for the health of boys and men. This acute infectious disease is caused by a virus that primarily and always affects the salivary glands to the same extent, less often - glandular organs (testicles and prostate gland, ovaries, lacrimal and mammary glands, thyroid gland (rarely), pancreas gland), sometimes the disease affects and on the nervous system.
In the external environment, the virus is stable, it can live for several days at a temperature of 20 degrees Celsius, and at lower temperatures - up to 8 months. The virus enters the environment (air, household items) with droplets of saliva from a sick person or a virus carrier. It enters the body through inhalation or through the mucous membrane of the mouth, from where it enters the bloodstream and circulates through all organs, lingering in the body much longer than the flu virus. The virus is found in saliva, blood, urine, brain matter and cerebrospinal fluid, breast milk. It is impossible to predict which organ the mumps virus will choose to defeat. As well as it is impossible to stop his attack with antibiotics or other chemotherapeutic drugs.
Mumps - a disease whose consequences do not immediately. The disease can take several forms. These are: typical mumps (parotitis) - with damage to the salivary glands (primarily the parotid glands - at first the gland swells on one side, after two days - on the other), the glandular form - only glandular organs are affected (parotid, submandibular, etc.), nervous form - isolated damage to the central nervous system (CNS) - manifested as serous meningitis, meningoencephalitis, combined form - damage to the CNS and glands (serous meningitis and parotitis), atypical form - the characteristic symptoms of the disease are erased or they cannot be determined.
In the beginning, the disease manifests itself as headache, loss of appetite, fatigue, fever. Then - pain in the ears, which increases with chewing. At the end of the first or second day of the disease there is a swelling of the parotid glands - a characteristic diagnostic sign of mumps. The mucous membrane is condensed and reddened in the place of the excretory duct of the parotid gland. The tumor increases a few days. Then the submandibular lymph nodes are inflamed, which is marked by swelling of the submandibular region. In severe cases, the hypodermic cellulose of the face and neck swells, the sublingual lymph node becomes inflamed (swelling under the tongue). Sometimes swollen, inflamed salivary glands squeeze the facial nerve, which leads to non-closure of the palpebral fissure (“hare eye”). Swelling of the salivary glands usually lasts a week, rarely two or three. On days 5–9 from the onset of the disease, pancreatitis can develop - acute abdominal pain, nausea or vomiting, flatulence, in the stool - undigested food. Symptoms of pancreatitis disappear in 10 days. Sometimes, usually on the 6th day, in boys, the virus leads to orchitis - inflammation of the testicles, first one and then the other.
Mumps, the consequences of which can manifest themselves in the form of hearing loss, damage to the heart, central nervous system and liver, are quite dangerous. Among experts there is an opinion that mumps in girls can lead to infertility, but for now this is only an assumption. The consequences of mumps in boys (almost in every three of them who have had mumps) manifest themselves in the period of puberty in the form of orchitis. Usually this disease passes without consequences, but some cases cause infertility. But for men who have had mumps in adulthood, the effects of the disease, expressed by infertility, are more frequent.
Special treatment for mumps is not prescribed. Bed rest, general warmth for the patient and dry heat on the inflamed salivary glands, hunger in the first day or two, then a sparing diet in the form of chopped food (dishes only boiled or stewed). You need plenty of drink, oral hygiene in the form of rinsing with a solution of the drug "Furacilin", "Tantum Verde", taking the pills "Lisobact", "Imudon", "Stomatidin". The use of herbal medicine - drinking decoctions of medicinal plants. For example, tea is made from equal parts of raspberry, currant and lingonberry leaves. Useful rhizomes of wheatgrass - 1 tbsp. l raw materials poured 1.5 cups of boiling water and boiled over low heat for 10 minutes. Strained warm broth to drink a day 3 times 1 tbsp. l A pleasant and useful collection for inhalation: take 2 tbsp. l a leaf of sage and flowers of elder black and linden, add 1 tbsp. dill seeds and peppermint leaf. Grind the mixture, brew 2 liters of boiling water. Bend over the brewed mixture and breathe over the steam (1 time per day for 30 minutes).
So that your child does not hit the mumps - a disease, the consequences of which may affect its future, do timely preventive vaccination against mumps. Vaccination of children who do not have mumps, is carried out once on prescription at the age of one. Immediately vaccinate children who are not sick with parotiditis and not vaccinated, who had contact with the patient. It is necessary to alleviate the course of the disease. Once again, mumps is a disease, the consequences of which can and must be prevented.
This disease is caused by a paramyxovirus pathogen (paramyxovirus parotidis), whose reservoir is only an infected person. People are highly susceptible to this pathogen, most often the disease is recorded in children. In this case, mumps disease affects boys more often (1.5 times more often than girls). Infants receive from the mother immunity to the disease, which lasts up to five years. Most often, children of preschool age are ill, but infection of adults also occurs. At the same time, the older the patient, the course of the disease is accompanied by more severe clinical symptoms and an increased risk of complications. The postponed disease gives long-lasting immunity to infection. Due to well-defined external symptoms, mumps is called mumps or mumps disease.
Highly contagious disease
Since the time of Hippocrates, this disease is known to mankind, and its name is connected with the fact that a sick person outwardly looks like a pig (shown in the photo). The mumps disease primarily affects the salivary parotid glands, the glandular tissue of which inflames and swells. The disease is transmitted only from the patient by airborne droplets. Domestic mode of disease transmission mumps is completely excluded. The seasonality of morbidity is associated with the ability of the pathogen to maintain contagiousness in cold and wet seasons of the year. At the same time, the virus is easily deactivated by drying, exposure to ultraviolet and disinfecting solutions.
Features of Mumps
The disease can occur in three manifest forms:
- Inaparative - the disease proceeds without visible and tangible symptoms.
- Uncomplicated - paramyxovirus affects only the glandular tissue of the salivary glands.
- Complicated - except for the salivary glands, the virus penetrates into the glands of other organs (sex glands, pancreas and nervous system).
Depending on the severity of symptoms, mumps disease can occur in mild, moderate and severe. Mumps is dangerous for its complications. The consequences of mumps disease can be deafness, testicular atrophy in men, infertility, and diabetes.
Stages of mumps development
During the disease there are the following periods:
- Incubation. Duration from 10 to 25 days. In this case, the patient is contagious on the 4th-5th day.
- The acute period or the height of the disease. Duration - up to 10 days. It is characterized by an increase in symptoms with a peak on the 3-5th day.
- Reconvalescence. The period of complete recovery lasts from 10 days to a month.
Symptoms of mumps disease
The acute period of mumps is accompanied by fever, chills, weakness and headache, tinnitus, pain when swallowing and opening the mouth. A visible sign of the disease is an increase in the salivary parotid glands, sometimes with involvement of the submandibular and sublingual glands in the inflammatory process. Their palpation is painful, the inflammation begins as one-sided, but by the 2-3rd day of the disease it passes into a bilateral phase. Puffiness begins to descend on the 4th-5th day, and only in adults the mumps disease can persist up to 2 weeks. With an uncomplicated course, after a week, the symptoms disappear and the patient can be considered as recovered.
Complicated form of the disease
On the 5-7th day of the disease in 10% of cases other organs are involved in inflammation.
With the defeat of the pancreas, symptoms of acute pancreatitis appear - pain in the upper abdomen, dyspepsia, vomiting, nausea. This complication is more common in adult patients and occurs in a ratio of 1 to 14 patients.
A paramyxovirus can infect the inner ear. The patient appears constant tinnitus, dizziness, impaired coordination and balance. Most often it is a unilateral lesion that can lead to hearing loss or loss.
A rare complication - involvement in inflammation of the thyroid gland - can lead to tissue degeneration, atrophy and oncology.
In severe cases, inflammation spreads to the lining of the brain, causing their swelling and the appearance of meningeal symptoms (temperature above 39 degrees, photophobia, vomiting, convulsions). In 10% of cases, the disease leads to the development of serous meningitis.
The consequences of mumps disease in the genital area
With the involvement of the genital organs in boys, orchitis can develop - swelling of the testicles 2-3 times, accompanied by compaction and pain in the groin. The consequences of mumps disease for boys 12 years old are especially serious. They irreversibly affect the sex cells, which leads to irreversible infertility. In other cases, swelling of the testes takes place on the 7th day, but with inadequate treatment of mumps disease in men from 1 to 3 months, testicular atrophy, impaired spermatogenesis and secondary infertility can develop. In some cases, post-infectious infertility in men is treatable, which requires considerable effort and material costs.
In women in rare cases (every twentieth) may develop ovarian inflammation, occurring almost asymptomatically. There is a risk of infertility.
Registration of the disease in a pregnant woman in the first trimester is an indication for abortion.
Diagnosis of Mumps
Diagnosis of mumps with marked clinical symptoms usually does not cause difficulties. But the final diagnosis is made on the basis of confirmed laboratory tests. The modern arsenal of diagnostic methods includes:
- Serological tests. Virus isolation from the secretion of the salivary gland, urine, flushing from the throat. Enzyme-linked immunosorbent assay (ELISA), complement fixation reaction (RSK) and hemagglutination inhibition reaction (rtga) are used. These tests may not be sufficiently reliable due to the cross-reaction with parainfluenza viruses.
- Polymerase chain reaction is one of the newest and most accurate methods for determining viral infection. This method gives an idea of the stage of the disease and the sensitivity of the pathogen.
Differentiation of the diagnosis of mumps is very important, since completely different diseases can hide under external symptoms. For example, sometimes swelling of the mucous membranes of the salivary glands and lymph node around the pharyngeal nodes accompanies no less dangerous diseases - lymphadenitis in toxic diphtheria. Such symptoms can be accompanied by infectious mononucleosis and herpes virus infections.
If you experience acute symptoms in a child should be called on the pediatrician's house. The appearance of mumps symptoms in adults often leads them to dentists or ENT doctors.
Most patients do not require hospitalization. It is carried out only in case of severe complications of mumps disease. Treatment is aimed at preventing the development of complications, reducing and alleviating the symptoms. Patients are prescribed bed rest, milk and vegetable diet, antipyretic and anti-inflammatory drugs. In case of severe intoxication of the body, intravenous administration of detoxification preparations (saline, 5% glucose solution) is possible. Multivitamin complexes are prescribed.
Home treatment involves a quarantine of up to 10 days. In institutions for the detection of parotitis, quarantine is announced for up to 3 weeks.
There is no specific prevention of mumps. Since the paramyxovirus is similar to the influenza virus, general preventive measures are the same as for the spread of general viral infections. General strengthening of the body, eliminating contact with patients significantly reduce the risk of disease.
The most reliable way to prevent mumps disease in children is vaccination. It is administered for the first time at the age of 1 year with a comprehensive mumps, measles and rubella vaccine. The second immunization is indicated for children 6–7 years old who have not had parotitis.
Immunization: Pros and Cons
The opinion of experts in this matter is ambiguous. There is an opinion that it is necessary to vaccinate only boys of puberty (beginning of puberty), who did not get sick with parotitis in childhood. The rationale for such a point of view is the immunity acquired by a boy after parotitis at an early age, lifetime, while the vaccine will ensure its availability for several years.
Supporters of compulsory immunization of all children at an early age appeal to the fact that no one is immune from the complications of the course of mumps. And if it is possible to avoid even a small probability of diabetes, deafness or atrophy of the testicles in a child, then it should be used.
Symptoms of mumps
The incubation period of the disease lasts from 11 to 23 days (usually 15–19 days). Some patients, 1–2 days before the typical symptoms of mumps, show the appearance of headache, muscular and joint pain, chills, dry mouth. This prodromal period is usually more pronounced in adults.
But most often, mumps begins acutely with a sharp increase in body temperature, the appearance of chills, headaches, weakness. High temperature lasts no more than 1 week. Sometimes the disease proceeds without fever.
The main symptom of mumps is inflammation of the parotid salivary glands, sometimes the submandibular and sublingual glands are involved in the process. A swelling appears in their projection, and palpation causes pain to the patient. With a strong increase in the parotid salivary gland, the patient's face becomes a pear-shaped form, the earlobe on the affected side rises. After 1–2 days, the inflammatory process usually seizes the gland from the opposite side, but sometimes the lesion can also be one-sided.
Patients complain of pain in the parotid region, aggravated at night, sometimes patients have pain and tinnitus. In severe cases, due to severe pain, the patient cannot chew food. The pain persists for 3-4 days, and after a week, it gradually passes away. At about the same time or a little later, the edema in the projection of the salivary glands decreases, but in some cases the swelling may last 2 weeks or more, which is more typical for adults.
Most mumps patients are treated on an outpatient basis. Hospitalization is necessary for patients who have developed complications, as well as for epidemiological indications. At home, patients are isolated for 9 days. In institutions where a case of mumps is registered, quarantine is set for 3 weeks.
There is no effective specific treatment for mumps. The main task of therapy is to prevent the development of complications, as well as relieve the symptoms of the disease.
Patients are shown bed rest for 10 days. To prevent the development of pancreatitis, a milk-vegetable diet must be observed. It is impossible to allow overeating, it is necessary to limit the use of white bread, pasta, fats. At the time of illness it is better to completely abandon fried, fatty, spicy foods, pickles and pickles. Sometimes it is necessary to pre-grind food in order to reduce pain during chewing. Plentiful warm drink is recommended (fruit drinks, dogrose broth, weak tea).
Patients are prescribed antipyretic and anti-inflammatory drugs (Paracetamol, Ibuprofen, Nurofen, Panadol), antihistamines (Claritin, Suprastin), multivitamin complexes (Biomax, Complivit).
In severe cases, with severe intoxication of the body, intravenous detoxification therapy (saline, 5% glucose solution) is performed. Usually such treatment is carried out in the hospital.
Most often, when a virus that causes mumps enters the blood, glandular organs are affected: the pancreas (acute pancreatitis), the testes in men (orchitis), the ovaries in women (oophoritis). The most serious complications of mumps in men are priapism and infertility. With the penetration of the virus into the brain, the development of meningitis is possible. В редких случаях у людей, перенесших свинку, развивается тугоухость или полная глухота.
Эпидемический паротит – это так называемая управляемая инфекция. Благодаря проводимой профилактической вакцинации, которая началась в середине 60-х годов, заболеваемость свинкой значительно снизилась. Vaccinations are given to children over the age of one, often in combination with rubella and measles vaccination. The vaccine is very effective, almost never gives general and local reactions.
Emergency vaccination is possible if a collective case of mumps is detected in the team, but the use of the vaccine in a sick person will not be effective.
In order to avoid infection with mumps it is necessary to prevent contact with a sick person.
Which doctor to contact
When a child has signs of an acute infection, a pediatrician should be called at home, and an adult should contact an infectious diseases specialist. Often, adults with this disease go to the dentist or ENT doctor who need to recognize parotitis in time. With the development of complications, an examination by a neurologist (with the development of meningitis), a gastroenterologist (with pancreatitis), a urologist (with the development of orchitis) or a gynecologist (with damage to the ovaries) is necessary. The advice of a nutritionist will be helpful.
Video version of the article:
Contraindications for vaccination
Current vaccines contain weakened paramyxoviruses and a protein component based on chicken or quail eggs or cattle protein. Vaccine features are considered in the presence of allergies in a child. There are monovaccines and polyvaccines. Comprehensive vaccines have long been a priority in western countries.
Vaccinations in Russia are carried out in accordance with the immunization schedule - in 1 year of life and in 6-7 years. Inoculation is effective even in the first 2 days after contact with the patient, in which case the risk of complications and a severe course of the disease is reduced.
The effectiveness of immunization with modern means is quite high - immunity persists for several years, sometimes for life. But there are some contraindications for children:
- Blood diseases and oncological diseases.
- Allergies and eggs, and beef.
- Immunodeficiency states.
- Intolerance to some antibiotics of the aminoglycoside group.
- Acute infectious conditions.
- Allergic reactions to previous vaccinations and exacerbations of chronic pathologies.
All side effects of the vaccine are associated with the characteristics of the course of mumps (temperature rise, respiratory and catarrhal manifestations, glandular edema). These manifestations can appear on the 10-12th day after vaccination, stay 1-2 days and go on their own.
What should parents do
Today, vaccination of children against mumps is not mandatory, and parents have the right to refuse to vaccinate their child. It is only a responsible approach to this issue, given the following facts:
- About 1.5 million children die annually in the world, whose death could have been prevented by timely vaccination.
- About 17 out of 100 children under the age of 5 could live with a vaccine against dangerous viral diseases.
- The development of meningoencephalitis, though not fatal, but leads to irreversible damage to the auditory nerves and deafness.
- Mortality in the case of mumps, although small, is 1 case per 100 thousand patients.
- About 25% of cases of male infertility are associated with viral parotid disease in childhood.
- Severe lesions of the pancreas can lead to the emergence of various forms of diabetes.
The distrustful attitude towards vaccination in modern society has long become a global global problem. It is formed under the influence of the following aspects: distrust of the vaccine itself (its effectiveness or its supplier), arrogance of the average person (underestimation of the risks of the disease), inconvenience of vaccination (geographical distance, stress or high cost). Which of the listed factors influences the decision of a specific parent and are you ready to say that you made a decision, not based on false conclusions?
From doubt to confidence
Distrust of vaccines in humans has existed since their invention. According to surveys, 1/5 of the population is ready to admit the existence of a medical conspiracy, according to which immunization is supported by government health authorities, despite the presence of side effects. You can argue about this for a long time, but every parent will have to take responsibility for the health of their child. We only recall that in the world today, thanks to vaccines, cholera, rabies, black smallpox, a form of meningoencephalitis, and even more than 10 diseases have been eliminated as completely disappeared dangerous infections. Vaccine production is a very complicated process, and modern certification methods are very strict. In any case, the choice remains an individual matter.
General information about mumps
Epidemic mumps is an acute viral disease caused by a paramyxovirus. Only a sick person is a carrier of pathology, and you can get infected from it even 1-2 days before the onset of symptoms. Mumps is characteristic of children, with mumps disease in boys is 1.5 times more common than in girls. Sick mainly in the period from 5 to 15 years.
Due to environmental degradation, mumps disease in adult women and men began to occur almost as often as in children. Paramyxovirus enters the body, affects the tonsils, upper respiratory tract, and then goes to the salivary glands. The main ways of infection with mumps:
- Airborne. This is the main route of transmission of the virus when the infection occurs in the immediate vicinity of a sick person.
- Contact and household. Dishes, toys and other personal belongings of the patient can also be a source of paramyxovirus.
Paramyxovirus parasitizes nerve fibers and glandular tissues. In most patients, the parotid and submandibular salivary glands are inflamed, which changes the contour of the human face. As a result, the disease received two distinctive names: mumps, mumps.
The incubation period of the disease is 10-25 days, more often - 2 weeks. At this time, the symptoms of mumps do not appear. First, the virus accumulates in the mucous membranes, and then enters the blood. In adults, 1-2 days before the onset of symptoms, headache, muscle and joint aches, dry mouth, weakness, chills can appear. For children, this prodromal syndrome is less characteristic. Other symptoms of mumps:
- swelling in the projection of the parotid salivary glands,
- pain in the parotid region, worse at night,
- increased salivation,
- decreased appetite
- temperature increase up to 40 degrees
- pain when opening mouth, swallowing food, chewing,
- dry mouth.
Hazards for boys and men
Boys are particularly at risk. The older the child, the greater the likelihood of complications, including infertility.
Features of the course of the disease in boys:
- The virus in 20% of cases passes to the genitals, destroys and affects the spermatogenic epithelium of the testes.
- The scrotum is inflamed, there is unbearable pain in it.
- Puffiness, severe redness soon passes to the second testicle. Atrophy, dysfunction, and then sterility, which is not amenable to treatment, develops.
Mumps is the greatest danger for adolescents in puberty. If parotitis is not accompanied by orchitis (inflammation of the testicle), then infertility will not occur. According to statistics, about 50% of men who have suffered bilateral mucus inflammation of the testicles become sterile in the future. It is possible to predict whether a boy will be fruitless only when he reaches the age of maturity. Orchitis occurs on the 5th-8th day and is often the only sign of mumps in the stronger sex.
Characteristic signs of mumps disease
The course of the disease has characteristic signs. A special feature is the increase in size of the parotid salivary gland, first one, and after 1-2 days symmetrical. There is swelling of this area, swelling, a diseased gland is painless on palpation, pain in the ear can occur due to the tension of soft tissues, and may increase with chewing and talking.
If the submandibular and sublingual salivary glands are affected, then swelling, swelling under the lower jaw appears, the glands grow in size, and can become hard when palpating.
Boys may develop orchitis - an increase in swelling of the testicles, sometimes in2-3 timeswith their compaction, the appearance of pain in the groin area. Inflammation of the testicles, depending on age, can lead to dangerous complications.
With the involvement of the pancreas, signs of acute pancreatitis may appear - surrounding pain in the upper abdomen, dyspeptic symptoms in the form of vomiting and nausea.
In severe cases, the central nervous system may be affected, the lining of the brain may be affected, with their swelling and manifestation of meningeal symptoms.: patients complain of severe headache, vomiting, confusion, agitation, convulsions, signs of diffuse polyneuritis with the participation of large nerve trunks can be observed.
The increase in the severity of the condition in a typical course of mumps occurs within 3-5 days, then the temperature returns to normal and the recovery process begins, which takes up to 10 days. After that, the patient can be considered fully recovered.
In infants, the disease is extremely rare, since with the mother's milk the child receives the necessary immunity, which persists for a period of 3 to 5 years. In any case, the disease begins with indisposition, symptoms of intoxication, weakness, weakness, muscle pain, fever. Fever is most pronounced on1-2day of illness and can stay 4-7 days.
In children of preschool and primary school age, the disease often occurs in a mild form. In older and especially adulthood, the disease is worse tolerated. First of all, when the child begins to fall ill, an increase in the parotid salivary gland is observed. It swells up, dry mouth and pain in the ear. The swelling increases, more by the third day, first with one, then with the other hand, making the face more rounded, after which it begins to subside, and passes by 7 to 10 days.
Complications of mumps disease
In 10% of cases, on 5-7 days of illness, regardless of gender, and in boys and girls, damage to the central nervous system may join, and meningitis may develop.
Meningitis occurs with a rise in temperature of up to 39 degrees, meningeal signs (Kernig's syndrome, Brudzinsky), photophobia, headaches, fever, vomiting, signs of meningitis pass within 10-12 days.
In adult men and adolescents, orchitis can occur - a testicular lesion that manifests on days 5–7 of illness, fever increases, and it can hurt in the lower abdomen, in the groin area. The testicles may increase to the size of a goose egg, the scrotum swells. Fever lasts 3-5 days more, and testicular edema lasts 5-7 days.
With insufficient and inadequate treatment after a period of one to two months, signs of testicular atrophy appear., violations of spermatogenesis with the formation of a serious complication - secondary infertility.
Orchitis is especially dangerous in adolescent boys aged 12 years; in their case it leads to irreversible infertility due to the defeat of the germ cells.
Every twentieth woman with an epidemic parotid inflammation of the ovaries is possible, oophoritis, can be almost asymptomatic, with pains in the lower abdomen of a pulling nature, there is a danger of female infertility.
If the virus affects the pancreas, then there are signs of acute pancreatitis in the background of fever, often it is encircling abdominal pain, nausea, vomiting. This complication is typical for adults and occurs about 1 time for 14 cases of the disease.
The mumps virus can affect the inner ear, which can lead to hearing loss, ringing, ringing in the ears, then dizziness, then signs of incoordination and vomiting. More often it is a one-way process, and after the passage of the disease, hearing is not restored.
In men, a rare complication can be inflammation of the large joints, which occurs as swelling and soreness and appears either before the onset of inflammation of the parotid glands, or after one or two weeks, and lasts for up to three months. The development of mumps in a pregnant woman in the first trimester is an indication for abortion. In women over 40, thyroid involvement can cause tissue degeneration and lead to atrophy and tumor development.
The most reliable way to prevent mumps is vaccination. The vaccine is a weakened strain of the mumps virus, which cannot cause the disease, but contains all the necessary antigens.
Immunization is carried out for the first time - in 1 year, together with the vaccine against measles and rubella, the most aggressive component of this vaccine measles, which can cause a rash on day 7. This vaccine is easily tolerated and does not cause illness. The second immunization with parotitis vaccine is carried out in 6-7 years old children who have not recovered.
Contraindications for vaccination:
- reduced immunity
- taking medications that depress immunity, for example, steroids or immunosuppressants,
- severe allergic reactions.
In preschool institutions, when identifying a mumps disease, quarantine is necessary, the kindergarten group is closed, the sick child must be isolated for at least 26 days in order not to spread the infection.
If you suspect mumps can not contact the children's clinic, during this period, you must call the doctor at the house.
How is the diagnosis of this disease
Diagnosis of mumps is carried out according to laboratory data and the clinical picture.
Differential diagnostics must be performed with autoimmune pathologies, leukemia, lymphadenitis, inflammatory diseases of non-viral etiology, salivary stone disease, sarcoidosis. Parotid meningitis must be differentiated from enteroviral serous meningitis, lymphocytic choriomeningitis, tuberculous meningitis.
Sometimes under the parotitis masked swelling of the subcutaneous tissue and lymphadenitis in toxic forms of diphtheria, infectious mononucleosis and herpes virus infections.
Parotid pancreatitis must be differentiated from acute pancreatitis, cholecystitis, appendicitis, requiring surgical intervention. In parotid orchitis, differential diagnosis is carried out with orchitis in case of tuberculosis, gonorrhea, trauma, brucellosis.
To diagnose mumps, the most reliable and reliable method is to isolate a virus from the secretion of the salivary gland, urine, and pharyngeal swabs, but in practice using this method is difficult, time-consuming and expensive.
The possibilities of serological diagnostics are presented by an enzyme immunoassay, RSK and RTGA. For the acute period of mumps characterized by low IgG titer on the background of high IgM titer. The increase in IgG 4 times or more in the study of antibodies after 3-4 weeks from the onset of the disease has a diagnostic value.
RSK and RTGA are not completely reliable because they can cross-react with parainfluenza virus.
Recently, PCR diagnosis of mumps is widely used. Also for the diagnosis of pancreatitis and differentiation of meningitis use the determination of the activity of diastase and amylase in the blood and urine.
As with most viral diseases, there is no specific treatment for this ailment. Easy flow does not require special events, it is recommended to drink plenty of fluids, take vitamins to increase the body's resistance, mainly vitamin C.
The main thing is the patient's behavior, bed rest is recommended for 10 days. It is recommended that the vegetable-milk diet, the restriction of fats, flour foods, give preference to dairy and vegetable foods, black bread, do not overeat.
With moderate and severe recommended antiviral, nonsteroidal anti-inflammatory, antipyretic drugs. In cases of orchitis and meningitis, timely treatment with corticosteroids can prevent the development of infertility. With the involvement of the pancreas, the use of enzymes is recommended.
When orchitis compresses, ointments, creams, warming are strictly prohibited. With catarrhal phenomena, you can gargle with chamomile, sea water, you can carry out treatment with propolis tincture.
Often the mumps passes without complications, leaving lifelong immunity. Complications depend on the organ involved in the process. Orchitis and oophoritis can cause infertility, damage to the inner ear to deafness, damage to the lacrimal glands, to their atrophy and dry eyes. If the boy had mumps without orchitis, infertility does not threaten him. In case of damage to the pancreas, such a complication as diabetes mellitus from various sources is doubtful.
How is mumps disease manifested in men?
Gilt disease can occur in men who have not had it in childhood. For such a man is dangerous infectious people, and airborne transmission in crowded groups contributes to morbidity.
In men, very often, mumps is accompanied by inflammation of the testicle - orchitis, the untimely and inadequate treatment of which can lead to infertility, but not to diseases of the penis, as many believe.
В некотором случае мужское бесплодие после перенесенной свинки можно вылечить, с применением усилий и материальных затрат. It must be remembered that it is much easier to have a mumps pig in childhood or to be vaccinated than to suffer the consequences.
How is mumps disease manifested in boys?
The mumps disease in boys at preschool age can proceed easily and practically without consequences. Pig in life can be shed only once. In case of mild course and compliance with all rules of treatment and treatment, the occurrence of orchitis and the development of infertility can be prevented.
In moderate to severe forms, swelling and inflammation of the testicle can develop. This usually occurs 3-5 days after the onset of the disease, the testicles increase in size, become edematous, pain appears in the lower abdomen and in the groin area. And, if one testicle is affected, problems with conception can occur in 20% of cases, if two, then in 70% of cases. More often it is observed in conditions of untimely and insufficient treatment.
This insidious complication manifests itself after a while, and may show up after puberty. If there was no orchitis, then we can say that infertility does not threaten the future man due to the illness.
Ways of infection
Viral disease is transmitted by airborne droplets when an infected person is nearby. Toys, dishes, having visited the patient, also become carriers of the disease. People not previously exposed to the virus have very high chances of infection, especially children. Boys suffer from mumps more often than girls, and the disease manifests itself on the basis of the current season: it is almost impossible to become infected in the fall, and it worsens in the spring.
The spread of the virus begins with the tonsils, upper respiratory tract, and later goes to the salivary glands. Over time, when the initial sign appeared, the symptoms of mumps in children became more noticeable, but no treatment followed, the disease spreads to the central nervous system and other organs. An allergic reaction of the body, manifested in external changes of the face, can remain forever.
With first symptoms of mumps there is a strong edema and inflammation of the salivary glands located near the ears, extending to the area in front of the ears, cheeks, increases the face, now resembling the face of a pig.
The initial 1-2 days after infection are accompanied by the following symptoms:
- There is a headache
- Child or teenager is shivering, there is a dry mouth,
- Muscles, joints sore.
Adults feel the symptoms more than children.
- Often the body temperature rises to 40 degrees in a short period of time, does not decrease during the week,
- Headaches become unbearable,
- A person experiences severe chills.
- There is a weakness in the whole body.
Symptoms of mumps in adults and children are expressed by swelling located near the auricles, submandibular and sublingual glands. When pressing on the inflamed area, there are strong painful sensations, and with the course of the disease the face becomes pear-shaped. The pain intensifies when a person absorbs food, feels stronger when night falls. The swelling goes away a couple of days after the acute pain passes, in adults, the period lasts up to 14 days. The disease is not accompanied by a rash of the face or body.
Boys who get mumps are at a special risk zone. The older the child, the greater the likelihood of complications and the occurrence of pathologies, including infertility. After damage to the glands and nervous system, the disease in 20% of cases passes to the male genital organs, destroying and acting on the spermatogenic epithelium of the testes. The testicles are inflamed, the boy is experiencing unbearable pain in the groin and genital glands. A strong redness, swelling and increase in the size of the testicle is accompanied by pain, and soon passes to the second testicle, which leads to atrophy, dysfunction, as a result, infertility, which is not treatable.
Medicine is not able to offer options for getting rid of the pathology, doctors create conditions so that the disease does not diverge further. Requires strict bed rest, careful care for the child in a separate room. In order to avoid pancreatitis, the baby is prescribed a special diet. Without the appearance of complications, the disease can be cured in ten days.
The older the patient, the harder it is to get rid of a viral disease. For a boy who has undergone mumps, not accompanied by orchitis, infertility will not arise and will not be a life sentence. The disease is most dangerous for adolescents in the period of sexual development. In order to avoid infection in the first year of life, the child is vaccinated, repeated at the age of 6-7 years.
Disease in adults
The appearance of the disease in adulthood is a rare phenomenon, but in identifying the disease complications can not be avoided. With strong immunity, a person will more easily tolerate the disease and undergo a course of treatment, but in any case, vaccination is needed in early childhood. The symptomatology of the disease, manifested in an adult man or woman, is no different from a child’s: swelling of the ear, cheeks, neck, fever, pain. The work of the pancreas is worsening, the genitals are affected. Doctors strongly advise against self-medication.
If there are deterioration in the digestive system, the person loses his appetite, experiences acute sharp pain, diarrhea, vomiting. Complications in men are manifested in atrophy of the testicles, and for women, it threatens with strong changes and disorders of the menstruation cycle.
It is dangerous for men over 30 to have mumps because the form of the disease will be severe, and complications, including orchitis, will have a profound effect on health. The duration of the acute form of the disease, accompanied by vomiting, pain in the whole body, temperature rise up to 40 degrees and other manifestations, is three, and in rare cases more, weeks.
- With damage to the central nervous system, the virus penetrates the brain tissue, and the development of miningoencephalitis leads to partial or complete hearing loss,
- Disorders in the reproductive organs occur in 30% of cases of infection in men, regardless of the form. The adult feels intense heat, swelling and pain in the area of the reddened scrotum. If untreated, the disease becomes aggravated, orchitis occurs, the man loses the opportunity to become a father in the future,
- If the thyroid gland is inflamed, the appearance of encephalitis, meningitis is likely.
The whole medical process, with the exception of the occurrence of complications, takes place at home. If the situation requires medical intervention, the patient is hospitalized in the infectious disease ward. Home conditions are created to alleviate the condition of the infected.
- Compresses are applied to the throat and cheeks, a warm scarf is used for dressing,
- It is allowed to use oil compresses. To create it, heat up a couple of tablespoons of oil, moisten a gauze bandage in the resulting solution. It is important to ensure that the liquid is not too hot, otherwise the skin can be burned,
- Rinse the throat with water, with pre-added and thoroughly mixed soda. The proportions are: a teaspoon of soda per cup of warm water,
- Strict adherence to bed rest, from the first day until the full recovery of the infected. Failure to follow the rules will cause complications that affect the patient’s condition as a whole,
- The patient must have his own set of dishes, cutlery, hygiene products, he must be placed in a separate room so that the virus does not pass to the rest.
- To reduce the temperature, use antipyretic: no-silos, suprastin, analgin,
- If complications arise, consult a doctor. He prescribes a course of antibiotics, so as not to have purulent discharge,
- If the glands have festered, the patient is immediately hospitalized with surgery. The man is observed for ten days,
- To get rid of asthenia, intoxication, prescribe special drugs, as well as antihistamines,
- When a patient has heart problems, they are prescribed medications to maintain and improve their condition and work.
Causative agent of infection
The mumps pathogen is Mumps rubulavirus, a virus that belongs to the family of Paramyxoviruses (Paramyxoviridae). The virus particle has a spherical shape, the size of which can reach 200 nm in diameter. Genetic information is represented by single-stranded RNA, which explains the occurrence of a large number of mutations in the viral genome.
Virion can save its properties in the environment for a short time. Under the influence of high temperatures (above 70 degrees), drying, ultraviolet radiation, as well as disinfecting chemicals, the pathogen dies.
The survival rate of the virus is significantly reduced at temperatures below 10 degrees Celsius. At higher values, the virion can retain its properties for a relatively long time. That is why the risk of virus infection in the autumn and spring period increases significantly.
The entrance gate of the infection is the nasopharynx. After adsorption of a viral particle on epithelial cells of the nasopharynx, the virion penetrates into the cell, where it replicates, that is, multiplies. The paramyxovirus then penetrates the bloodstream, where it, along with the blood, is distributed throughout the body. Thus, the virus reaches the salivary glands, where its reproduction occurs.
Course of the disease in boys
In boys, besides the above symptoms, during illness may develop orchitis, which is accompanied by a significant increase and swelling of the testes (2−3 times), as well as their compaction. With this complication, there is severe pain in the groin. Depending on the severity of orchitis, the boy may develop infertility, which can be cured with a long course of therapy.
With mumps disease, only one of the two testicles can be affected, so if this happens, the probability that the boy will be infertile decreases significantly. Statistics show that in this case only 20% of men who have had mumps in childhood cannot have children. With bilateral orchitis, the probability of infertility is 70%.
It is important to note that mumps is much easier tolerated by boys in childhood than by men, but it is not possible to diagnose that a child is infertile at an early age. This can be done only on reaching sexual maturity.
The development of signs in babies
In infancy, the occurrence of mumps occurs in rare cases. This is explained by the fact that during breastfeeding the child receives antibodies from the mother, which help in time to recognize xenobiotics in the body and begin to fight them. If, however, a paramyxovirus infection has occurred, then an intoxication of the organism occurs, followed by the appearance of fever.
When pigs in infants there is a significant increase in body temperature, the values of which can reach 39.0−39.5 degrees. Fever can last for 7 days. The maximum rates of temperature increase are observed in the first days of the disease.
Children of preschool and school age
The most common mumps among children of preschool and primary school age. Mumps occurs in later years very rarely, but if a person becomes ill, the form of the disease is usually severe.
Gilt in children aged 3 to 7 years is characterized by an increase in the parotid glands, first on one side and then on the other, as a result of which the face becomes rounded. Puffiness increases over several days, and reaches a maximum on the third day. The inflammatory process is accompanied by pain in the ear, as well as an increase in temperature and the appearance of dry mouth. By 7−10 day swelling subsides, recovery begins.
Epidemic parotitis in men and women
There is mumps in adults only when in contact with a sick person, namely when talking and breathing closely. That is why an unvaccinated person or a person who has not had parotitis in childhood should beware of contact with the virus carrier.
Adults are much harder to suffer the disease, because they have it is accompanied not only by a significant increase in body temperature, but also by inflammation of the testicles or ovaries. It is important to note that when mumps does not develop any diseases of the penis, as many believe. In women, mumps can be accompanied by oophoritis - inflammation of one or two ovaries.
Oophoritis is accompanied by the following symptoms:
- severe pain in the abdomen,
- increased body temperature
In the absence of treatment or incorrect therapy, the risk of infertility in women is very high due to significant accumulation of pus in the ovary.
The defeat of the nervous system and pancreas
During the course of a disease in a complex form, the pancreas and organs of the nervous system (NS) can be affected by a virus. The most dangerous violations in the work of the central NA. They are:
- severe headaches
- nausea and vomiting,
- confused consciousness
- severe cramps
- development of polyneuritis.
Also, if you have mumps disease, inflammation of the pancreas can occur - pancreatitis. It is characterized by the appearance of abdominal pains in the abdomen, nausea and vomiting. Rarely, patients develop inflammation of the thyroid gland or the middle ear. In the latter case, this can lead to hearing loss.
The first signs of damage to the middle ear are:
- ringing and tinnitus
- nausea and vomiting.
All these processes are accompanied by a rise in body temperature up to 39 degrees Celsius.
Complications of the disease
A complication of mumps is a violation in the functioning of the central nervous system. With the defeat of the virus in 10% of cases, both boys and girls develop meningitis.
- temperature increase up to 39 degrees
- Kernig syndrome - increased tone of the flexor muscles of the leg (a person can not bend the leg at the knee joint),
- Brudzinsky's symptom is pulling up the second leg to the stomach while checking the first one for Kernig syndrome.
As noted above, the disease is especially dangerous for men. In the absence of treatment or improper therapy after 1 month, testicular atrophy occurs. As a result, spermatogenesis is first disturbed, and then secondary infertility occurs.
For boys aged 11–12 years, infection of paramyxoviruses usually ends in irreversible infertility. This is due to the fact that during this period puberty occurs, during which the germ cells are most affected by both physical and chemical factors, and biological.
In men, damage to the joints can be a complication, which is also accompanied by painful sensations and swelling. Such symptoms may appear either before the inflammation of the parotid glands (1–2 days), or after, 10–14 days later. Puffiness does not disappear for three months.
If a pregnant woman gets mumps, then in the first trimester the indication is abortion. In later periods, preterm labor takes place, and the fetus is born dead. In rare cases, a newborn child has significant pathologies that are usually incompatible with life.
With the defeat of the thyroid gland in both men and women, a complication is the atrophy of its tissues and their subsequent degeneration. This may cause tumors.
With severe damage to the pancreatic paramyxovirus, the patient may develop irreversible diabetes mellitus. This is due to the fact that the islets of Langerhans are atrophied, as a result of which impossible synthesis of insulin becomes possible.
In rare cases, a dry eye syndrome may develop in a patient after suffering dacryadenitis. It occurs with the defeat of the lacrimal glands. Unpleasant sensations with proper treatment disappear after a month.
If the patient had a complication such as meningitis during mumps, then there is a high probability of losing sensitivity. Since the virus affects those parts of the brain that are responsible for sensitivity. It is worth noting that this process is reversible, but requires long-term treatment (months, and sometimes years).
The main event for the prevention of mumps is the vaccination of the population. For this purpose, a vaccine is used, based on a weakened strain of the mumps virus. He himself can not cause the development of the disease. Suppressed viral particles contain antigens on their surface, so when such virions enter the human body, specific antibodies are produced that can recognize the real causative agent of an infectious disease and start to fight it in a timely manner.
The first immunization should be given to a child aged 1 year. In addition to the paramyxovirus, the vaccine contains measles and rubella pathogens. As a rule, vaccination is easily tolerated by children. A side effect may be the appearance of a rash after 1 week from vaccination. Такая реакция возникает на ослабленный вирус краснухи.
Последующую иммунизацию делают в возрасте 6−7 лет детям, не переболевшим свинкой.
Противопоказанием к вакцинации является:
- reduced immunity
- treatment at the time of immunization with drugs that reduce immunity (for example, immunosuppressants, steroid drugs),
Important! If you have mumps in a small child who attends kindergarten, it is necessary to organize quarantine in a preschool institution. The baby must be isolated from children for a period of not less than 26 days.
If parents suspect the development of parotitis in a child, it is strictly forbidden to visit a children's clinic. It is necessary to call the attending physician home.
Diagnosis of mumps in humans is carried out by laboratory methods that are aimed at identifying the infectious agent. To make a diagnosis only on the patient's history is impossible. This is due to the fact that under some symptoms of diseases can be hidden parotitis, or vice versa.
The following diseases have similar symptoms:
- inflammatory diseases of non-viral nature,
- salivary stone disease
- enteroviral serous meningitis,
- lymphocytic choriomeningitis,
- tuberculous meningitis,
- fiber edema,
- toxic form of diphtheria,
- Infectious mononucleosis,
- herpes virus infection
- acute pancreatitis,
The most reliable way to detect the disease is serological diagnosis. It consists in the detection of antibodies to the pathogen of mumps from saliva, urine, or other secrets of the patient. It should be noted that this method is not cheap, as well as a long time.
Serological methods that can confirm or disprove the disease are:
- Immunoassay (ELISA).
- Complement binding reaction (RAC).
- Hemagglutination inhibition reaction (rtga).
In the acute stage of mumps, there is a significant decrease in the titer of immunoglobulin G, while the IgM titer exceeds the normal values. It is important to note that the use of rtga and drs does not always give reliable indicators, since such reactions can also occur to the parainfluenza virus.
Polymerase chain reaction
Polymerase chain reaction (PCR) is the simplest, and most importantly, accurate method for diagnosing a disease. The essence of this study is to identify in the patient's saliva the genetic information of the virus, that is, ribonucleic acid. The marker is parotitis virus RNA.
In laboratories, this type of diagnosis is most often used, since in a short period (1 day) it is possible to establish with 100% certainty the presence or absence of a virus in the human body.
Treatment of mumps occurs at home, if there are no complications. The patient must comply with bed rest from the time of diagnosis and until full recovery, that is, up to 2 weeks. The course of therapy is prescribed by an infectious diseases doctor.
After complete recovery, you must be examined by the following specialists:
You will also need to turn to narrow specialists if complications appear during the illness: the development of pathological conditions of the pancreas, thyroid and sexual glands, diseases of the central nervous system and organs of hearing, joint damage.
Today there is no treatment aimed at the destruction of the virus in the human body. Therefore, symptomatic therapy. If only the salivary glands are affected, then the patient with home treatment recovers within 2 weeks. With a complex form of therapy may last up to one month or longer.
When treating parotitis, the patient should observe bed rest, diet, and take certain medications. The latter depend on the severity of the disease.
Nursing and Compliance
Compulsory for each patient is the observance of bed rest from the moment the doctor decides the diagnosis and until the main symptoms of the disease disappear. To do this, it must take at least 10 days. It is especially important that during this period the patient did not have any physical and emotional stress, and also did not supercool. According to statistics, those patients who did not comply with bed rest, in most cases had complications.
Patient care is to comply with preventive measures, that is, to prevent the spread of the virus. This requires the use of bandages not only to visitors, but also to the patient. It is especially important that during this period the patient is not visited by those people who in childhood did not get mumps or were not vaccinated.
It is very important to air the room where the patient is, as often as possible. Also required is periodic disinfection of those items with which the patient has been in contact.
For people who care for patients, it is strongly recommended to strengthen the immune system, even if they have been vaccinated. To do this, you will need to stop smoking and drinking alcoholic beverages. Also important will be dieting (refusal of fat, the prevalence in the diet of plant and animal food with lots of vitamins).
Especially important during the period of the disease diet. This is necessary in order to avoid any complications from the pancreas. For this, we recommend therapeutic food "Table number 5".
The essence of this diet is the following principles:
- eating non-fatty foods
- the number of calories should not exceed 2600 Kcal per day,
- you should eat often, but in small portions (4−5 times a day),
- drink at least 1.5-2 liters of water per day.
This is aimed at reducing the production of pancreatic enzymes, thereby removing the load from it. It is necessary to limit in the diet foods such as sausages, eggs, butter, cheese, fish caviar.
It is forbidden to use during illness:
- fresh baked goods
- alcoholic beverages
- fried foods
- smoked products
- all beans,
- onion and garlic,
- canned food.
Treatment with drugs
Symptomatic mumps therapy. Prompt treatment with medications avoids serious consequences for the patient's health. Especially important is the timely diagnosis. It is important to understand that self-medication at home is unacceptable.
Drugs used during therapy:
- Nonsteroidal drugs (Aspirin, Ibuprofen, Piroxicam, Ketoprofen, Diclofenac, Ibufen). Such anti-inflammatory drugs are essential during the treatment of mumps. Their action is aimed at reducing the high body temperature.
- Corticosteroid medicines (Methylprednisolone, Dexamethasone, Prednisone). Used for complications. Used to eliminate inflammation. They have a number of side effects, one of which is suppression of the immune response.
- Desensitizing drugs (Erius, Tavegil, Suprastin). Used in combination with other medicines. Eliminate inflammation in the body.
- Painkillers (Baralgin, Pentalgin, Analgin). Appointed by the attending physician for complications such as pancreatitis, orchitis, oophoritis, or meningitis, which are accompanied by pain.
- Preparations, the main active ingredient of which are pancreatic enzymes (Festal, Mezim, Pancreatin). These drugs are used only in case of a violation of the gastrointestinal tract (nausea and vomiting, pancreatitis, etc.).
It is important to remember that when using any medication it is necessary to take into account their interaction, since some of them can not only increase or decrease the effects of others, but also cause the appearance of side effects. That is why before use you should not only study the instructions of the medicinal product, but also consult with your doctor.
In rare cases, in addition to complex treatment, experts recommend that patients undergo irradiation of the salivary glands and puncture the spinal cord. This is necessary for the speedy recovery of the patient, if the disease develops with serious complications. Also, to reduce the load on the pancreas, some doctors recommend putting ice on the stomach just below the chest.
Gilt is one of the most dangerous viral diseases for humans. With proper and timely treatment, it is possible to avoid serious consequences.