The article will talk about one of the manageable infections - mumps or mumps in the people. Since the 60s of the last century, when mass preventive vaccination began, infection has significantly decreased. What are the symptoms of mumps in children and adults, what are its consequences and how effective is vaccination - we will answer these and other questions in the article.
General information
This disease is caused by the pathogen paramyxovirus parotidis, the reservoir of which is only an infected person. People are highly susceptible to this pathogen, more often the disease is recorded in children. At the same time, boys suffer from mumps more often (1.5 times more often than girls). Infants receive immunity to the disease from their mother, which lasts up to five years. Most often, children of preschool age get sick, but infection of adults also occurs. Moreover, the older the patient, the more severe clinical symptoms and increasedthe risk of complications. The transferred disease gives a stable lifelong immunity to infection. In connection with the clearly expressed external symptoms, mumps is called mumps disease or mumps.
Highly contagious disease
Since the time of Hippocrates, this disease has been known to mankind, and its name is due to the fact that a sick person looks like a pig (shown in the photo). Mumps disease primarily affects the salivary parotid glands, the glandular tissue of which becomes inflamed and swells. The disease is transmitted only from the patient by airborne droplets. The household method of transmission of the mumps disease is completely excluded. The seasonality of the incidence is associated with the ability of the pathogen to maintain contagiousness in the cold and damp seasons of the year. At the same time, the virus is easily deactivated by drying, exposure to ultraviolet light and disinfectant solutions.
Features of mumps
The disease can occur in three manifest forms:
- Inaparat - the disease proceeds without visible and tangible symptoms.
- Uncomplicated - paramyxovirus affects only the glandular tissue of the salivary glands.
- Complicated - in addition to the salivary glands, the virus penetrates the glands of other organs (gonads, pancreas and nervous system).
Depending on the severity of the symptoms, mumps can be mild, moderate or severe. Parotitis is dangerous for its complications. The consequences of mumps can be deafness, testicular atrophy in men,infertility, diabetes.
Stages of mumps development
During the course of the disease, the following periods are distinguished:
- Incubation. Duration from 10 to 25 days. At the same time, the patient is contagious on the 4th-5th day.
- 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 3rd-5th day.
- Reconvalescence. The full recovery period lasts from 10 days to a month.
Symptoms of mumps
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 involving the submandibular and sublingual glands in the inflammatory process. Their palpation is painful, inflammation begins as one-sided, but by the 2-3rd day of the disease it passes into a bilateral phase. Puffiness begins to go down on the 4th-5th day, and only in adults can mumps remain puffy for up to 2 weeks. In an uncomplicated course, after a week, the symptoms disappear and the patient can be considered recovered.
Complicated form of the disease
On the 5-7th day of the disease, in 10% of cases, other organs are involved in inflammation.
When the pancreas is damaged, symptoms of acute pancreatitis appear - pain in the upper abdomen, dyspepsia, vomiting, nausea. This complication is more typical for adult patients and occurs in a ratio of 1 to14 cases.
Paramyxovirus can infect the inner ear. The patient develops constant tinnitus, dizziness, impaired coordination and balance. It is most often unilateral and 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 membranes 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.
Consequences of mumps in the genital area
When the genitals are involved, boys may develop orchitis - 2-3 times swelling of the testicles, accompanied by their induration and pain in the groin. The consequences of mumps for 12-year-old boys are especially serious. Their reproductive cells are irreversibly affected, which leads to irreversible infertility. In other cases, testicular edema disappears on the 7th day, but with inadequate treatment of mumps in men, testicular atrophy, impaired spermatogenesis and secondary infertility may develop within 1 to 3 months. In some cases, post-infectious infertility in men can be treated, which requires significant effort and material costs.
In women, in rare cases (every twentieth) may develop inflammation of the ovaries, occurring almost asymptomatically. There is a risk of infertility.
Registration of a disease in a pregnant woman infirst trimester is an indication for abortion.
Diagnosis of mumps
Diagnosing mumps with severe clinical symptoms is usually straightforward. But the final diagnosis is made on the basis of confirmed laboratory tests. The modern arsenal of diagnostic methods includes:
- Serological tests. Isolation of the virus from the secret of the salivary gland, urine, flushing from the pharynx. Enzyme-linked immunosorbent assay (ELISA), complement fixation tests (RCC) and hemagglutination inhibition tests (RTGA) are used. These tests may not be reliable due to cross-reactivity with parainfluenza viruses.
- Polymerase chain reaction is one of the newest and most accurate methods for detecting viral infection. This method gives an idea of the stage of the disease and the susceptibility of the pathogen.
Differentiation of the diagnosis of mumps is very important, since completely different diseases can be hidden under external symptoms. For example, sometimes swelling of the mucous salivary glands and lymphatic parapharyngeal nodes accompanies no less dangerous diseases - lymphadenitis with toxic diphtheria. Such symptoms may be accompanied by infectious mononucleosis and herpesvirus infections.
Mumps treatment
When acute symptoms appear in a child, a pediatrician should be called to the house. The appearance of mumps symptoms in adults often leads them to see dentists or ENT doctors.
Most patients do not require hospitalization. It is carried out only in case of severecomplications of mumps disease. Treatment is aimed at preventing the development of complications, reducing and alleviating symptoms. Patients are prescribed bed rest, a dairy and vegetable diet, antipyretic and anti-inflammatory drugs. In case of severe intoxication of the body, intravenous administration of detoxification drugs (saline solution, 5% glucose solution) is possible. Multivitamin complexes are prescribed.
Treatment at home involves quarantine for up to 10 days. In children's institutions, if mumps is detected, quarantine is declared for up to 3 weeks.
Prevention measures
There is no specific prevention of mumps. Since 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, elimination of contacts with patients significantly reduce the risk of disease.
The most reliable way to prevent mumps in children is vaccination. It is given for the first time at the age of 1 year with a complex vaccine against mumps, measles and rubella. The second immunization is indicated for children 6-7 years old who have not had mumps.
Immunization: pros and cons
The opinion of experts on this issue is ambiguous. There is an opinion that only boys of puberty (the onset of puberty) who did not have mumps in childhood should be vaccinated. The rationale for this point of view is that the immunity acquired by the boy after mumps at an early age is lifetime, while the vaccinewill ensure its availability for several years.
Supporters of mandatory immunization of all children at an early age appeal to the fact that no one is immune from the complications of mumps. And if it is possible to avoid even the slightest chance of a child developing diabetes, deafness, or testicular atrophy, then you should use it.
Vaccination contraindications
Modern vaccines contain attenuated paramyxoviruses and a protein component based on chicken or quail eggs or cattle protein. Features of vaccines are taken into account 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 calendar - at 1 year of age and at 6-7 years of age. Vaccination is also effective in the first 2 days after contact with the patient, in which case the risk of complications and severe course of the disease is reduced.
The effectiveness of immunization with modern means is quite high - immunity lasts for several years, sometimes for life. But there are still contraindications for children:
- Blood diseases and oncological diseases.
- Allergic to both 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 (fever, respiratory andcatarrhal manifestations, swelling of the glands). These manifestations may appear on the 10-12th day after vaccination, last for 1-2 days and pass on their own.
What should parents do
Today, vaccinating children against mumps is not mandatory, and parents have the right to refuse to vaccinate their child. One has only to responsibly approach this issue, given the following facts:
- Approximately 1.5 million children die every year around the world, whose death could have been prevented by timely vaccination.
- About 17 out of 100 children under the age of 5 could live if vaccinated against dangerous viral diseases.
- The development of meningoencephalitis, although not fatal, leads to irreversible damage to the auditory nerves and deafness.
- Lethality in the case of epidemiological parotitis, although small, is 1 case per 100 thousand patients.
- About 25% of male infertility cases are associated with viral mumps suffered in childhood.
- Severe damage to the pancreas can lead to various forms of diabetes.
Distrustful attitude to vaccination in modern society has long become a global problem. It is formed under the influence of the following aspects: distrust of the vaccine as such (its effectiveness or its supplier), the arrogance of the layman (underestimation of the risks of the disease), the inconvenience of organizing vaccination (geographical remoteness, stress or high cost). Which of the following factors influences the decisionparent and are you willing to say that you made a decision not based on false conclusions?
From doubt to certainty
Human mistrust of vaccines has existed since their invention. According to polls, 1/5 of the population is ready to admit that there is a medical conspiracy, according to which government he alth authorities support immunization 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 he alth of their child. We only recall that in the world today, thanks to vaccines, diseases such as cholera, rabies, smallpox, a form of meningoencephalitis and more than 10 diseases have been brought into the category of completely disappeared dangerous infections. The production of vaccines is a very complex process, and current certification methods are very strict. In any case, the choice remains an individual matter.
