Mumps: Symptoms, Types, Causes and Treatment

Mumps is a contagious viral infection that, despite being preventable through vaccination, continues to spark outbreaks in different parts of the world. Known for its characteristic swelling of the salivary glands, particularly the parotid glands, mumps can sometimes lead to serious complications if left unmanaged. In this article, we'll delve into the key aspects of mumps, exploring its symptoms, types, underlying causes, and the most up-to-date treatment strategies. Our goal is to provide clear, evidence-based information to help you understand and recognize this disease—and know what to do if you or someone you know is affected.

Symptoms of Mumps

Recognizing mumps early is crucial for limiting its spread and managing its often uncomfortable symptoms. While many people associate mumps with the classic swollen cheeks, the disease can present with a variety of signs—some more subtle than others.

Main Symptom	Presentation	Frequency/Severity	Source
Parotid Swelling	Painful, non-suppurative salivary gland swelling	Most common, hallmark symptom	1 2 3 4 5
Fever	Low to moderate temperature	Common, especially in children	3
Headache	Mild to moderate	Frequently reported	3
Malaise	General feeling of unwellness	Common, especially in prodrome	2 3
Myalgia	Muscle aches	Often present in early stages	2
Loss of Appetite	Reduced desire to eat	Frequently observed	3
Asymptomatic	No noticeable symptoms	Up to 30% of unvaccinated cases	1 3
Complications	Orchitis, oophoritis, meningitis, etc.	Rare but serious, especially in adults	1 2 3 4 5

Table 1: Key Symptoms of Mumps

Hallmark Signs: Parotitis and Beyond

The most recognizable sign of mumps is parotitis—painful swelling of one or both parotid (salivary) glands, located just below and in front of the ears. This symptom often leads to the characteristic "chipmunk cheeks" appearance. The swelling can last for several days and may be accompanied by tenderness and pain when chewing or swallowing 1 2 3 4 5.

Early and Non-Specific Symptoms

Before the glands swell, many people experience a prodrome:

• Low-grade fever
• Headache
• Muscle aches (myalgia)
• Malaise (a general sense of being unwell)
• Loss of appetite

These symptoms can make early diagnosis challenging, as they resemble many other viral illnesses 2 3.

Asymptomatic Cases

Surprisingly, up to 30% of unvaccinated individuals infected with the mumps virus may not show any symptoms at all. This silent form of the disease makes controlling outbreaks more difficult, as people can spread the virus without realizing they are infected 1 3.

Complications: When Mumps Gets Serious

While most cases are mild, mumps can sometimes cause serious complications, especially in adolescents and adults:

• Orchitis (inflammation of the testicles) in males, which can very rarely lead to infertility
• Oophoritis (inflammation of the ovaries) in females
• Meningitis and encephalitis (inflammation of the brain and its lining)
• Pancreatitis
• Deafness, which is rare but can be permanent 1 2 3 4 5

Symptom Variability by Age

Children are more likely to have classic symptoms, while adults may have more severe or complicated cases. Notably, complications like orchitis are more frequent in post-pubertal males 3 4 5.

Types of Mumps

Though mumps is generally considered a single disease, its presentation can vary based on several factors, including age, immune status, and complications. Understanding these variations can help guide both diagnosis and treatment.

Type	Description	Common in	Source
Classic Mumps	Parotid gland swelling, fever, malaise	Children, young adults	1 2 3 5
Asymptomatic Mumps	Infection with no visible symptoms	Up to 30% unvaccinated	1 3
Complicated Mumps	Includes CNS involvement, orchitis, etc.	Adults, older children	1 2 4 5
Vaccine-Associated	Rare, mild form post-vaccination	Vaccinated children	4 6

Table 2: Types of Mumps Presentations

Classic (Symptomatic) Mumps

This is the "textbook" version of mumps, with parotid gland swelling, fever, and general malaise. It is most common in unvaccinated children and young adults 1 2 3 5.

Asymptomatic Mumps

In this type, individuals carry and transmit the virus without developing noticeable symptoms. This silent spread is a major public health challenge, as people may unknowingly infect others 1 3.

Complicated Mumps

Some patients—especially adolescents and adults—develop more severe forms involving:

• Central nervous system (CNS) infections (aseptic meningitis, encephalitis)
• Orchitis, oophoritis, pancreatitis
• Hearing loss (rare) 1 2 4 5

These cases require careful monitoring and, sometimes, hospitalization.

Vaccine-Associated Mumps

Rarely, mild symptoms resembling mumps can occur following vaccination. In very infrequent cases, certain vaccine strains have been linked to aseptic meningitis, but these events are exceedingly rare compared to the risks from natural infection 4 6.

Age and Immune Status: Influencing Factors

• Children tend to have milder, classic presentations.
• Adults are at higher risk for severe complications.
• Immunized individuals may have milder or atypical presentations if infected, but the risk is much lower overall 3 4 5 6.

Causes of Mumps

To understand how mumps spreads and why outbreaks still occur, it's important to look at the virus itself, how it infects people, and the factors influencing its prevalence.

Cause	Details	Transmission Route	Source
Mumps Virus (MuV)	Paramyxoviridae family, RNA virus	Respiratory droplets, saliva	1 4 5 6
Human Reservoir	Only infects humans	Person-to-person	1 6
Contagion	Highly contagious, especially in close-contact settings	Airborne, direct contact	2 3 5
Vaccine Gaps	Lack of vaccination, waning immunity	N/A	3 5 6

Table 3: Main Causes and Transmission of Mumps

The Mumps Virus

Mumps is caused by the mumps virus (MuV), a member of the paramyxovirus family. It is an enveloped, non-segmented, negative-sense RNA virus 1 4 5 6.

Transmission: How Mumps Spreads

MuV spreads easily from person to person through:

• Respiratory droplets (coughing, sneezing)
• Direct contact with saliva (sharing utensils, kissing)
• Contaminated surfaces (less common)

The virus has a 12–25 day incubation period. Infected individuals can spread the virus even before symptoms appear, making it highly contagious in community settings like schools and colleges 1 2 3 5 6.

Human-Only Reservoir

Mumps only infects humans—there are no animal reservoirs. This means that effective vaccination programs can, in theory, eliminate the disease from a population 1 6.

Why Outbreaks Still Happen

Despite the availability of an effective vaccine, outbreaks still occur:

• Incomplete vaccination coverage: Not all children receive the required two doses of the MMR (measles-mumps-rubella) vaccine.
• Waning immunity: Immunity from vaccination can decrease over time, especially in young adults who may not have received natural "boosters" from prior exposure 5 6.
• Vaccine hesitancy: Misinformation and lack of access can lead to lower vaccination rates, as seen in some countries 3.

Global and Regional Patterns

Mumps is more common in areas with limited vaccination programs. For instance, countries without routine MMR vaccination report higher incidence rates and larger outbreaks, such as the significant surge in cases in Pakistan following the COVID-19 pandemic 3.

Treatment of Mumps

While there is no specific antiviral medication that cures mumps, management focuses on relieving symptoms, preventing complications, and controlling the spread. Let's explore both standard and alternative approaches, as well as the pivotal role of vaccination.

Treatment	Approach/Details	Effectiveness/Notes	Source
Supportive Care	Rest, hydration, pain/fever relief	Mainstay of treatment	2 5 6
Isolation	Stay home during infectious period	Limits spread	2 3 6
Vaccination (MMR)	Preventive—2 doses recommended	88% effective with 2 doses	3 5 6
Hospitalization	For severe complications	Required for CNS involvement, orchitis	3 4 5
Alternative Therapies	Acupuncture, Chinese herbs, andrographolide	Limited evidence, not standard of care	7 8 9 10

Table 4: Mumps Treatment Strategies

Supportive Care: The Foundation

Since mumps is caused by a virus, antibiotics are not effective. Supportive care remains the cornerstone:

• Rest: Letting the body recover naturally
• Hydration: Drinking plenty of fluids to avoid dehydration
• Pain and fever relief: Using acetaminophen or ibuprofen as needed
• Soft foods: To reduce discomfort from swollen glands

Most patients recover fully within a couple of weeks 2 5 6.

Preventing Spread: Isolation

People with mumps should stay home and avoid close contact with others, especially during the infectious period (from a few days before gland swelling to about five days after). This is critical to stopping outbreaks in schools, workplaces, and other group settings 2 3 6.

Managing Complications

If complications arise—such as orchitis, oophoritis, pancreatitis, or signs of CNS involvement—hospitalization and more intensive management may be necessary. Severe pain, high fever, or neurological symptoms warrant immediate medical attention 3 4 5.

Vaccination: The Game Changer

The MMR vaccine (measles-mumps-rubella) is the most effective tool for preventing mumps and its complications. Two doses of MMR provide about 88% protection. Outbreaks are much less common in highly vaccinated populations, but can still occur if coverage drops or immunity wanes 3 5 6.

• First dose: at 12-15 months of age
• Second dose: at 4-6 years of age

A third dose may be recommended during outbreaks in certain settings 6.

Alternative and Complementary Therapies

Some studies, mostly from China, have explored the effectiveness of acupuncture, Chinese medicinal herbs, and plant-based compounds like andrographolide for treating mumps:

• Acupuncture: One low-quality study suggested higher recovery rates but a slightly longer time to cure compared to standard care. More research is needed before this can be recommended 7 9.
• Chinese herbal medicine: No high-quality randomized trials currently support its use 8.
• Andrographolide: Early studies in children suggest some benefit compared to ribavirin, but larger, higher-quality research is needed 10.

At this time, these therapies are not considered standard treatment and should not replace supportive medical care.

Antibiotics: Not Effective

Because mumps is a viral infection, antibiotics like aureomycin are not effective and are not recommended unless there is a secondary bacterial infection 11.

Conclusion

Mumps remains a significant health concern in parts of the world, especially where vaccination rates are low or outbreaks occur in close-contact settings. With its hallmark parotid swelling and potential for serious complications, early recognition and supportive care are crucial. Vaccination remains the best defense against mumps, both for individuals and whole communities.

Key takeaways from this article:

• Mumps is a viral illness with classic symptoms like parotid gland swelling, fever, headache, and malaise, but can also be asymptomatic in up to 30% of cases 1 2 3.
• Complications such as orchitis, meningitis, and hearing loss, while rare, can be severe, particularly in adolescents and adults 1 2 3 4 5.
• The mumps virus spreads via respiratory droplets and saliva, with humans as the only reservoir, making vaccination highly effective for control 1 2 3 4 5 6.
• Supportive care is the mainstay of treatment, as there is no specific antiviral therapy. Hospitalization is rare but may be required for severe complications 2 3 5 6.
• The MMR vaccine is the most effective preventive measure, reducing risk by up to 88% with two doses. Maintaining high vaccination coverage is essential for outbreak prevention 3 5 6.
• Alternative therapies like acupuncture and herbal medicine are not currently supported by strong evidence and should not replace standard care 7 8 9 10.
• Public health strategies should focus on vaccination, timely diagnosis, isolation of cases, and education to minimize the impact of mumps 2 3 6.

Protecting yourself and your community starts with awareness and vaccination—let’s keep mumps in check!