Mumps staging a comeback

There’s another health issue to consider, if you’re agonising about the MMR vaccination for your infant. Mumps is making a comeback – Jane Bartlett reports.

According to figures just released from the Public Health Laboratory Service, cases of mumps, the viral infection which typically affects children, have doubled in the past two years. In 2000 there were 654 confirmed cases in England and Wales, compared to 358 in 1999, and 121 in 1998. Stockport, Bradford and Northern Ireland have been particularly badly hit.

In recent years we’ve almost forgotten mumps. Vaccination has a 90% protection rate, which has made it rare, but it used to be very common. You may remember suffering as a child with the swollen glands and stiff neck. Wherever children gathered in groups, parotitis, otherwise known as mumps, could be found doing the rounds, especially in the winter and the spring.

Most of the current cases of mumps are in older children, aged between 12 and 18, who have missed out on the MMR vaccination. Other cases are amongst those children, who have only had one of the two MMR jabs needed to give full protection. However, health officials fear that, the recent drop in numbers of infants receiving the MMR vaccination, will lead to a further upsurge in mumps. About 12% of parents are refusing to give their children the triple dose vaccine, for fear of possible links to autism and bowel disease.

So just how dangerous is mumps?
It’s caused by a virus similar to influenza. It can be caught easily through coughs and sneezes, or simply chatting to someone, or coming into contact with contaminated objects, such as toys and cups. It’s not as contagious as chicken pox or measles, though. Symptoms often don’t appear until 14 to 25 days after exposure. A child is thought to be infectious from three days before signs of sickness, to the forth day of active disease. Stopping the silent spread of mumps around the nursery or classroom is like trying to contain foot and mouth – a formidable challenge. In fact, before vaccination, most children used to get mumps – it was impossible to avoid.

In about one third of people, mumps is so mild it causes few or no symptoms. But others can feel very ill, and the comic depiction of mumps, transforming a child’s face into a hamster with bulging cheeks, belies the fact that it can be very unpleasant. The facial swelling is caused by an inflammation of the salivary glands, under and in front of the ears. It’s painful, it hurts to swallow, and the mouth becomes dry. Other symptoms typically include a fever and, possibly, a headache. There may be ear tenderness and pain when chewing.

For the most part it’s not dangerous, and children are back on their feet and running around after two weeks. Mumps, however, shouldn’t be taken lightly – in some rare cases, it can lead to something more serious.

About 3 children in every 100 who get mumps, also get viral meningitis (an inflammation of the coverings of the brain and spinal cord), and in one in 6,000 cases, it can cause encephalitis, an inflammation of the brain itself, which can lead to one or two-sided deafness. Before vaccination, mumps was one of the main causes of deafness in children.

Adolescents tend to feel worse for longer with mumps, and boys are at particular risk, with about 1 in 4 having painful swelling of the testicles, which in rare cases may lead to sterility (although there is no definitive evidence of this). Women who have mumps during the first trimester of pregnancy are also at increased risk of miscarriage.

How to treat your child with mumps

  • Let your child rest, and keep them away from school or nursery
  • Give paracetamol for pain and fever
  • Put a cool flannel over the swollen jaw
  • Offer bland, soft pureed foods and, if necessary, give liquids with a straw
  • Clean teeth regularly to refresh mouth
  • Eating and drinking are most painful, first thing in the morning, so give your child sips of liquid before offering food.
Contact your doctor again, if your child becomes worse or shows any of the following symptoms:
  • They become irritable and/or drowsy
  • They are reluctant to bend neck
  • They have convulsions
  • They seem unsteady or confused
  • Stomach ache or vomiting
The upsurge in mumps gives parents further food for thought, when considering the MMR controversy and, in the opinion of many medical experts, it’s a warning that vaccination is vital.

Find out more about MMR:
MMR - Friend or foe?
MMR - Miracle cure or dangerous cocktail?
The MMR minefield