Mumps (mumps) - a widespread viral disease, occurring with lesions of the glandular organs (Most of the salivary glands, parotid particularly, less pancreas, reproductive, and mammary al.), And the nervous system (meningitis, Meningoencephalitis).
Causes of mumps
Source mumps - a sick person contagious for 9 days of illness. route of transmission - airborne. The most striking contingent - school age children. With age, the number of cases of mumps falls due to growth in the number of immune individuals. Cases of the disease among children in the first year of life are extremely rare. Rarely the disease occurs in patients older than 40 years.
The incubation period - from 11 to 21 days.
Symptoms of mumps
In some patients, 1-2 days before the onset of a typical pattern of mumps premorbid observed phenomena in the form of weakness, malaise, muscle pain, headache, chilling, sleep disturbances and appetite.
With the development of inflammatory changes in salivary gland, these phenomena become more pronounced, marked symptoms associated with damage to the salivary glands, - dry mouth, pain in the ear, worse when chewing, conversation.
In typical cases, the fever reaches its maximum severity at 1-2-th day of illness and lasts 4-7 days.
A characteristic feature of mumps - the defeat of the salivary glands (in the majority of patients - the parotid). FIELD enlarged prostate painful to palpation. The pain is particularly pronounced at certain points: front earlobe, behind the ear lobe and in the mastoid.
With increased salivary gland and skin lesions noted on it (depending on the degree of increase). Skin becomes tense, shiny, swelling can spread to the neck. Salivary gland enlargement is growing rapidly, and within 3 days is maximized. At this level of swelling is kept for 2-3 days, and then gradually (within 7-10 days) decreases.
complications of mumps
When mumps complications occur more frequently in the defeat of glandular organs and central nervous system. In diseases of children by one of the most frequent complications is inflammation of the meninges (meningitis). The frequency of complications is greater than 10%. In male subjects developed meningitis 3 times more often than women. Typically, the symptoms of the nervous system appear after inflammation of the salivary glands, but maybe a one-time loss of the salivary glands and the nervous system (in 25-30% of patients). Meningitis often begins rapidly (usually 4-7-day sickness): there is a fever, the body temperature rises again (to 39 ° C and above), worried about a severe headache, vomiting.
Orchitis (inflammation of the testicles) are more common in adults. Symptoms of orchitis are marked on 5-7 day from the beginning of mumps, and are characterized by a new wave of fever (Up to 39-40 ° C), the emergence of severe pain in the scrotum and testicles, sometimes extending to the lower abdomen. Egg increases, reaching the size of a goose egg. The fever lasts 3-7 days, increase egg - 5-8 days. Then the pain passes, and the egg is gradually reduced in size. In the future (1-2 months) signs of testicular atrophy may occur, which have been reported in 50% of patients after orchitis (if not administered hormones corticosteroids in the early development of complications).
Inflammation of the pancreas develops in the 4-7th day of illness. There is a sharp pain in the epigastric region, nausea, repeated vomiting, fever.
The defeat of the organ of hearing sometimes leads to complete deafness. The first sign is the appearance of noise and ringing in the ears. About an inflammation of the inner ear suggests dizziness, vomiting, incoordination. Usually deafness is unilateral (on the affected side of the salivary glands). In the period of recovery of hearing can not be restored.
Inflammation of the joints occurs in approximately 0.5% of cases, most often in adults, and in men more often than women. They are observed in the first 1-2 weeks after the defeat of the salivary glands, but may cause them to change glands. It is most often affected large joints (wrist, elbow, shoulder, knee and ankle). Joints swell, become painful. The duration of arthritis usually 1-2 weeks, some patients joint damage persists up to 1-3 months.
It is now established that the mumps virus in pregnant women may cause fetal loss. In particular, the children have a kind of change of heart - the so-called primary fibroelastosis infarction. Other complications (prostatitis, Oophoritis, mastitis, thyroiditis, Bartonility, nephritis, myocarditis, Thrombocytopenic purpura) are rare.
Diagnosis of mumps
- Virus isolation: the traditional isolation of viruses from nasal mucus of biomaterial;
- Detection of antibodies to the virus antigens: DGC RTNGA (diagnostic titer of 1:80 or higher). In assessing the results of the study take into account the possible vaccine reactions;
- Allergic method: setting intradermal allergic reaction diagnosticum mumps; now rarely used;
- Blood analysis;
- Analysis of urine.
Treatment of mumps
There is no specific treatment. An important objective of treatment is to prevent complications. Must be met bed rest for at least 10 days. Men who do not comply with bed rest for the first week, orchitis develops in about three times more frequently than in patients who were hospitalized in the first three days of illness.
For the prevention of pancreatic inflammation, in addition, it is necessary to observe a diet: avoid overeating, reduce the number of white bread, pasta, fat, cabbage. The diet should be lacto-vegetarian. Cereal is better to eat rice, allowed black bread, potatoes.
When orchitis as early as possible prednisolone within 5-7 days from 40-60 mg and reducing the dose every day for 5 mg, hormones or other corticosteroids in equivalent doses.
When meningitis apply the same treatment with corticosteroids. For a mumps meningitis favorable influence lumbar puncture with the extraction of a small amount of cerebrospinal fluid.
When inflammation of the pancreas prescribed liquid sparing diet, atropine, papaverine, chill on stomach, vomiting - chlorpromazine, and also preparations inhibiting enzymes, in particular contrycal (trasilol), which is administered intramuscularly (slowly) a solution of glucose, on the first day 50 000 units, followed by 3 days 25,000 IU / day. and another 5 days at 15,000 IU / day. Locally - a hot compress.
Prediction and prevention
Forecast in mumps favorable deaths are very rare (1 in 100,000 cases); but consider the possibility of deafness and testicular atrophy with subsequent infertility.
Vaccination mumps vaccine at 12 months of age. Revaccination at six years of age: using domestic or foreign preparations (incl.. and combined).
There are observations of cases of mumps among children vaccinated previously. The disease occurs in these cases is relatively easy with the involvement in the process only the salivary glands. Children of the first 10 years, who have had contact with the patient, uncoupling on the 21 th day after isolation of the sick.
