Overview
Mumps is a contagious viral infection best known for the puffy cheeks and tender, swollen jaw it causes, from swelling of the salivary glands in front of and below the ears.
It is usually mild and settles in about two weeks without specific treatment. It matters because of its complications: WHO describes mumps as a leading cause of acquired hearing loss in children, and it can inflame the brain, the testicles and the pancreas.
Disease Summary
- Category
- Infectious Disease
- Cause
- Mumps virus
- Transmission
- Saliva and respiratory droplets
- Body System
- Multiple organ systems
- Preventable
- Yes
- Curable
- No
Symptoms
Common Symptoms
Symptoms appear on average 16 to 18 days after infection, with a range of 12 to 25 days. Some people have no symptoms at all and can still pass the virus on.
Swollen, Tender Salivary Glands
Puffy cheeks and a tender, swollen jaw. CDC reports the swelling peaks in 1 to 3 days and lasts about 5 days on average, with most cases settling after 10 days.
Low Fever
A mild fever that may last 3 to 4 days and can begin several days before the swelling appears.
Headache
Headache often comes before the gland swelling, which is part of why early mumps is hard to recognise.
Muscle Aches
Aching muscles are listed among the early symptoms.
Tiredness
General malaise and fatigue arrive with the other early symptoms.
Loss of Appetite
Eating becomes uncomfortable because chewing moves the swollen glands.
Mainly Respiratory Symptoms
CDC notes that mumps may present only with non-specific or mainly respiratory symptoms, without the classic swelling.
No Symptoms at All
CDC reports that a substantial proportion of infections cause no symptoms, yet the person can still pass the virus on.
Danger Signs
Seek urgent medical attention immediately if any of the following symptoms develop.
Confusion, Drowsiness or Seizures
CDC identifies inflammation of the brain as the most serious complication of mumps and states it can lead to death or permanent disability.
Severe Headache With a Stiff Neck
This suggests inflammation of the lining of the brain and spinal cord and needs same-day assessment.
Painful Testicular Swelling
CDC reports this in approximately 30% of unvaccinated and 6% of vaccinated males past puberty who catch mumps.
Severe Stomach Pain With Vomiting
This can indicate inflammation of the pancreas.
New Hearing Loss
CDC states hearing loss from mumps can be temporary or permanent, and WHO calls mumps a leading cause of acquired hearing loss in children.
A Child Unable to Eat or Drink
Painful swallowing that prevents fluid intake needs medical assessment, particularly in a young child.
Diagnosis
Examination of the Salivary Glands
CDC describes the hallmark as pain, tenderness and swelling of one or both parotid glands. The swelling obscures the angle of the jaw and pushes the ear outwards, which is what separates it from swollen neck glands.
Exposure and Vaccination History
CDC states that vaccination status and the timing of sample collection are both important for interpreting the laboratory result.
Timing From Exposure
Symptoms appear on average 16 to 18 days after infection, with a range of 12 to 25 days, which anchors contact tracing.
Laboratory Confirmation
A confirmed case requires a positive molecular test. Clinical appearance alone is not enough, because several other infections cause the same swelling.
Reassessment of Repeated Swelling
CDC advises collecting both a swab and a blood sample from each separate episode when the swelling recurs.
Laboratory Tests
Molecular Test for Mumps Virus
CDC calls this the preferred method to confirm mumps. It should be collected as soon after the swelling starts as possible, ideally within 3 days.
Mumps IgM Antibody
Supports the diagnosis but does not confirm it. CDC notes that previously vaccinated people may have a brief or absent antibody response, so a negative result does not exclude mumps.
Paired Antibody Blood Tests
Measures the rise in antibody between the acute illness and recovery.
Viral Culture
Used alongside the molecular test to confirm infection. The yield depends heavily on how soon the sample was taken.
Genetic Typing
Characterises the circulating virus and links cases into transmission chains during an outbreak.
Treatment
Supportive Care
There is no specific antiviral treatment for mumps, and antibiotics do not work against a virus. Rest, fluids and soft foods carry most people through.
Pain and Fever Relief
Simple pain-relieving and fever-reducing medicines ease the headache, muscle ache and gland tenderness.
Cold or Warm Compresses
Eases pain and tenderness over the swollen glands. Sour or acidic foods make the pain worse and are best avoided.
Care for Testicular Swelling
Support, rest and cold compresses ease the pain of testicular inflammation, which needs medical assessment.
Isolation to Stop Spread
CDC advises that a person with mumps avoids contact with others from diagnosis until 5 days after the swelling starts, staying away from school, work and social events.
Prevention
Two doses of mumps-containing vaccine
CDC recommends two doses of the combined measles, mumps and rubella vaccine, and this is the best protection available.
Understand what the vaccine does and does not do
CDC reports that one dose is about 72% effective against mumps and two doses about 86%. Protection is good but not complete, which is why outbreaks still occur.
Stay home while infectious
CDC advises staying away from school, work and social events until 5 days after the swelling begins.
Do not share cups, bottles or utensils
Mumps spreads through saliva, so anything that carries saliva can carry the virus.
An extra dose during an outbreak
CDC states that an additional dose may be offered to people at increased risk during an outbreak, as decided by public health authorities.
Check immunity before university, work or travel
CDC highlights students, health workers and international travellers as groups who should confirm they are protected.
Risk Factors
People in Close-Contact Settings
Mumps spreads where people share air, saliva and space.
- Students in schools and universities
- People in crowded residential settings
- Sports teams and households
- Even well-vaccinated groups, because two doses are about 86% effective
Unvaccinated and Under-Vaccinated People
Complication rates are considerably higher in people who were never vaccinated.
- People who never received a mumps-containing vaccine
- People who received only one dose
- Communities where the vaccine has not been introduced
- CDC reports testicular inflammation in around 30% of unvaccinated males past puberty, against 6% of vaccinated ones
Males Past Puberty
Testicular inflammation is the commonest serious complication in this group.
- Adolescent and adult males
- CDC reports only one testicle is affected in most cases
- The inflammation can lead to shrinkage of the testicle
- Assessment is needed rather than waiting it out at home
Health Workers and Travellers
Both groups meet more cases than the general population.
- Health workers without evidence of immunity
- International travellers to areas with low coverage
- Women planning pregnancy, who should confirm immunity beforehand
- Anyone working in a setting where an outbreak is under way
Complications
Testicular Inflammation
CDC reports this in approximately 30% of unvaccinated and 6% of vaccinated males past puberty, usually affecting one side.
Inflammation of the Brain
CDC identifies this as the most serious complication and states it can lead to death or permanent disability, though it occurs in under 1% of cases.
Inflammation of the Lining of the Brain
Now uncommon, occurring in under 1% of cases in recent outbreaks, but far more common before vaccination.
Hearing Loss
CDC states hearing loss can be temporary or permanent. WHO calls mumps a leading cause of acquired hearing loss in children.
Inflammation of the Ovaries, Breast Tissue or Pancreas
All are recognised complications and all are far less common now than before vaccination.
Rare Severe Outcomes
CDC lists kidney and heart inflammation, seizures and other rare outcomes, and states that death from mumps is exceedingly rare.
When to Seek Medical Care
Any Suspected Mumps, After Telephoning First
Call ahead so the visit can be arranged without exposing other patients.
Confusion, Drowsiness or Seizures
These point to inflammation of the brain and are an emergency.
Severe Headache With a Stiff Neck
This suggests inflammation of the lining of the brain.
Painful Testicular Swelling
Needs assessment because of the risk of lasting damage to the testicle.
Unable to Eat or Drink, or Severe Stomach Pain
Both are reasons for same-day assessment, particularly in a child.
Prognosis
Most People Recover Fully
CDC states most people recover completely within about 2 weeks. The gland swelling peaks in 1 to 3 days and most cases resolve after 10 days.
Death Is Exceedingly Rare
CDC describes mumps mortality as exceedingly rare, with no deaths reported in recent outbreaks.
Complications Are Now Uncommon
CDC reports that brain, pancreas and hearing complications each occur in under 1% of cases in recent outbreaks, well below pre-vaccination rates.
Vaccinated People Fare Better
CDC reports testicular inflammation in 6% of vaccinated against around 30% of unvaccinated males past puberty.
Differential Diagnosis
Swollen Neck Glands
CDC states this is what mumps is most often confused with. Neck glands have distinct borders and sit behind the angle of the jaw, while mumps swelling obscures that angle and pushes the ear outwards.
Other Viral Infections of the Salivary Glands
Several viruses cause the same swelling and are separated only by specific testing.
Influenza and Other Respiratory Viruses
Can cause gland swelling alongside the usual respiratory symptoms, and are separated by respiratory viral testing.
Bacterial Infection of a Salivary Gland
Usually affects one gland, is more acutely painful, and may produce pus from the duct inside the cheek.
Salivary Gland Stones
Cause swelling that comes and goes with meals rather than a steady swelling with fever.
References
World Health Organization: Mumps
WHO overview of mumps, its complications and the place of mumps vaccine in national programmes.
CDC: Clinical Features of Mumps
Symptoms, timing, complications and complication rates by vaccination status.
CDC: Laboratory Testing for Mumps
Which tests to use, when to collect samples and how to interpret results.
CDC: Mumps, Pink Book
Detailed chapter on the virus, clinical features, complications and vaccination.
Frequently Asked Questions
How long is mumps contagious?
CDC states the infectious period runs from 2 days before the gland swelling starts to 5 days after it appears. A person with mumps should avoid contact with others from diagnosis until 5 days after the swelling begins.
Can you get mumps if you have been vaccinated?
Yes. CDC reports that one dose of the combined vaccine is about 72% effective against mumps and two doses about 86%, so breakthrough infections happen. Vaccinated people who catch mumps have milder illness and far fewer complications.
How long does mumps last?
CDC states the gland swelling usually peaks in 1 to 3 days and then settles over the following week, lasting about 5 days on average, with most cases resolving after 10 days. Most people recover completely within about 2 weeks.
Is there a medicine for mumps?
No. There is no specific antiviral treatment, and antibiotics do not work because mumps is caused by a virus. Care is rest, fluids, soft food, compresses to the swollen glands and simple pain relief.
Can mumps cause deafness or affect fertility?
CDC states that hearing loss from mumps can be temporary or permanent, and WHO calls mumps a leading cause of acquired hearing loss in children. Testicular inflammation affects around 30% of unvaccinated males past puberty and can cause shrinkage of the affected testicle, so it should always be assessed.