Mumps is a contagious disease that is caused by the mumps virus. Mumps typically starts with a few days of fever, headache, muscle aches, tiredness, and loss of appetite, and is followed by swelling of salivary glands. Anyone who is not immune from either previous mumps infection or from vaccination can get mumps.

Before the routine vaccination program was introduced in the United States, mumps was a common illness in infants, children and young adults. Because most people have now been vaccinated, mumps has become a rare disease in the United States.

Currently, there is no specific treatment for mumps. Supportive care should be given as needed. If someone becomes very ill, they should seek medical attention. If someone seeks medical attention, they should call their doctor in advance so that they don't have to sit in the waiting room for a long time and possibly infect other patients.

Signs & Symptoms of Mumps Up to half of people who get mumps have very mild or no symptoms, and therefore do not know they were infected with mumps. Most people with mumps fully recover after a few weeks. The most common symptoms include: Fever Headache Muscle aches Tiredness Loss of appetite Swollen and tender salivary glands under the ears on one or both sides (parotitis) Others may feel extremely ill and be unable to eat because of pain around the jaw, and a few will develop serious complications. Symptoms typically appear 16-18 days after infection, but this period can range from 12-25 days after infection.

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Complications of Mumps

Mumps is best known for the swelling of the cheeks and jaw that it causes, which is a result of swelling of the salivary glands. It is usually a mild disease, but can occasionally cause serious complications.

The most common complication is inflammation of the testicles (orchitis) in males who have reached puberty; rarely does this lead to fertility problems.

Other rare complications include:

• Inflammation of the brain and/or tissue covering the brain and spinal cord (encephalitis/meningitis)
• Inflammation of the ovaries (oophoritis) and/or breasts (mastitis) in females who have reached puberty
• Temporary or permanent deafness

Transmission of Mumps

Mumps is spread by droplets of saliva or mucus from the mouth, nose, or throat of an infected person, usually when the person coughs, sneezes, or talks. Items used by an infected person, such as soft drink cans or eating utensils, can also be contaminated with the virus, which may spread to others if those items are shared. In addition, the virus may spread when someone with mumps touches items or surfaces without washing their hands and someone else then touches the same surface and rubs their mouth or nose.

Most mumps transmission likely occurs before the salivary glands begin to swell and up to 5 days after the swelling begins. Therefore, CDC recommends isolation of mumps patients for 5 days after their glands begin to swell. The incubation time (how long it takes for symptoms to appear after a person is exposed to the virus) can range from 12-25 days.

Some things people can do to help prevent the spread of mumps and other infections include

• Washing hands well and often with soap, and teaching children to wash their hands too
• Not sharing eating or drinking utensils
• Cleaning surfaces that are frequently touched (such as toys, doorknobs, tables, and counters) regularly with soap and water or with cleaning wipes
• Minimize close contact with other people if you are sick
• Cover your mouth and nose with a tissue when you cough or sneeze, and put your used tissue in the trash can. If you don’t have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands

When you have mumps, you should avoid close and prolonged contact with other people until at least 5 days after your glands begin to swell because you are contagious during this time. This means you should stay home when you are sick with mumps. You should not go to work or school. Even at home, you should limit contact with the people you live with; for example, sleep in a separate room by yourself if you can. Staying home while sick with mumps is an important way to avoid spreading the virus to other people. People who are infected with mumps don’t get sick right away—it can take 2-4 weeks for them to show signs of infection.

Mumps Vaccination

Mumps vaccine, which is included in the combination measles-mumps-rubella (MMR) and measles-mumps-rubella-varicella (MMRV) vaccines, is the best way to prevent mumps. Mumps vaccine effectiveness has been estimated at 62-91% for one dose and 76-95% for two doses. The first vaccine against mumps was licensed in the United States in 1967, and by 2005, high two-dose childhood vaccination coverage reduced disease rates by 99%. Both MMR and MMRV vaccine may be given at the same time as other vaccines.

Children should receive the first dose of mumps-containing vaccine at 12-15 months and the second dose at 4-6 years. Those children between 13 and 18 years or old should get MMR and varicella vaccines as separate shots. All adults born during or after 1957 should have documentation of one dose. Adults at higher risk, such as university students, health care personnel, and international travelers, and persons with potential mumps outbreak exposure should have documentation of two doses of mumps vaccine or other proof of immunity to mumps.

Protecting Your Child Against Serious Diseases: Making Sure Kids Get All Their Shots (Kindle)

Encyclopedia of Vaccines, 2009: An encyK Resource for Parents, Patients & Professionals (Kindle)

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Some people should not get MMR vaccine or should wait.

• People should not get MMR vaccine who have ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or to a previous dose of MMR vaccine.
• People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting MMR vaccine.
• Pregnant women should wait to get MMR vaccine until after they have given birth. Women should avoid getting pregnant for 4 weeks after getting MMR vaccine.
• Some people should check with their doctor about whether they should get MMR vaccine, including anyone who:
  • Has HIV/AIDS, or another disease that affects the immune system
  • Is being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer.
  • Has any kind of cancer
  • Is taking cancer treatment with x-rays or drugs
  • Has ever had a low platelet count (a blood disorder)
• People who recently had a transfusion or were given other blood products should ask their doctor when they may get MMR vaccine.

Ask your provider for more information.

Children should not get MMRV vaccine if they:

• Have ever had a life-threatening allergic reaction to a previous dose of MMRV vaccine, or to either MMR or varicella vaccine.
• Have ever had a life-threatening allergic reaction to any component of the vaccine, including gelatin or the antibiotic neomycin. Tell the doctor if your child has any severe allergies.
• Have HIV/AIDS, or another disease that affects the immune system.
• Are being treated with drugs that affect the immune system, including high doses of oral steroids for 2 weeks or longer.
• Have any kind of cancer.
• Are being treated for cancer with radiation or drugs.

Check with your doctor if the child:

• Has a history of seizures, or has a parent, brother or sister with a history of seizures.
• Has a parent, brother or sister with a history of immune system problems.
• Has ever had a low platelet count, or another blood disorder.
• Recently had a transfusion or received other blood products.
• Might be pregnant.

Children who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting MMRV vaccine. Children who are only mildly ill may usually get the vaccine.

Ask your provider for more information.

Mumps Outbreaks

In 2006, the United States experienced a multi-state outbreak involving 6584 reported cases of mumps. This resurgence predominantly affected Midwestern college students with the highest attack rates occurring among those living in dormitories. In the following two years, the number of reported cases returned to usual levels, and outbreaks involved fewer than 20 cases.

However, beginning in July 2009, the largest U.S. mumps outbreak since 2006 has occurred. The index case was an 11-year-old boy who had returned on June 17 from the United Kingdom where an ongoing mumps outbreak involves more than 4000 cases. Because of the potential for more extensive disease transmission, efforts should be made to heighten surveillance for mumps and assure that children and adults are appropriately vaccinated against this disease

If you do get ill with mumps, avoid close contact with people until at least 5 days after your glands began to swell.

Also remember that in any situation, keeping hands clean is one of the most important steps you can take to avoid getting sick and spreading germs to others. It is best to wash your hands with soap and clean running water for 20 seconds. However, if soap and clean water are not available, use an alcohol-based product to clean your hands. Cover your mouth and nose with a tissue when you cough or sneeze, and throw out your used tissue. If you don’t have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands.

Travelers Overview on Mumps

The risk of exposure to mumps among travelers can be high in most countries of the world, especially for travelers who are older than 12 months and who do not have evidence of mumps immunity.

Acceptable presumptive evidence of immunity to mumps for international travelers includes:

• Documented administration of two doses of live mumps virus vaccine at least 28 days apart, on or after the first birthday
• Laboratory evidence of immunity
• Birth before 1957
• Documentation of physician-diagnosed mumps

Although some countries have had variable successes with a national vaccination program—including Finland, which has declared elimination—the risk of contacting imported mumps in these countries is still a concern.

For more information on mumps and travel, see the mumps chapter from CDC’s Health Information for International Travel 2010 (the Yellow Book).

Travelers Questions and Answers on Mumps

Q: What should I do if I plan to travel to a state affected by a mumps outbreak?

A: Although the risk of exposure to mumps for most travelers will be relatively low, you should make sure that you are fully vaccinated or immune. This is especially important if you plan to travel to states experiencing mumps outbreaks.

Here is what it takes to be fully vaccinated or immune:

• All children who are12 months to 4 years of age should have had 1 dose of MMR or MMRV vaccine
• All school-aged children (K-12) and students attending post-high school educational institutions should have had 2 doses of vaccine
• Adults who live in or travel to an outbreak affected area should have at least 1 dose, unless you were diagnosed by a doctor with mumps earlier in life, or have laboratory evidence of immunity to mumps.
• Most people born in the United States before 1957 had mumps and cannot get it again. If you don't know if you had vaccine or mumps in the past, vaccination with two doses of mumps-containing vaccine should be considered.

It takes about 2 weeks after vaccination before your body develops immunity to mumps. If you must travel to an affected area before you have immunity from vaccine, wash your hands frequently, do not share eating utensils or beverage containers, and avoid other sources of saliva from another person, such as from a person who is sneezing or coughing.

One dose of vaccine protects about 80% of the people who receive it. Two doses protect about 90%. Watch yourself carefully for signs of mumps (fever, headache, muscle aches, tiredness, and loss of appetite, followed by swelling of salivary glands). The parotid salivary glands (which are located within your cheek, near your jaw line, below your ears) are most often the ones that swell. See your health care provider if you develop these symptoms.

Q: Can mumps be spread on airplanes?

A: There may be some risk of getting sick from illnesses, such as mumps, during air travel that can be spread by mucus or droplets from the nose or throat of an infected person, usually when a person coughs or sneezes, but the risk of mumps transmission on an airplane is probably low.

Q: What can I do to protect myself from infection during air travel?

A: The most effective tool for preventing mumps is to be vaccinated with MMR or MMRV vaccine unless you have other evidence of immunity to mumps. Another important thing travelers can do to keep from getting sick is to wash their hands often and well with soap and water. Frequent hand washing washes away germs that may have been picked up from other people or from contaminated surfaces. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol).

Travelers who are sick can help prevent the spread of infection by not flying while they are ill. If travel is unavoidable, ill travelers should use tissues to cover their coughs and sneezes, wash their hands often, and avoid close contact with others.