Public health priority: Routine.
PHU response: Enter confirmed cases on NCIMS within 5 working days.
Case management: Responsibility of treating doctor. Case should not attend work, school, preschool or childcare for 9 days from onset of swelling or until fully recovered, whichever is sooner.
Contact management: None routinely.
To monitor the epidemiology of the disease and so inform the development of better prevention strategies.
A confirmed case requires
Detection of mumps-specific IgM antibody (in the absence of recent mumps vaccination).
A clinically compatible illness characterised by swelling of the parotid or other salivary glands lasting 2 days or more without other apparent cause.
An epidemiological link is established when there is contact between two people involving a plausible mode of transmission at a time when:
Mumps is to be notified by:
Only confirmed cases should be entered onto NCIMS.
The mumps virus.
Mumps is transmitted by droplet infection and direct contact with the saliva of infected persons.
The typical incubation period is 16 to 18 days (range 12 to 25 days).
Mumps is communicable from about 6-7 days before onset of overt parotitis to 9 days after onset. Maximum infectiousness occurs from 2 days before to 4 days after onset of illness.
There is often a prodromal illness of low-grade fever, anorexia, malaise, and headache. The case may report earache followed by tenderness and visible swelling of one or both parotid glands and sometimes other salivary glands.
Approximately one third of cases develop a respiratory tract infection without salivary gland swelling.
25% of postpubertal males develop orchitis (usually unilateral). 5% of postpubertal females develop oophritis. Infertility following gonadal involvement is rare.
Meningitis occurs in 1 to 10% of cases and mumps encephalitis occurs in approximately 0.1% of cases. CSF pleocytosis occurs in 50% of cases (many of whom don't have symptoms of meningitis)
Rare clinical manifestations of mumps include migratory polyarthritis, pancreatitis, nephritis and myocarditis.
Infection in the first trimester of pregnancy is associated with spontaneous abortion. Mumps virus crosses the placenta but does not cause congenital malformations.
Within 5 working days of notification enter on NCIMS confirmed cases only.
The response to a notification will normally be carried out in collaboration with the case's health carers. Regardless of who does the follow-up, PHU staff should ensure that action has been taken to:
Where a cluster of cases occurs consider initiating a public health investigation to identify people who are not fully vaccinated
Cases requiring hospitalisation should be managed using droplet precautions.
The case or care-giver should be informed about the nature of the infection and the mode of transmission.
Recommend exclusion from work, school, preschool, child care or other settings where there are susceptible individuals, especially young children and infants, for 9 days from the onset of swelling.
None usually required.