INFECTIOUS DISEASE Viral Illnesses • Chickenpox • Mumps • Postherpetic neuralgia • Croup • Measles • Rubella • Mononucleosis • Smallpox • Parvovirus infection • West Nile virus • Roseola • Rabies • SARS • Viral hemorrhagic fevers • Polio • Hand-foot-and-mouth disease

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Mumps is a viral infection that primarily affects the parotid glands — one of three pairs of salivary glands, located below and in front of your ears. If you or your child contracts mumps, it can cause swelling in one or both parotid glands.

Your odds of contracting mumps aren't very high. Mumps was common until the mumps vaccine was licensed in 1967. Before the vaccine, up to 200,000 cases of mumps occurred each year in the United States. Since then, the number of cases has dropped dramatically.

Outbreaks of mumps still occur in the United States, and mumps is still common in many parts of the world, so getting a vaccination to prevent mumps is important.

About one in five people infected with the mumps virus have no signs or symptoms. When signs and symptoms do develop, they usually appear about two to three weeks after exposure to the virus and may include:

• Swollen, painful salivary glands on one or both sides of the face
• Pain with chewing or swallowing
• Fever
• Weakness and fatigue

The primary — and best known — sign of mumps is swollen salivary glands that cause the cheeks to puff out. In fact, the term "mumps" is an old expression for lumps or bumps within the cheeks.

The cause of mumps is the mumps virus, which spreads easily from person to person through infected saliva. If you're not immune, you can contract mumps by breathing in saliva droplets of an infected person who has just sneezed or coughed. You can also contract mumps from sharing utensils or cups with someone who has mumps. Mumps is about as contagious as the flu.

If you suspect that you or your child has mumps, see your doctor. Mumps has become an uncommon illness, so it's possible that your signs and symptoms are caused by another more common condition. Swollen glands and a fever could be an indication of inflamed tonsils (tonsillitis) or a blocked salivary gland. Other, rarer viruses can infect the parotid glands, causing a mumps-like illness.

If your doctor suspects that you or your child has mumps, a virus culture or a blood test may be needed. The blood test can detect mumps antibodies, which indicate whether you've had a recent or past infection.

Complications of mumps are potentially serious, but rare. These include:

• Orchitis. This inflammatory condition causes swelling of one or both testicles. Orchitis is painful, but it rarely leads to sterility — the inability to father a child.
• Pancreatitis. This is swelling of the pancreas. Signs and symptoms of pancreatitis include pain in the upper abdomen, nausea and vomiting.
• Encephalitis. A viral infection, such as mumps, can lead to inflammation of the brain (encephalitis). Encephalitis can lead to neurologic problems and become life-threatening. Although it's serious, encephalitis is a rare complication of mumps.
• Meningitis. Meningitis is infection and inflammation of the membranes and fluid surrounding your brain and spinal cord. It can occur if the mumps virus spreads through your bloodstream to infect your central nervous system. Like encephalitis, meningitis is a rare complication of mumps.
• Inflammation of the ovaries. Pain in the lower abdomen in women may be a symptom of this problem. Fertility doesn't seem to be affected.
• Hearing loss. In rare cases, mumps can cause hearing loss, usually permanent, in one or both ears.

Because mumps is caused by a virus, antibiotics aren't effective. Like most viral illnesses, a mumps infection must simply run its course. Fortunately, most children and adults recover from an uncomplicated case of mumps within two weeks.

In general, you're considered immune to mumps if you've previously had the infection or if you've been immunized against mumps.

The mumps vaccine is usually given as a combined measles-mumps-rubella (MMR) inoculation, which contains the safest and most effective form of each vaccine. Two doses of the MMR vaccine are recommended before a child enters school — the first between ages 12 and 15 months, and the second between ages 4 and 6 years.

In response to a mumps outbreak in the Midwest, college students and health care workers in particular are encouraged to make sure they've had two doses of the MMR vaccine. A single dose doesn't appear to offer sufficient protection during an outbreak. Since the recommendation for a second dose didn't begin until the late 1980s or early 1990s, many young adults may not have received their second dose and should have one now.

Do you need the MMR vaccine?
You don't need a vaccine if you:

• Had two doses of the MMR vaccine after 12 months of age or one dose of the MMR vaccine plus a second dose of measles vaccine
• Have blood tests that demonstrate you're immune to measles, mumps and rubella
• Are a man who was born before 1957
• Are a woman who was born before 1957 and you don't plan to have any more children, you already had the rubella vaccine or you have a positive rubella test

You should get a vaccine if you don't fit the criteria listed above and you:

• Are a nonpregnant woman of childbearing age
• Attend college, trade school or postsecondary school
• Work in a hospital, medical facility, child care center or school
• Plan to travel overseas or take a cruise

The vaccine isn't recommended for:

• Pregnant women or women who plan to get pregnant within the next four weeks
• People who have had a life-threatening allergic reaction to gelatin or the antibiotic neomycin

If you have cancer, a blood disorder or another disease that affects your immune system, talk to your doctor before getting an MMR vaccine.

Side effects of the vaccine
You can't get mumps from the MMR vaccine, and most people experience no side effects from the vaccine. About 25 percent of people feel some aching in their joints, 10 percent develop a fever between five and 12 days after the vaccination, and about 5 percent develop a mild rash. Less than one out of a million doses causes a serious allergic reaction.

Although concerns have been raised about a connection between the MMR vaccine and autism, extensive reports from the American Academy of Pediatrics, the Institute of Medicine and the Centers for Disease Control and Prevention conclude that there's no scientifically proven link between the MMR vaccine and autism. In addition, there's no scientific benefit in separating these vaccines. These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which happens to be about the time children are given their first MMR vaccine. But this coincidence in timing shouldn't be mistaken for a cause-and-effect relationship.

If you or your child has mumps, time and rest are the best treatments. There's little your doctor can do to speed recovery. But you can take some steps to ease pain and discomfort and keep others from becoming infected:

• Rest in bed until the fever goes away.
• Isolate yourself or your child to prevent spreading the disease to others.
• Take acetaminophen (Tylenol, others) or a nonsteroidal anti-inflammatory drug such as ibuprofen (Advil, Motrin, others) to ease symptoms. Adults may also use aspirin. Don't give aspirin to children because of the risk of Reye's syndrome, a rare but potentially fatal disease.
• Use a cold compress to ease the pain of swollen glands.
• Wear an athletic supporter to ease the pain of tender testicles.
• Avoid foods that require lots of chewing. Instead, try broth-based soups or soft foods, such as mashed potatoes or cooked oatmeal, for nourishment.
• Avoid sour foods, such as citrus fruits or juices, that stimulate saliva production.
• Drink plenty of fluids.
• Plan low-key activities.

If your child has mumps, the most important thing you can do is to watch for complications. In boys, watch especially for high fever, with pain and swelling of the testicles. In girls, abdominal pain may mean involvement of the ovaries. Abdominal pain in boys or girls may be a sign of pancreatitis. If your child's fever is very high, contact your doctor for advice.