Clinical Review

Mumps and the UK epidemic 2005

BMJ 2005; 330 doi: http://dx.doi.org/10.1136/bmj.330.7500.1132 (Published 12 May 2005) Cite this as: BMJ 2005;330:1132
  1. Ravindra K Gupta, specialist registrar1,
  2. Jennifer Best, reader in virology2,
  3. Eithne MacMahon, consultant (eithne.macmahon@gstt.sthames.nhs.uk)1
  1. 1 Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH,
  2. 2 Department of Infectious Diseases, King's College London (Guy's, King's and St Thomas' School of Medicine), St Thomas' Campus, London SE1 7EH
  1. Correspondence to: E MacMahon

    Introduction

    The United Kingdom is in the grip of a nationwide mumps epidemic with almost 5000 notifications in the first month of 2005 alone.1 Most patients are aged between 19 and 23, and there is now the threat of outbreaks among under-immunised children.

    As a result of the measles, mumps, and rubella (MMR) vaccine, which was introduced in 1988, the current generation of practising doctors have little experience of mumps infection. Mumps may have permanent sequelae, and not all cases can be diagnosed clinically. Here we explain the basis of the current epidemic and review the epidemiology, clinical presentation, complications, laboratory confirmation, and treatment of mumps.

    Methods

    We searched Medline for evidence based information on the internet, using a range of search terms. Other internet based resources included the websites of the Health Protection Agency (HPA), the World Health Organization (WHO), and the US Centers for Disease Control (CDC). We also used various formal texts.

    Mumps and its transmission

    Mumps is an enveloped, single stranded RNA virus belonging to the family paramyxoviridae, which causes an acute infectious disease mainly in children and young adults.2 Transmission is by droplet spread, and humans are the only known host. Mumps is highly infectious and spreads rapidly in susceptible people living in close proximity. The number of secondary cases of infection expected to result from an index case of mumps in a fully susceptible population (R0 or basic reproduction number) is 10-12. By comparison, measles—a notoriously infectious virus—has an R0 of 15-17.3

    The incubation period from infection to appearance of the characteristic swelling of the parotid glands is 15-24 days.4 The infectious period starts several days before the onset of parotitis and continues for several days afterwards.4 w1Infection control guidance for schools and nurseries advises that children stay away from school for …

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