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Stephanie Miau

BIO 260

Professor Matthew Legter

07/28/18

All About Mumps

The mumps virus was first described over two thousand years ago. It was first discovered by Hippocrates in the fifth century BC and a vaccine in the United States was first put into use in the late 1960s. Although there is a vaccine available to help eliminate this virus, it has been a roller coaster of events through these cases. In the 1980s, there very few cases reported. In 2001, the disease was almost seen to eliminated! This was seen not only  in the United States, but also in other countries through vaccination. After years with little to no cases about the mumps disease, the mumps outbreaks began to appear globally (Rubin, 2015). Between the years of 2005-2010, there were more than 560,000 cases reported globally. The re emergence of mumps can be argued on different reasons but reasons like waning immunity and vaccine efficacy are examples of how there have been continuous mumps outbreaks. The definition of the term waning immunity is best summarized as protective antibodies losing its ability to protect against a disease (Waning, 2009). Vaccine efficacy also brought up safety concerns because it was found that there are some vaccine strains that lead to meningitis. This was seen in Japan, where the mumps vaccination is removed and now Japan has the highest rate of mumps annually in a developing country (Rubin, 2015). This is another contributor to the re emergence of mumps because the virus is more likely to spread globally with the ability to travel globally.  

Mumps Virus

Shreve (2018) defined the make up of mumps as “mumps is caused by a paramyxovirus, which is a single-strand RNA virus in the Rubulavirus genus in the family Paramyxoviridae, order Mononegavirales”. Other paramyxoviruses that also belong to the paramyxoviridae family are the parainfluenza virus, measles virus, respiratory syncytial virus, and human metapneumovirus. This virus in an animal only virus and is unable to replicate with things other than a living animal cell. Mumps is made up of seven major proteins, and the major antigens are glycoproteins V and F antigen, and a nucleocapsid protein S antigen (Choi, 2010).

Transmission, Complications, Treatment

The mumps virus is highly, highly contagious. It is spread by respiratory droplets or saliva and has an incubation period of a maximum amount of 25 days. This makes it extremely tricky because it is possible to not show symptoms for 25 days from when someone is first exposed to the virus (Mumps, 2017). One-third to one-half of the mumps virus is also be seen to be asymptomatic, so it really ranges with the mumps virus. The start of mumps starts out with non specific signs and symptoms. Some symptoms can include a fever, headache, vomiting, tiredness, and muscle aches. Mumps is typically diagnosed by these symptoms but virus isolation using saliva, CSF, or seminal fluid can be collected the first three days of illness to confirm the diagnosis of mumps. The biotechnology method used to detect the mumps virus is RT-PCR (Choi, 2010). RT-PCR stands for Reverse Transcription Polymerase Chain Reaction where a RNA molecule is converted to its complementary DNA ( ).The symptoms can last for one to two days and then the parotid gland will start to enlarge. In humans, the parotid gland is on each side of the mouth and in front both ears (Harvard, 2012). The swelling can last for one to three days and will gradually decrease by seven days (Choi, 2010). If there is a manifestation of mumps, the sublingual glands can also be impacted. The sublingual glands is another salivary gland and it is located beneath the tongue (Harvard, 2012). Located other than the salivary glands, a complication that is also very common is orchitis  (Shreve, 2018). Orchitis is the swelling of one of both testicles and is commonly seen with young pubertal and postpubertal males (Orchitis, 2014). As for postpubertal women, oophoritis has also been associated with mumps. Oophoritis is the swelling of the ovaries and occurs less so than orchitis (Gill, 2017). Treatment for this virus are over the counter anti inflammatory drugs that will reduce fevers, drinking liquids to avoid dehydration, and using heat or ice that can help with the pain if there happens to be swelling in the parotid gland (Shreve, 2018).

Prevention

The most important way to prevent mumps is through vaccination. When the vaccine was first created, there was only a need for a 1-dose protocol. This had an efficacy rate of immunity of 78%. In 1989, it was seen that a 1 dose protocol was unable to provide the adequate protection for mumps hence, the need to have a 2-dose protocol. This 2-dose protocol  was combined with the measles and rubella vaccines, creating the MMR (Measles, Mumps, Rubella) vaccine and increasing the efficacy rate to 88% (Shreve, 2018).  As more and more outbreaks popped up globally, it was recognized that two doses may not be effective for lifetime immunity. This is best described as waning immunity, protective antibodies losing its ability to protect against a disease (Waning, 2009). With the realization that lifetime immunity from mumps is not realistic, there has been a booster shot that has been created for people that are at an increased exposure to mumps (Shreve, 2018). Even though the two doses cannot guarantee lifetime immunity for mumps, it is still very important to complete both vaccinations. The first dose is typically completed at about 12 months old, and the second dose around four to six years old. People that have received both do have a lower risk at complications.

Importance of Mumps

In the United States, many of the mumps outbreak are centered around school-age and college students. This seems to be the case because there are increased opportunities for closer contact and exposure to the virus. With this in mind, it is, once again, extremely important to complete the two dose vaccination for mumps also because the vaccine strains in the United States have not been found to lead to other complications. It is also important to receive these vaccines because some individuals have life-threatening reactions to components of the MMR vaccine that aren’t able to receive this vaccine, making this population more susceptible to the mumps. Some other populations that are also susceptible to the mumps virus is babies less than a year old and children over one year of age who have received only one dose of the MMR (Mumps, 2017).

Moving Forward

1.   Summarize all the main points of the article.  You must explain all concepts

and define unfamiliar terms.

2.   Provide any relevant background information using secondary references

3.   Discuss why the issue is interesting and important.

4.   Address current and future implications and/or related questions.

Bibliography

Choi, K. M. (2010). Reemergence of mumps. Korean Journal of Pediatrics, 53(5), 623–628.

http://doi.org/10.3345/kjp.2010.53.5.623

Gill, K. (2017). Oophoritis: Symptoms, Causes, and More. Retrieved from

https://www.healthline.com/health/womens-health/oophoritis

Harvard Health Publishing. (2012). Salivary Gland Disorders - Harvard Health.

Retrieved from https://www.health.harvard.edu/diseases-and-conditions/salivary-gland-disorders-

Mumps: Guidance for the Greek Community. (2017). Retrieved from

http://depts.washington.edu/hhpccweb/mumps-greek/

Orchitis. (2014). Retrieved from

https://www.mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860

Quinlisk, M., (2010). Mumps Control Today. The Journal of Infectious Diseases, Volume 202,

Issue 5, 655-656. https://doi.org/10.1086/655395

Rubin, S., Eckhaus, M., Rennick, L. J., Bamford, C. G., & Duprex, W. P. (2015). Molecular

biology, pathogenesis and pathology of mumps virus. The Journal of Pathology, 235(2),

242–252. http://doi.org/10.1002/path.4445

Shreve, M., Mcneill, C., & Jarrett, A. (2018). Mumps: A Call for Vigilance. The Journal for

Nurse Practitioners, 14(2), 81-87. doi:10.1016/j.nurpra.2017.11.017

Waning immunity. (n.d.) Medical Dictionary. (2009). Retrieved from

https://medical-dictionary.thefreedictionary.com/waning+immunity

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