Mumps
Mumps is a viral infection that inflames the salivary glands. The face swells in front of the ears and under the jaw, the jawline disappears and the neck…
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Mumps is a viral infection that inflames the salivary glands. The face swells in front of the ears and under the jaw, the jawline disappears and the neck looks broader. In most people it settles on its own within two weeks, but in teenagers and adults it causes complications considerably more often, which is why it is worth recognising early rather than carrying on as usual.
What mumps looks like
The main sign is a painful swelling of the cheek in front of the ear and below the earlobe, building up over a few days. It usually starts on one side and reaches the other a day or two later; in roughly one person in four it stays on one side only. The earlobe seems to lift away and the angle of the jaw can no longer be felt.
Because of this the ear aches, chewing and swallowing become difficult and speech is less clear. Anything sour makes the pain shoot through the gland: lemon, juice, vinegar. Sour food drives saliva production up, and the saliva has nowhere to drain.
Along with the swelling, or a couple of days before it, there may be:
- a raised temperature, usually moderate;
- headache and aching muscles;
- tiredness and a wrung-out feeling;
- a dry mouth;
- loss of appetite.
Two to three weeks normally pass between catching the virus and the first signs, so it is not always possible to work out where it came from. A person becomes infectious a few days before the swelling and stays infectious for about five days after it appears. Quite often the infection is mild or causes no symptoms at all, and it still spreads.
Looks like mumps but may not be
Swelling in that area has several causes, and the difference matters, because some of them need an antibiotic or an operation.
- Inflamed lymph nodes from tonsillitis or a dental infection: the node feels like a separate firm lump below and behind the angle of the jaw, not a diffuse swelling in front of the ear.
- Bacterial infection of the salivary gland: the skin over it is red and hot, the fever is high, and pressing on the gland pushes pus out of the duct inside the mouth. This does need antibiotics.
- A stone in the salivary duct: the swelling appears while eating and goes down afterwards, over and over again.
- A dental abscess, an ear infection and, less often, a tumour of the gland if the swelling lasts for weeks and does not hurt.
- Other viruses inflame the salivary glands too, including influenza and Epstein-Barr virus.
Mumps is unlikely if you have had two doses of the measles, mumps and rubella vaccine or have had mumps before. It cannot be ruled out entirely: vaccinated people occasionally catch it, but have a milder illness.
What to do if you suspect it
Contact a doctor rather than turning up unannounced in a crowded waiting room: the infection travels through the air and the clinic needs to know in advance. The first conversation is often held by phone or online.
The diagnosis is confirmed in the laboratory: a swab from inside the mouth by the opening of the gland's duct, or a saliva sample for PCR, and sometimes a blood test for antibodies. This is not a formality. In most countries mumps is a notifiable infection, and the confirmation decides whether the people around you are tested and offered vaccination.
Antibiotics do nothing against the virus. They are prescribed only when the gland turns out to be infected by bacteria or another infection has joined in.
Tell the doctor explicitly if you are pregnant, if your immune system is weakened by illness or treatment, and also if the swelling has appeared in a teenage boy or an adult man: in these groups the illness tends to be harder.
Easing it at home
There is no medicine against the virus itself; treatment is about getting through the week and a half or two more comfortably.
- Rest, and drink often: water, weak tea, anything that is not acidic. Dehydration comes on faster than expected when swallowing hurts.
- Eat soft food: purées, porridge, soup, yoghurt. Avoid sour and spicy food and anything that needs a lot of chewing.
- Hold a warm towel against the cheek, or a cool compress instead, whichever eases your pain better.
- Rinse your mouth with warm water often and keep brushing your teeth: stagnant saliva invites infection.
- Paracetamol or ibuprofen will bring down fever and pain. Ibuprofen and the other anti-inflammatory drugs in its group are not taken if there is a stomach ulcer, kidney disease or significant dehydration, nor alongside another drug of the same class; if you have long-term conditions or already take medication, check the choice with a doctor.
- Aspirin is not given to children and teenagers: in them it has been linked to a rare but severe illness affecting the liver and brain during a viral infection.
How to avoid passing it on
The virus spreads in droplets of saliva when coughing, sneezing and talking, and through shared cups and cutlery.
- Stay at home for at least five days from the start of the swelling, do not go to work and keep children away from school or nursery.
- Wash your hands with soap, cough and sneeze into a tissue and throw it away straight afterwards.
- Do not share cups, spoons, bottles, towels or bedding.
- Warn anyone you have been close to, especially the unvaccinated, pregnant women and people with weakened immunity: they may need medical advice.
How mumps can turn serious
Most people recover with no lasting effects, but complications happen, and nearly all of them are commoner in teenagers and adults than in young children.
- Inflammation of the testicle, the most frequent complication in males after puberty. It usually starts a few days after the face swells: the testicle becomes sharply painful and enlarged and the temperature rises. Usually only one is affected. A noticeable drop in fertility is uncommon and infertility is rare, but the condition itself is very painful and needs to be examined.
- Inflammation of an ovary or of breast tissue in women: pain low in the abdomen, tender breasts.
- Inflammation of the membranes around the brain. It is usually mild and clears without trace, but it presents as genuine meningitis and needs urgent assessment. Inflammation of the brain itself is rare but dangerous.
- Inflammation of the pancreas: severe pain high in the abdomen spreading to the back, with vomiting.
- Hearing loss, usually in one ear and temporary; permanent deafness on one side is rare but does not recover.
- In the first three months of pregnancy the infection raises the risk of miscarriage. Mumps does not cause birth defects.
When urgent help is needed
Call an ambulance (112 across much of Europe) if the person has:
- a very severe headache together with vomiting;
- a stiff neck and discomfort on looking at light;
- confusion, unusual drowsiness or delirium;
- a seizure;
- loss of consciousness;
- a rash of small bleeding spots that does not fade when pressed.
Do not drive yourself: ask someone to take you or wait for the ambulance. Bring a list of the medicines you take.
See a doctor the same day if there is sudden pain and swelling of a testicle, severe pain high in the abdomen with vomiting, a sudden drop in hearing, if a child refuses to drink and is barely passing urine, and also if the fever lasts more than a week or the swelling turns red and hot instead of going down.
Vaccination is the surest protection
The combined vaccine against measles, mumps and rubella protects against mumps. The first doses are given in the first or second year of life, with a further dose afterwards; the exact timing is set by the national schedule of the country where you live, and it is best confirmed with your own doctor.
Two doses give good and long-lasting protection, though not absolute: vaccinated people do occasionally catch mumps, but the illness is milder and complications are less likely. Adults who were neither vaccinated nor infected in childhood can have the doses at any age, which is particularly sensible before travelling, before starting a course of study, or when working with children or in healthcare.
This is a live vaccine, so it is not given during pregnancy or with significant immune suppression; anyone planning a pregnancy is vaccinated beforehand. An allergy to a vaccine component is also a reason to discuss it separately with a doctor.
Online consultation
A remote appointment suits this situation particularly well: leaving the house with a contagious infection is unwise, and questions start on day one. From your description and a photograph the doctor will judge whether this looks like mumps or more like an inflamed lymph node, a dental infection or a duct stone, will say which test is needed and how to have it done without infecting a waiting room, will go through pain relief in the light of your long-term conditions, and will list the signs that mean going to hospital immediately.
Vaccination is worth covering in the same conversation: what you and your children have had, whether an adult needs a dose, what contacts should do. Have ready the dates your symptoms started, temperature readings, a list of medicines and any vaccination records you have. A face-to-face examination will be needed for testicular pain, signs of meningitis or severe abdominal pain.
This material is for information only and does not replace medical advice.
Consult with a doctor about Mumps
Discuss your symptoms and possible next steps with a doctor online.
Online doctors for Mumps
Discuss your symptoms and possible next steps for Mumps with a doctor online.
