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Mumps

• Signs and Symptoms
• What Causes It?
• Who's Most At Risk?
• What to Expect at Your Provider's Office
• Treatment Options
• Prognosis and Possible Complications
• Supporting Research

Mumps is a highly contagious viral disease that causes painful swelling of the parotid glands (the largest of the three major salivary glands, located in the cheeks). The disease usually strikes children and adolescents. It is generally self-limited, which means that the virus usually clears up completely after running its course without long-term complications. Prior to the introduction of a mumps vaccine in 1967, about half of all children contracted mumps. Since then, the incidence of the disease has decreased about 99% in the United States, with only around 1,500 cases reported each year. A person develops lifelong protection against mumps after having the disease one time.

Signs and Symptoms

Mumps is accompanied by the following signs and symptoms:

• Swelling of the salivary glands in the face and jaw line
• Fever, chills, headache, loss of appetite, and a general feeling of discomfort
• Pain when chewing or swallowing
• Orchitis, or inflammation of the testicles (in up to 25% of males who get the disease after they reach puberty)

Symptoms usually start 14 - 24 days after infection with the virus.

What Causes It?

Mumps is caused by a virus ( paramyxovirus ) spread through infected saliva. Most symptoms are the result of direct infection of the salivary glands, testes, pancreas, eyes, ovaries, or kidneys. The nervous system may be involved as well.

Who's Most At Risk?

People who are not immunized, particularly children and adolescents, are at risk for developing mumps. Mumps occur most often in children between the ages of 5 - 9.

What to Expect at Your Provider's Office

If you are experiencing symptoms associated with mumps, you should see your health care provider. Your health care provider will check for swelling in the facial region, especially below the ear and above the jaw. Lab tests using samples from the throat, cerebrospinal fluid, blood, or possibly urine can reveal the presence of the virus. Routine hearing tests on young children can detect any temporary or, rarely, permanent loss.

Treatment Options

Prevention

Vaccination is the key to preventing mumps. The live mumps virus is about 95% effective in preventing the disease. The vaccine is available alone or in the combination vaccine of measles-mumps-rubella (MMR), and usually lasts at least 20 years with very few side effects. It is generally given at age 15 months, but may be given to adolescents and adults as well. Women should not be vaccinated during pregnancy, and people with severe fever or allergies to eggs will need to discuss vaccination with their health care provider.

Treatment Plan

If you have mumps, you should be kept out of school or work for 7 - 10 days after symptoms begin, as you are considered highly contagious during that period. You should eat soft foods, avoid acidic foods and beverages, such as citrus or tomato products, and take pain relievers as needed. A male with swollen testicles should rest in bed until symptoms subside. Pain may be relieved with ice packs, or by supporting the scrotum with cotton or gauze, or an athletic supporter. A health care provider may perform a hearing test on young children who develop mumps, to detect any possible loss of hearing. If the patient develops pancreatitis (inflammation of the pancreas) with nausea and vomiting, the provider may administer IV fluids. Please see the monograph on Pancreatitis for further information.

Drug Therapies

No medications other than pain relievers are needed for uncomplicated cases of mumps.

Complementary and Alternative Therapies

The mumps virus normally resolves on its own, and treatment is meant to relieve symptoms. Acupuncture may help clear up mumps faster. Other CAM therapies may also support recovery by reducing symptoms.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

• Avoid acidic foods, such as eggs and dairy products (such as cheese and sour cream), meats, grains (such as rice, wheat, and oats), nuts, and chocolate.
• Avoid refined foods, such as white breads, pastas, and sugar.
• Use healthy cooking oils, such as olive oil or vegetable oil.
• Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid coffee and other stimulants, alcohol, and tobacco.
• Drink 6 - 8 glasses of filtered water daily.

You may address nutritional deficiencies with the following supplements:

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources.
• Probiotic supplement (containing Lactobacillus acidophilus ), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
• Resveratrol (from red wine), 50 - 200 mg daily, for antioxidant and immune effects.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

• Green tea ( Camellia sinensis ) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Reishi mushroom ( Ganoderma lucidum ), 150 - 300 mg two to three times daily, for antiviral and immune activity. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
• Elderberry ( Sambucus nigra) extract, 1 tablespoonful two times daily, for antiviral and immune support. Ask your health care provider about dosing for your children.
• Cat's claw ( Uncaria tomentosa ) standardized extract, 20 mg three times a day, for inflammation and antiviral activity.
• Bromelain ( Ananas comosus ) standardized, 40 mg three times daily, if needed for pain and inflammation.

Soothing herbal teas may help decrease pain and swelling, such as chamomile ( Matricaria chamomilla ), licorice ( Glycyrrhiza glabra ), and marshmallow ( Althea officinalis ).

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for mumps based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

• Aconitum -- useful for childhood illnesses including the mumps, particularly when onset is sudden and the individual has a fever.
• Belladonna -- most common treatment for mumps, particularly if it comes on rapidly.
• Mercurius -- for mumps with swelling that is worse on the right side, excessive foul-smelling perspiration and salivation.
• Phytolacca -- for mumps in which glands feel swollen and hard.
• Pilocarpinum --for mumps with excessive perspiration and salivation, as well as considerable thirst. This is considered by some homeopaths to be the best remedy for this purpose.
• Pulsatilla -- for the later stages of mumps, especially in adults or children approaching puberty.
• Rhus toxicodendron -- for mumps with swelling that is worse on the left side.

Acupuncture

Acupuncture may make mumps less severe and shorten its course. However, it is difficult to test such claims since the mumps infection normally resolves on its own within 7 - 14 days.

Prognosis and Possible Complications

For uncomplicated cases of mumps, the prognosis is excellent. Complications are more likely in people who have reached puberty and beyond. These may include meningoencephalitis (inflammation of the brain and its membranous coverings), deafness, orchitis, pancreatitis, and miscarriage in early pregnancy.

Supporting Research

Advisory Committee on Immunization Practices (ACIP). Mumps Prevention. MMWR Morb Mortal Wkly Rep. 1989;38(22):388-392, 397-400.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy . Whitehouse Station, NJ: Merck & Co.; 1999:2325-2327.

Bhat KPL, Kosmeder JW 2nd, Pezzuto JM. Biological effects of resveratrol. Antioxid Redox Signal. 2001;3(6):1041-64.

Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs . Newton, Mass: Integrative Medicine Communications; 2000:458-459.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr . 2006;25(2):79-99.

Clancy RL, Gleeson M, Cox A, et al. Reversal in fatigued athletes of a defect in interferon gamma secretion after administration of Lactobacillus acidophilus. Br J Sports Med . 2006;40(4):351-4.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3 ^rd ed. New York, NY: Penguin Putnam; 1997.

Dong GR, Zhang Y, Yan YX. Bilateral Taichong and Hegu in treatment of mumps: an observation of 108 cases. Int J Clin Acupunct . 1995;6(1):65-66.

Eo SK, Kim YS, Lee CK, Han SS. Antiviral activities of various water and methanol soluble substances isolated from Ganoderma lucidum. J Ethnopharmacol . 1999;68(1-3):129-36.

Hale LP, Greer PK, Trinh CT, James CL. Proteinase activity and stability of natural bromelain preparations. Int Immunopharmacol . 2005;5(4):783-93.

LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide . Hudson, OH:LexiComp; 2000: 452-454.

Maceoin D, Cope E. A hearing for an alternative approach to vaccine. Guardian . October 19,1988.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms . Albany, Calif: Hahnemann Clinic Publishing; 1993:3-7, 58-62, 297-299, 310-315.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin . 2001;17(1):239-47.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr . 2002;21(6):495-505.

Song GY. 1000 cases of mumps treated with ear needling on Pingjian point (MA-T2). J Tradit Chin Med. 1989;9(1):14.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs . 2000;9(9):2103-19.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J . 2005;46(5):585-96.

Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res . 2004;32(2):132-40.

• Review Date: 9/6/2006
• Reviewed By: Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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