2015-09-07Staff Report 2 Mumps has been known and treated differently among different culture groups. There has been varying understanding of the disease and its treatment. It used to occur in epidemics but this reduced tremendously with the introduction of the MMR (measles, mumps, rubella) vaccine. Mumps is known as omakuma among the Otjiherero people, okakombo in Oshiwambo, pampoentjies in Afrikaans and mahumunya in Shona, just to mention a few. It presents itself with painful swelling on the side of the face below the ears in the parotids glands. This gives a typical hamster face appearance. It may also present with a headache, joint pains and a high temperature which may develop a few days before the swelling. How is mumps spread? Mumps is a contagious viral infection spread in the same way as colds and flu by droplet spread or by direct contact. The incubation period is 16-18 days but may vary from 14 to 25 days. Usually one may have a prodromal upper respiratory-like infection occurring 1 -2 days before the parotid enlargement. A patient with mumps may then develop enlargement of one parotid gland followed 1-5 days later by enlargement of the other gland. The swelling may start to subside after 4 to 7 days. Prevention of mumps If one has mumps it’s spread can be limited by good hygiene: • regularly wash hands with soap; • use and dispose of tissues when one sneezes; • cover the mouth when coughing; • avoid sharing utensils with an affected person. Avoid going to school or work for at least five days after onset of symptoms. The MMR vaccine gives 95% protection against mumps. This is usually given in two doses, at 15 months and at 5 years. International travellers should always make sure that they are protected. After infection with the mumps virus one normally develops a lifelong immunity. Treatment of mumps Different cultures have developed their own ways of treating mumps. Among the Shona people mumps was treated by tying maize cobs on the swollen glands and keeping the infected person warm and away from others. Some tribes in Namibia would warm maize mealie meal, wrap it in pieces of cloth and sponge the swollen glands. One patient also told me that one may be taken to a kraal where there are goats and one would have to make the sound of a little goat (okakombo). Another version says one actually cries into the mouth of a little goat and the goat cries back. The truth behind the treatment of mumps is that there is currently no cure for it. The infection would pass within one to two weeks. Symptomatic treatment may be used. In the traditional treatments one achievement was to relieve pain by applying warm or cool compressions to the swollen glands. Bed rest and plenty of fluids may be beneficial too, and pain and fever may also be controlled by taking pain killers such as paracetamol and ibuprofen. What to do when suspecting mumps Although mumps is not usually serious it is still important to see your doctor who would confirm the diagnosis and exclude more serious infections such as tonsillitis or glandular fever. The doctor may carry out some laboratory tests to confirm the diagnosis although the clinical presentation may be adequate. Complications of mumps • Orchitis and oophoritis: There may be swelling of the testicle or inflammation of the fallopian tubes in women, causing lower abdominal pain. • Viral menengitis: The virus may spread to cause inflammation of the coverings of the brain and spinal cord. A more rare complication is when the brain itself is affected to cause encephalitis. • Hearing loss: Mumps has been associated with a transient hearing loss although permanent dysfunction may occur. This was more common before the MMR vaccine. • Athralgia: Pain affecting a large joint may develop two weeks after the swollen glands. Other complications which have been noted include an apparent increased risk of miscarriage, which could be attributed to hormonal imbalance. Transient renal dysfunction, thyroiditis, myocarditis, pancreatitis and insulin dependent diabetes are among other complications associated with mumps. Always practise good hygiene and visit your doctor when in suspicion. • Dr Emmanuel Tom is a general practitioner at Wanaheda Medical Centre. He can be contacted at etom@wanmedcentre.com and web www.wanmedcentre.com 2015-09-07Staff Report 2
