By Tedler D. Depaynos, MD
From our old textbook, Mumps is a systemic disease that “produces painful swelling of the parotid gland”. It comes from the British word “mump” which means “grimace”. Perhaps due to the parotid enlargement, the patient appears to be grimacing.
Since it is due to a virus it is referred to sometimes as “viral parotiditis”. The virus is transmitted thru the respiratory system and usually affects children. Incubation period is usually 2 weeks or more or less. The fever which is characterized as moderately high usually last for 3 to 5 days and just like the ordinary “flu”, it is self-limiting. Parotid swelling may occur 2 to 3 days after the start of fever and may peak after 2 to 3 days. It may gradually subside and the swelling may last for a total of 7 to 10 days.
Both parotid glands are usually affected but their swelling may not start at the same time. Likewise, their reduction in size. They may be tender to touch and may cause great discomfort. Eating food that may stimulate salivary secretions like acidic ones may worsen the discomfort. The angle of the jaw may be obliterated and the ear pinna may be pushed backwards.
Basic treatment is just antipyretic and analgesics like the common paracetamol. Sometimes stronger pain killers are added. Anti-viral meds is not even recommended. A lawyer friend once mentioned that during his much younger days he had seen affected classmates with the blue laundry “aniel” and even “mud” or “pitak” in the dialect being applied to their affected parotid glands as home remedy.
Not all patients with the “mumps virus” may have parotid swelling. They may however incur the rare but possible complications like pancreatitis, meningococcemia, arthritis, thyroiditis, mastitis and even renal involvement. Of all the complications, acute orchitis causes the most concern. By statistics one third of patients develop this complication and since most of them are post pubertal males, the concern of sterility which is supposed to be rare causes much worry.
Actually, I suddenly have an unexpected detailed review of this disease when a very young pediatrician joined our table with a bottle of Coke. Although he appeared to be well versed with the disease, he still has a few experience with it because the incidence has been negative for quite some time. Perhaps it was partly due to the immunization that some pediatricians routinely inject to their young patients.
It was his first time to encounter acute orchitis as a complication so that he was curios of my experience knowing that I am two decades older than he is. Have I encountered sterility as a result of this complication? Being a non-pediatrician, the very few cases I encountered and could still remember because they were relatives and children of town mates are all with kids. In short, never! He appeared happy with a smile which made me imagine that perhaps he was reminded that he had this complication when he incurred this disease during his younger days and began to worry because he is about to get married.
