eMedicine Specialties > Emergency Medicine > Pediatric

Pediatrics, Mumps: Follow-up

Author: Eileen C Quintana, MD, Assistant Professor, Departments of Pediatrics and Emergency Medicine, St Christopher's Hospital for Children
Coauthor(s): Hosseinali Shahidi, MD, MPH, Assistant Professor, Departments of Emergency Medicine and Pediatrics, State University of New York and Health Science Center at Brooklyn
Contributor Information and Disclosures

Updated: Jul 9, 2009

Follow-up

Further Inpatient Care

  • Admit patients with mumps to the pediatric floor if signs of toxicity or dehydration are present.

Further Outpatient Care

  • Arrange for a follow-up visit with the primary care physician within 1-2 days.

Deterrence/Prevention

  • Droplet precautions are recommended until 9 days after the onset of parotid swelling.
    • Children should be excluded from school and childcare centers for 9 days from the onset of parotid gland swelling.
    • If outbreaks occur in the school or childcare center, all should be vaccinated.
    • Those who have been exempted from vaccination for medical, religious, or other reasons should be excluded from school or day care until at least 26 days after the onset of parotitis in the last person with mumps in the affected school.

Complications

Prognosis

  • Most patients completely recover.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider the highly infectious nature of the disease (eg, protection of others, removal from day care)
  • In 2007, after a review of evidence, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) changed their recommendation from 9-day isolation guidance (standard precautions and droplets precautions) to 5 days after the onset of parotitis.12
  • Failure to consider other sources if the patient presents with meningoencephalitis

Special Concerns

  • Lifelong immunity usually follows clinical or subclinical infection, although second infections have been documented.
  • Transplacental antibodies seem effective in protecting infants during their first 6-8 months of life.
  • Infants born to mothers who have mumps in the week prior to delivery may have clinically apparent mumps at birth or develop illness in the neonatal period.
  • The severity ranges from mild parotitis to severe pancreatitis.
  • The serum neutralization test is the most reliable method for determining immunity.
 


More on Pediatrics, Mumps

Overview: Pediatrics, Mumps
Differential Diagnoses & Workup: Pediatrics, Mumps
Treatment & Medication: Pediatrics, Mumps
Follow-up: Pediatrics, Mumps
References
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References

  1. CDC. Revised U.S. surveillance case definition for severe acute respiratory syndrome (SARS) and update on SARS cases--United States and worldwide, December 2003. MMWR Morb Mortal Wkly Rep. Dec 12 2003;52(49):1202-6. [Medline].

  2. MMWR Morb Mortal Wkly Rep. Severe acute respiratory syndrome (SARS) and coronavirus testing--United States, 2003. MMWR Morb Mortal Wkly Rep. Apr 11 2003;52(14):297-302. [Medline].

  3. Dobson R. Mumps cases rise among teenagers and young adults. BMJ. Jul 17 2004;329(7458):132. [Medline].

  4. Kancherla VS, Hanson IC. Mumps resurgence in the United States. J Allergy Clin Immunol. Oct 2006;118(4):938-41. [Medline].

  5. Koskiniemi M, Donner M, Pettay O. Clinical appearance and outcome in mumps encephalitis in children. Acta Paediatr Scand. Jul 1983;72(4):603-9. [Medline].

  6. Committee on Infectious Diseases, American Academy of Pediatrics. Report of the Committee on Infectious Diseases. In: Red Book. 2003:439-443.

  7. Hashimoto H, Fujioka M, Kinumaki H. An office-based prospective study of deafness in mumps. Pediatr Infect Dis J. Mar 2009;28(3):173-5. [Medline].

  8. Niizuma T, Terada K, Kosaka Y, Daimon Y, Inoue M, Ogita S, et al. Elevated serum C-reactive protein in mumps orchitis. Pediatr Infect Dis J. Oct 2004;23(10):971. [Medline].

  9. [Guideline] Averhoff FM, Williams WW, Hadler SC. Immunization of adolescents: recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association. J Sch Health. Sep 1997;67(7):298-303. [Medline].

  10. CDC Immunization Schedules. Last updated March 2009. United States Centers for Disease Control and Prevention. Available at http://www.cdc.gov/vaccines/recs/schedules/default.htm.

  11. MMWR Morb Mortal Wkly Rep. Recommended immunization schedules for persons aged 0 through 18 years --United States, 2009. MMWR Morb Mortal Wkly Rep. Jan 2 2009;57(51):[Full Text].

  12. [Guideline] CDC. Updated recommendations for isolation of persons with mumps. MMWR Morb Mortal Wkly Rep. Oct 10 2008;57(40):1103-5. [Medline].

  13. Gilgen-Anner Y, Heim M, Ledermann HP, Bircher AJ. Iodide mumps after contrast media imaging: a rare adverse effect to iodine. Ann Allergy Asthma Immunol. Jul 2007;99(1):93-8. [Medline].

  14. Gold E. Almost extinct diseases: measles, mumps, rubella, and pertussis. Pediatr Rev. Apr 1996;17(4):120-7. [Medline].

  15. Hinman A. Eradication of vaccine-preventable diseases. Annu Rev Public Health. 1999;20:211-29. [Medline].

  16. MMWR Morb Mortal Wkly Rep. Status report on the Childhood Immunization Initiative: reported cases of selected vaccine-preventable diseases--United States, 1996. MMWR Morb Mortal Wkly Rep. Jul 25 1997;46(29):665-71. [Medline].

  17. Phillips C, Behrman RE, Vaughan VC, eds. Mumps. In: Nelson's Textbook of Pediatrics. 13th ed. 1987:673-5.

  18. Sherris JC, Ryan KJ, eds. Mumps. In: Medical Microbiology: An Introduction to Infectious Diseases. 2nd ed. 1994:517-9.

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Further Reading

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Keywords

mumps, mumps virus, MMR, parotitis, epidemic parotiditis, measles-mumps-rubella vaccine, MMR vaccine, paramyxovirus, viremia, viruria, viral pediatric disease, live-attenuated mumps virus vaccine, meningoencephalitis, parotid gland enlargement

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Contributor Information and Disclosures

Author

Eileen C Quintana, MD, Assistant Professor, Departments of Pediatrics and Emergency Medicine, St Christopher's Hospital for Children
Eileen C Quintana, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Hosseinali Shahidi, MD, MPH, Assistant Professor, Departments of Emergency Medicine and Pediatrics, State University of New York and Health Science Center at Brooklyn
Hosseinali Shahidi, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, and American Public Health Association
Disclosure: Nothing to disclose.

Medical Editor

Garry Wilkes, MBBS, FACEM, Director of Emergency Medicine, Bunbury Hospital, Western Australia; Medical Director, St John Ambulance, WA Ambulance Service; Adjunct Associate Professor, Edith Cowan University; Clinical Associate Professor, Rural Clinical School, University of Western Australia, Australia.
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Grace M Young, MD, Associate Professor, Department of Pediatrics, University of Maryland Medical Center
Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Richard G Bachur, MD, Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston
Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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