Mumps epidemic

Mumps epidemic (the mumps mumps) - acute, peculiar to children, but often observed in adults infectious disease characterized most often defeat the parotid salivary glands, less submandibular, sublingual and other glandular organs (pancreas, testes, ovaries)and Central nervous system.
Etiology. The causative agent of mumps is a virus Pneumophilus рarotitidis pathogenic for humans and monkeys. Its size varies from 100 to 600 MMK. To identify the virus put reaction of binding complement, delay agglutination and other
Epidemiology. Epidemic parotitis occurs in all latitudes of the globe. Statistical data show that he is on the third place after measles and varicella, exceeding in some years the incidence of the scarlet fever and whooping cough. The source of infection is a sick man. Infection occurs by airborne droplets; not exclude the possibility of infection through household items, toys infected with the saliva of the patient. The virus is found in saliva at the end of the incubation period and in the first 3-8 days of illness. At this time the patients are particularly contagious. The entrance gate infection of the mucous membranes of the upper respiratory tract, where the virus enters the bloodstream and is already the second time is recorded in the salivary glands and other organs. Incidence, as a rule, is an epidemic. The high incidence of falls in the cold season (January-March) and gradually decreases to spring. The emergence of outbreaks contributes to the overcrowding of the population. Outbreaks are limited, often extending beyond the school, kindergarten, creche, residences, houses, apartments, where susceptible persons sick gradually. Especially susceptible children; the highest number of cases occurs at the age of 5-15 years, less likely to get sick infants and adults at the age of 20-30 years. After the disease develops persistent immunity; re diseases occur only rarely.

mumps epidemic (mumps)
Sick of mumps.

The clinical picture. The disease often precedes unclear expressed prodromal period, manifested by General malaise, loss of appetite, headache and redness of the throat. The incubation period lasts from 3 to 35 days, usually from 14 to 21 days.
Onset is typically a sharp increase of temperature to 38-39 degrees and a slight fever. In children, the initial period may be accompanied by repeated vomiting, seizure twitching, meningeal phenomena. At the same time swell up and becomes painful parotid gland is often on one side. After 1-2 days mumps becomes usually bilateral. Marked pains in the parotid region, noise in the ears, the pain when chewing, sometimes when swallowing. Swelling of the parotid salivary gland becomes clearly visible in front of the ear then distribute it to the back and down (at the corner of the lower jaw); earlobe slightly bulged available behind her hole filled, feeling gland becomes slightly painful. Stretched over the affected gland skin is shiny, shiny. The degree of increase glands different from the subtle to significant.
In the center of the enlarged salivary gland has a solid elastic consistence, on the periphery it becomes softer.
For some patients from the region increased submandibular gland in the direction of the ear iradionet acute pain. When bilateral lesions of the parotid glands person gets sick characteristic (Fig.), resulting disease is called "mumps". The patient with a work reveals his mouth, and said in a low voice with a nasal tone. To 4-5th day of illness gland reach the greatest magnitude.
N. F. Filatov has described a few pain points, typical of mumps. Often marked tenderness in front of the ear lobe (on the lower edge of the outer ear canal), in the pit between the front edge of the mastoid process and a branch of the lower jaw.
In addition to the parotid glands, painful process can be involved sublingual and submandibular salivary glands. The total duration of febrile period, typically 3 to 4 days and only in more severe cases it can reach 6-7 days. Fever is usually a permanent type with political downfall. Rising temperatures in the course of the disease is an indicator of complications.
From the side of internal organs expressed pathology is usually not observed.
Of clinical variants of flow mumps deserves special attention orchitis (testicular form of mumps), rarely observed in children and often in adults. As a rule, he joins the mumps on 5-6-th day. By this time the General condition of the patient is noticeably worse, the temperature rapidly increases to 40-41 degrees and soon there acute pain in the testicle, then it is increased in 2-3 times. Scrotal skin redness, swollen; egg sharply painful to the touch.
Rarely observed meningeal or meningoencephalitides form of the disease, representing a complication of mumps or independent disease, caused by his agent, but is not accompanied by the increase in salivary glands.
Note that serous meningitis (see Meningitis), complicating mumps, occurs mainly in children aged 10-12 years. The disease starts acutely: vomiting, sudden headache, fever. Already in the first days of onset occurs meningeal syndrome.
Children often affect the pancreas. Appear sharp pain in the abdomen, constipation or diarrhea, decreased appetite, possible vomiting, are coated and dryness of the language; developing pancreatitis. Symptoms of pancreatitis (see Pancreatitis) are observed in different terms in relation to other manifestations of the disease.
In blood is more likely to occur leukopenia and lymphocytosis; in the first days of illness can leukocytosis. ROE slightly speeded up.
The prognosis isgenerally favorable. Death is a rare exception.
Enlarged salivary glands usually quickly reach normal size, and almost never nagnaivajutsja.
Complications: pleurisy, jade, otitis; in severe cases, arthritis, polyneuritis.
The diagnosis is based on clinical, epidemiological and laboratory data.
Treatment of mumps. Need bed rest, good care and drink plenty of water (tea, juice, mineral water).
Headache used amidopyrine, analgin, acetylsalicylic acid. On the affected gland designate dry heat, sollux, UHF. The mouth after eating rinse with boiled water, weak solution of potassium permanganate, of rivanol, boric acid. Antibiotics and sulfa drugs administered only in the juxtaposition of secondary infection. When meningeal phenomena shown spinal tap, cold in the head and dehydration therapy: intramuscularly 25% solution of magnesium sulfate, intravenous - 20 - 40% glucose with ascorbic acid and vitamin B1.
Prevention of mumps. Patients are isolated in the acute period of the disease.
In case of mumps in children's institution is declared quarantine for 21 days. Children who had contact with the patient at Home, in an institution is not allowed from 11-21-day incubation period. Specific prevention mumps is a live attenuated vaccine once intradermally 0.1 ml or subcutaneously in a dilution of 1 : 5,(0,5 ml).

Mumps epidemic (parotitis epidemica; synonym: the mumps mumps) is a common viral disease affecting mainly the parotid salivary glands.
Etiology. The mumps is part of the kind of paramyxoviruses; its dimensions vary from 100 to 600 MMK. The virions have a spherical shape and consist of a difficult arranged for the nucleocapsid and oil containing shell.
Virus isolated from saliva of patients, usually cultivated in the amniotic cavity 7-8-day-old chick embryos, which opened in 6-7 days after infection, as well as sensitive crops (chicken embryo fibroblasts, some primary and human cultures received from the tissue of humans and monkeys). In the process of reproduction of the virus mumps forms eosinophilic cytoplasm on and causes the formation of multi-core cells (simpleton).
The virus differs pronounced hemagglutinins and hemosiderosis activity against the red blood cells of mammals and birds. All known strains it belong to one antigenic type; antigenic structure stable.
The virus entered in the " pinhole cameras " duct or directly into the parotid gland monkeys, causing the disease resembling mumps person. Virulent it is for suckers rats, mice and ferrets.
To identify the virus put reaction of binding complement, delay agglutination and other
Complementative antibodies are determined in the blood of patients a week after the occurrence of the first clinical symptoms of the disease.
Epidemiology. Mumps epidemic spread around the globe and is ranked third after measles and varicella, exceeding in some years, the incidence of scarlet fever and whooping cough. The source of infection is a sick person. The disease is transmitted by droplets; not exclude the possibility of infection through household items, toys infected with the saliva of the patient. The virus is found in saliva at the end of the incubation period and in the first 3-8 days of illness. At this time the patients are particularly contagious. Incidence, as a rule, is an epidemic. The high incidence of falls in the cold season (December - March) and gradually decreases to spring. Summer is marked only sporadic cases.
The disease contributes to the overcrowding of the population. So, epidemic outbreaks are possible in the barracks, ships, schools, kindergartens, creche. Outbreaks are often local - confined to one residences, houses, apartments, where the incidence is spreading gradually. Especially susceptible children, the largest number of cases occurs at the age of 7-8 years. A significant percentage of people to cope with the illness in childhood, often in the form of light. However, there may be sick and adults. Mumps epidemic leaves behind a strong immunity: re diseases are rare.
Pathological anatomy. Parotid gland with mumps swollen, red-blooded, with point hemorrhages on the cut. Microscopic examination of visible characteristic of this disease mononuclear, mainly lymphoid, infiltrates around glandular cells and ducts (with the vulgar mumps exudate located mostly in the ducts). In the glandular epithelium observed dystrophic changes until necrosis of individual cells; in the Lumina ducts gross secret, in adults with admixture of white blood cells. Purulent inflammation of the salivary glands for mumps is not typical.
Orchitis is more likely to occur in young men; the characteristic features of its focal lymphoid interstitial infiltrates and dystrophic changes in the cells of the seminiferous tubules. In severe cases, the process falls in a diffuse interstitial inflammation with extensive foci of necrosis, which may lead to sclerosis and testicular atrophy. Oophoritis, occurs less frequently. Similar, mainly interstitial, inflammatory processes in mumps can be in the pancreas, the thyroid, thymus, and the breast, liver, kidneys and heart.
Encephalitis is characterized by the swelling of soft meninges and the brain. In cerebral membranes can be dotted haemorrhage. Microscopic examination reveal lymphoid infiltrates and serous or sero-fibrinous exudate. Encephalitis in mumps has no special features. In the white matter of the brain are swelling, perivascular lymphoid infiltrates, foci of demyelination; in nerve cells - secondary degenerative changes. Sometimes the disease is complicated by the serous labyrinthitis.