Mumps Virus

Diagnosis

Indications for Testing

  • Atypical presentation of secondary complications from suspected mumps
  • Epidemiologic evidence during suspected outbreak

Laboratory Testing

Differential Diagnosis

Clinical Background

Mumps is an acute, contagious disease of short duration, usually self-limiting, and characterized by swelling of the parotid gland.

Epidemiology

  • Prevalence – multiple outbreaks since 2003, each involving >1,000 people
  • Age – highest incidence at 16-24 years
  • Transmission
    • Highly contagious and transmitted by droplets spread from the upper respiratory tract

Organism

  • Paramyxoviridae family; Rubulavirus genus
  • Single-stranded RNA virus
  • Immunity after infection appears to be lifelong
    • Silent reinfection occurs infrequently

Clinical Presentation

  • Incubation period – 18-21 days
    • 25-30% of all infections are silent
  • Most common clinical feature is bilateral or unilateral parotitis (60-70% of infections)
  • Secondary complications can involve the following
    • Testes (orchitis)
      • Orchitis, particularly in teenagers, can lead to decreased fertility or infertility
    • Ovaries (oophoritis)
    • Central nervous system – aseptic meningitis, encephalitis
    • Rare – pancreatitis, peripheral neuritis, uveitis, otitis, myocarditis

Treatment

  • Supportive

Prevention

  • Vaccination with MMR vaccine (75-90% effective)
  • Mumps is uncommon in the U.S.; secondary to current vaccination programs
  • Administer vaccine to infants (age 12-15 months) with revaccination during childhood (age 4-12 years)
  • Since vaccine is live, attenuated virus, vaccination is not recommended for patients who are
    • Significantly immunosuppressed (eg, HIV, cancer, chronic corticosteroid therapy)
    • Allergic to gelatin (component of the vaccine)
    • Pregnant

Indications for Laboratory Testing

  • Tests generally appear in the order most useful for common clinical situations
  • Click on number for test-specific information in the ARUP Laboratory Test Directory
Test Name and Number Recommended Use Limitations Follow Up
Mumps Virus Culture 0065056
Method: Cell Culture/Immunofluorescence

Confirm mumps infection

Collect during first 3 days of illness; if collecting urine, collect first morning void

   
Mumps Virus Antibody, IgM 0099589
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Confirm acute infection

IgM and IgG testing best performed with paired specimens

Testing immediately post-exposure is of no value without a later convalescent specimen

If equivocal, repeat testing in 10-14 days may be helpful

Mumps Virus Antibody, IgG 0050390
Method: Semi-Quantitative Chemiluminescent Immunoassay

Determine patient's immune status to mumps

IgM and IgG testing best performed with paired specimens

If equivocal, repeat testing in 10-14 days may be helpful

Mumps Virus RNA Qualitative, Real-Time PCR 2009387
Method: Qualitative Real-Time Polymerase Chain Reaction

Can be used for molecular confirmation of mumps infection

   
Additional Tests Available
 
Click the plus sign to expand the table of additional tests.
Test Name and NumberComments
Mumps Virus Antibody IgM, CSF 0054443
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Confirm mumps as the etiology of meningoencephalitis

Mumps Virus Antibody IgG, CSF 0054442
Method: Semi-Quantitative Chemiluminescent Immunoassay

Confirm previous episode of mumps meningoencephalitis

Encephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, CSF 2008916
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay
Encephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, Serum 2008915
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay
Viral Culture, Respiratory 2006499
Method: Cell Culture