Even though they might never have had or seen a kid with mumps, most people know the tell-tale signs and symptoms.
But mumps isn’t the only thing that causes parotitis, especially in the post-vaccine era.
Does Your Child with Parotitis Have Mumps?
So having parotitis doesn’t automatically mean that you have mumps.
“Mumps is diagnosed by a combination of symptoms and physical signs and laboratory confirmation of the virus, as not all cases develop characteristic parotitis and not all cases of parotitis are caused by mumps.”
Mumps Questions and Answers
What else can cause parotitis?
- bacterial infections, including Staphylococcus aureus, especially when the swelling is just on one side of the child’s face
- blockage of the salivary gland because of a stone in the duct that drains the glands (sialadenitis), again, would be more common on just one side of the child’s face
- viral infections, including adenovirus, Epstein-Barr virus (EBV), CMV, coxsackie A virus, HHV-6, influenza A, parainfluenza virus types 1, 2 and 3, and echovirus
- less common causes in children might include medications, benign and malignant tumors, and immunologic diseases
There are even case reports of the SARS-CoV-2 virus causing parotitis.
“In conclusion, parotid inflammation might be encountered in COVID-19 patients and could be related to intraparotid lymphadenitis. Even in persons vaccinated against mumps, testing for viruses that cause a parotitis-like illness is important, including rubella virus, influenza virus, and SARS-CoV-2. Additional studies to characterize parotid manifestations in COVID-19 patients will help determine diagnosis and treatment.”Lechien et al on Parotitis-like symptoms associated with COVID-19, France, March–April 2020. Emerg Infect Dis. 2020 Sep
So how do you know if your child with parotitis has the mumps or some other infection or condition?
“Mumps infection is most often confused with swelling of the lymph nodes of the neck. Lymph node swelling can be differentiated by the well-defined borders of the lymph nodes, their location behind the angle of the jawbone, and lack of the ear protrusion or obscuring of the angle of the jaw, which are characteristics of mumps.”
Mumps for Healthcare Providers
There are an increasing number of mumps outbreaks being reported these days and many cases are in vaccinated teens, so it might be easy to just say it is the mumps and recommend that you wait it out, as there is no treatment for the mumps or most other viral infections.
The only problem with that strategy is that if your child has a bacterial infection that is causing their parotitis, then they will likely need antibiotics. Some even go on to develop abscesses that need to be drained. Getting diagnosed with mumps might delay their treatment. And kids with mumps get quarantined far longer than kids with other viral infections.
Fortunately, testing is available, either a real-time RT-PCR (rRT-PCR) or mumps virus culture from a parotid duct swab. You can also do titer testing, although testing for the mumps virus is considered to be more accurate.
So does your child with parotitis have mumps?
They likely do if they have acute parotitis lasting at least 2 days, and either:
- a positive test for serum anti-mumps immunoglobulin M (IgM) antibody,
- a positive test for mumps virus with the reverse transcription polymerase chain reaction (RT-PCR) test or culture
- a link or exposure to someone else with mumps
Of course, there are other signs and symptoms of mumps besides parotitis. In fact, instead of the parotid gland, your child with mumps could have swelling of other salivary glands, like their sublingual or submandibular gland.
Confusing things, some kids with mumps do have parotitis on just one side of their face, or one side swells before the other. So you can’t say it isn’t mumps just because it is one side. And some kids with mumps never even develop parotitis, but may still have other symptoms and go on to develop complications of mumps.
“CDC recommends that a buccal or oral swab specimen and a blood specimen be collected from all patients with clinical features compatible with mumps.”
CDC on Collecting and Shipping Specimens for Suspected Mumps Cases
Still, many recent studies have confirmed few actual cases of mumps among kids with parotitis, especially among sporadic, non-outbreak cases. That makes it important to actually confirm that a child has mumps if you are going to diagnosis them with mumps.
And get your kids vaccinated and protected. The mumps vaccine isn’t perfect, but you are still much more likely to get mumps if you are unvaccinated.
What to Know About Mumps and Parotitis
While most kids with mumps have parotitis, not everyone with parotitis will have mumps, as there are many other things that cause pain and swelling of the parotid glands.
More on Mumps and Parotitis
- What to Do If Your Child Is Exposed to Mumps
- Mumps on the USS Fort McHenry
- Do Your Kids Need a Mumps Booster Shot?
- Waning Immunity
- Is Mutating Mumps More Than the MMR Can Manage?
- MMWR – Parotitis-like symptoms associated with COVID-19, France, March–April 2020. Emerg Infect Dis. 2020 Sep
- Diagnosing Mumps: Don’t Be So Sure
- Study – Etiology of mumps-like illnesses in children and adolescents vaccinated for measles, mumps, and rubella.
- Study – Mumps clinical diagnostic uncertainty.
- Study – Difficulty with mumps diagnosis: what is the contribution of mumps mimickers?
- Study – Viruses detected among sporadic cases of parotitis, United States, 2009-2011.
- Study – Viral etiology of mumps-like illnesses in suspected mumps cases reported in Catalonia, Spain.
- Study – Viral etiology of sporadic cases of parotitis among children in Korea during 2013-2014.
- Study – Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases
- CDC – Laboratory Testing for Mumps Infection
- CDC – Mumps Laboratory Confirmation by IgM Serology and Questions and Answers
- CDC – Collecting and Shipping Specimens for Suspected Mumps Cases
- CDC – Mumps and the Vaccine (Shot) to Prevent It
- CDC – Mumps Vaccine-Preventable Diseases Infographic
- CDC – Signs and Symptoms of Mumps
- CDC – Mumps for Healthcare Providers
- Mumps Questions and Answers
- Manual for the Surveillance of Vaccine-Preventable Diseases
- CDC – Mumps Case Definition
- Influenza & Parotitis: Question & Answers for Health Care Providers
- Where Are Your Salivary Glands?
- Salivary Gland Disorders
- Juvenile recurrent parotitis