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Microbiology

Pathogens

Question 2 of 180

What is the school exclusion period of mumps:

Answer:

Infected patients should be isolated to prevent spread. Patients are advised to stay away from school/nursery/work for five days from onset of swelling.
Virus Mumps
Transmission Respiratory droplet route
Incubation period 14 - 24 days
Relation of infection to immunity Natural infection is followed by lifelong immunity
Clinical features Non-specific features (fever, malaise, myalgia, headache) associated with bilateral tender parotitis, usually resolves after about 7 - 10 days
Complications Meningitis, post meningitis deafness, encephalitis, orchitis (+ infertility), oophoritis, pancreatitis
Diagnosis NAAT, culture or serology
Treatment Supportive, notifiable disease
Vaccination MMR vaccine given at one year and preschool age

Transmission and Epidemiology

Mumps usually occurs in childhood. The incubation period is about 14 - 24 days. Subclinical infection is common, especially in children. It is transmitted primarily by the respiratory droplet route. Natural infection is followed by lifelong immunity. Epidemics can re-emerge if vaccination coverage falls.

Clinical Features

Clinical features usually include non-specific features such as fever, malaise, myalgia and headache associated with parotid gland inflammation (parotitis). Parotitis is usually bilateral and tender, lasting for about 7 - 10 days.

Complications

Complications include:

  • aseptic meningitis
  • post meningitis sensorineural deafness
  • encephalitis
  • orchitis (and subsequent infertility)
  • oophoritis
  • pancreatitis (although complications in a post-vaccine era are rare)

Diagnosis

Diagnosis is usually clinical, but should be confirmed by NAAT or culture of saliva or serology.

Treatment

Treatment is supportive with bed rest and isolation to prevent spread. There are no specific treatments available.

Prevention

Infected individuals should be advised to stay away from school/nursery/work for five days after onset of facial swelling.

The MMR vaccine is given at one year, and at preschool age (three years four months old).

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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