Microbiology
Pathogens
Regarding mumps, which of the following statements is INCORRECT:
Answer:
Mumps is not typically associated with the development of a rash. A morbilliform rash appearing first behind the ears is typical of measles.Mumps
Microbiology / Pathogens / Measles, Mumps and Rubella
Last Updated: 21st April 2019
| 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 |
