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Mumps (mumps) - refers to acute contagious viral diseases, characterized by fever, general intoxication, an increase and soreness of the salivary glands, mainly the parotid.

Etiology. The virus, the causative agent of mumps infection, is unstable, is inactivated by heating (at a temperature of 70 ° C for 10 min), ultraviolet radiation, and exposure to low concentration formalin solutions. It is well preserved at low temperatures (-10—70 ° C).

The source of infection is a sick person. The virus spreads from person to person by airborne droplets, with objects contaminated with saliva (toys). In some cases, intrauterine infection with the mumps virus has been described - a vertical transmission route. The patient is contagious in the last days of the incubation period, in the prodromal period and in the first 5 days of the disease. Reconvalescents (recovered) are not sources of infection. The disease is ubiquitous, people of both sexes fall ill, but boys are 1.5 times more likely than girls. In 85% of cases, mumps occurs in children under the age of 15 years. Persons who did not suffer from mumps remain susceptible to the disease throughout their lives, which leads to the development of mumps in different age groups. Epidemic outbreaks can occur at any time of the goal, but they are more often observed at the end of winter and in spring (March-April). Mumps infection is one of the most common viral diseases that occurs in all countries of the world. After the disease, a strong immunity remains. Maternal antibodies circulating in the blood of a child provide immunity to mumps during the first 6-8 months of life. From women who have had the disease a week before giving birth, children with pronounced clinical signs are born.

Clinic. The incubation period is 14-24 days, most often 17-18 days. Prodromal symptoms in children are rare and can be expressed by a fever, muscle pain (usually the neck), headaches, and a feeling of malaise. The onset of the disease is usually characterized by pain and swelling of one parotid salivary gland or both. Iron can increase very quickly, in just a few hours, but reaches its maximum size 1-3 days after the onset of the disease. A swelling hides the angle of the lower jaw, the earlobe rises and is directed anteriorly. Over the next 3-7 days, the swelling gradually decreases and disappears. At first, as a rule, one gland is affected, and after 1-2 days there is an increase in the other. The area of ​​edema is dense and painful. Patients are worried about chewing pain. Especially painful is expressed with the use of acidic liquids that cause salivation, such as lemon juice. Swelling and redness can also be seen at the exit of the duct of the gland. At the same time, swelling of the larynx and soft palate, tonsil displacement can occur. With a unilateral lesion of the salivary glands, the patient often tilts his head toward the affected gland. Often there is a moderate increase in body temperature. Despite the fact that in most patients only the parotid glands are affected, the submandibular can be involved in the process. In these cases, the swelling spreads anteriorly and downward from the angle of the lower jaw and acquires an oval shape, sometimes it resembles an egg in shape and is located mainly downward from the edge of the lower jaw.
Pain in this case is less pronounced than when the parotid gland is involved in the process. The sublingual salivary glands are rarely infected. In these cases, the changes are symmetrical, the swelling is localized in the chin and at the bottom of the oral cavity.

Complications Perhaps the development of meningitis, meningoencephalitis, orchitis, acute pancreatitis, arthritis, myocarditis, etc.

Serous meningitis is the most common and characteristic complication of mumps that occurs after inflammation of the salivary glands, most often after 4-10 days. Meningitis begins acutely, with fever, headache, and vomiting. Stiff neck is determined.

Sometimes there is a weakness in the muscles of the neck, shoulder girdle and legs, which resembles poliomyelitis. Some patients develop clinical signs of meningoencephalitis: impaired consciousness, lethargy, drowsiness, uneven tendon reflexes, facial paresis, lethargy of pupillary reflexes. The course of meningoencephalitis of mumps etiology is usually favorable.

Orchitis and epididymitis. These complications are rare in prepubertal children, but quite often in adolescents and adults. They can develop both in isolation and jointly. Orchitis is noted mainly 8 days after the onset of the disease, but sometimes later, and can occur without visible damage to the salivary glands. It begins with fever, chills, headaches, nausea, pain in the scrotum and testis. Involvement in the process of the right testicle sometimes simulates acute appendicitis. The affected testicle becomes dense and swollen, the skin above it swells and turns red. The enlargement of the testicle lasts for 5-8 days, then its size decreases, the pain goes away. In the future, some patients may show signs of testicular atrophy.

Oophoritis complicates the course of mumps in girls and women.

Pancreatitis Pancreatitis is a severe pancreatic complication that usually develops on the 4th-7th day of illness. It is rare, but mild forms of pancreatitis develop more often than they are diagnosed. The main symptoms of the disease are sharp abdominal pain, often cramping or girdling in nature, fever, nausea, repeated vomiting, constipation or diarrhea.

Nephritis. The virus is often excreted in the urine. Renal dysfunction, according to one study, was found in all adults with mumps, and the causative agent in the urine was found in 75% of them. The frequency of kidney damage in children remains unknown.

Myocarditis. Severe myocarditis is rare, but its mild forms are observed in many patients.

Hearing damage is rare, but can lead to deafness. Mostly unilateral damage to the auditory nerve is noted. The first signs are tinnitus, then manifestations of labyrinthitis join: dizziness, impaired coordination of movement, vomiting. Hearing is usually not restored.

Arthritis is a rare complication of mumps. Swelling of the joint, redness and soreness appear. Recovery is usually complete.

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  1. Parotitis
    Training target: using diagnostic algorithms, be able to establish a diagnosis of mumps, determine the clinical form of the disease, complications and prescribe adequate treatment. Assignment for independent study of the topic. Using a textbook and lecture material to acquire the necessary basic knowledge, learn the following sections for practical training: 1.
    C. George Ray (C. George Ray) Definition. Mumps (mumps) is an acute highly contagious disease of viral etiology, characterized by an increase in the parotid salivary glands, and sometimes involvement in the process of the sex glands. meninges, pancreas, and other organs. Etiology. The causative agent of mumps belongs to the family
  3. Parotitis
    Mumps (mumps) is a childhood viral infection characterized by acute inflammation in the salivary glands. The causative agent of mumps belongs to the RNA-containing viruses, the genus Paramyxovirus. Infection occurs by airborne droplets. The susceptibility to this disease is about 50-60% (that is, 50-60% of those who were in contact and did not get sick or not vaccinated get sick). Piggy
  4. Parotitis.
    Mumps (mumps) is an acute infectious disease with a primary lesion of the salivary glands. The causative agent is the Pneumophilis parotidis RNA virus from the genus paramyxoviruses. Infection occurs from a patient with manifest or, more often, erased and asymptomatic forms of the disease. The route of infection is airborne. Transmission of the virus through toys and household items infected
  6. Question 28 The epidemic process
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