Health Notes

Sun (Auckland), Volume 1, Issue 103, 22 July 1927, Page 7

Health Notes

MUMPS | TRANSMISSION AND TREATMENT i (.Contributed by the Department of Health. > Mumps is a general infectious and I contagious disease. As a rule, it tirst I attacks the parotid gland, which is the largest salivary gland, and is situated | in front and below the ear. The other | salivary glands (the submaxiliary and | sublingual) are also often affected. The i organism which causes mumps has not i been isolated, but the infective agency has been proved to exist in the saliva {of patients suffering from the disease. The virus enters the blood stream, and hence other glands of the body (such as the thyroid, pancreas and reproductive glands) may be secondarily infected. The disease occurs in all climates, and spreads rapidly from individual to individual, especially where people are massed together, as in institutions, schools and camps. Coloured races are affected more readily and severely than are white. In most cases, constitutional symptoms are mild, and the disease is not severe. This is especially so in children. Though in later life complications may be troublesome; at all ages the death rate is very low. The most usual period for attack is between five and fifteen years of age during school life, but cases occur at any time from infancy to extreme old age. Girls and boys are equally liable ; to attack, but in adult life more men j are affected as a rule than women, probably owing to their greater exposure to risk of contagion. MODE OF TRANSMISSION The disease is a contagious one, being transmittetd directly from person to person. Infection is contained in the patient’s saliva, and is conveyed by coughing, sneezing, etc. A third and healthy person may transmit the disease if his hands, face, or clothing have become contaminated with the virus from an acute case of mumps, or possibly he may be himself a carrier of the an acute case of mumps, or possibly he may be himself a carrier of the virus. Rarely, inanimate object as books, clothing, etc., may act as carriers, presumably because they have been contaminated by infected saliva. In scrupulously clean households and hospitals, however, it is probably true that infection is transmitted only from person to person. PERIOD OF INFECTION The disease may be communicated in the early stages, viz., before the typical swelling of the glands occurs. The period of greatest infectivity lasts on an average for five to seven days, by which time the gland has, as a rule, reached its normal size. During the convalescence of the patient, there is less danger of infection, though in exceptional cases infection has been known to be transmitted six weeks after the development of the disease. One attack of mumps produces immunity, which in the majority of cases endures for years and even for life. A small proportion of however, suffer from the disease two or even more times. CAUSE AND SYMPTOMS The organism which causes mumps has never been isolated, but the agency of the saliva of patients in carrying infection has been proved. The average duration of time from exposure to infection to development of the disease is eighteen days. In the average or mild case of mumps the enlargement of the parotid gland is noted as a swelling below and in front of the ear. More rarely both parotid glands are affected. Stiffness of the jaw and pain on opening the mouth accompanying the swelling: a mild rise of temperature lasts about two days; and the swelling gradually subsides and disappears in four or five days. Unless involvement of other salivary glands occurs, or unless other complications develop, such as involvement of

J the reproductive glands, recovery i ; J complete at the end of seven or eitrhi days. Initial symptoms of the diseas, j are similar to those which usher Ir j • any infectious disease—headache, los; jof appetite, thirst, mild rise in teml peruture. pains in the back and limb:? la feeling of chilliness, or a distino: j chill, and in children convulsions oc ; casionally occur. Bleeding from th* nose has been noted in a number o, epidemics. * The swollen parotid gland is visible ! below and. in front of the ear. Th< J lobule of the ear is raised and oecn- | pies the centre of the swelling, whirl I mar reach backwards behind the ear In * more severe, cases, where othe- | salivary glands also are involved, th. j swelling may reach down to the collar i bone, obliterating the normal curve o. the neck. The enlargement of t! gland increases for two to four d;n> j remains stationary for two to fou- : days, and by the end of seven to for » days has. as a rule, subsided. Mor. {rarely, howeve \ the gland does not resume its normal size for three or fouweeks. The skin over the swellin* { is tense and not reddened. Fain is ; {constant symptom, and is caused »v I attempts to move the jaw as in oath - ior speaking. Some patients complain of earache. Relapses during con\ «l----i escence are not unknown, and th. second parotid gland is. as a rub. | affected in the relapse. TREATMENT

j The problem is to make the path n i comfortable, prevent complications a» | far as possible, and to protect other persons from infection. During the acute stage the patient should be kep ! in bed for a few days as this dimin - ishes the liability of complications. Thdiet should be light, the mouth should be kept dean and moist by a aimpU antiseptic wash. Soothing applications to the swelling give relief. When com plications occur appropriate treatmen is indicated, and rest in bed essential To protect other persons, the pat ion must be isolated as soon as the diag nosis is made, and should not be per nutted to associate with others until all symptoms have disappeared ant the glands have been normal for aboir. a week. For ordinary mild cases the period of quarantine should not be It than two weeks. In complicated case; it is necessarily extended. Pcrsonr who have been exposed to infection should bo kept under observation foil period of three weeks.