Mumps: Symptoms, causes and treatment

Once a common childhood illness, mumps is rare but it’s still around and can cause complications. Here’s what you need to know

Mumps was a common childhood illness until a vaccination for it was launched in the late Eighties. Now it’s relatively rare. But there have been sporadic outbreaks in the UK since. And, while most cases will pass without issues, there are also risks associated with catching mumps, especially if you’re older, including life-threatening complications and for men, infertility. Make sure you know what to look for, what to do and the red flags that need immediate attention.
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A viral infection that’s easily spread, mumps starts with standard flu-like symptoms like fever, muscle aches and pains (see below). “But the most pronounced feature of mumps is ‘parotitis’; a swelling of the salivary glands on the lower aspect of the cheeks, usually on both sides but sometimes only one,’ says Dr Nathalie MacDermott, a clinical lecturer in paediatric infectious diseases as King’s College, London. “That gives people a bit of a chipmunk look.”
“Although it’s not as contagious as measles, mumps is still infectious and passed on through respiratory droplets when an infected person coughs, sneezes or laughs’, explains Dr MacDermott. But it can also be transmitted through close-contact sports, sharing utensils, kissing and being in enclosed spaces with infected people. 
“You’re likely to be contagious about seven days before symptoms show,” Dr MacDermott says. “But you can remain infectious for about nine days after your symptoms have subsided.” 
About one in five people will show no symptoms but still be infectious. 
The incubation stage for mumps can last 12-25 days and have no symptoms, explains Paul Hunter, a professor of medicine at the University of East Anglia. “After that you’ll probably get the common signs of infection.” See below for details.
Mumps typically passes through several stages: 
Incubation period: This has no symptoms and can last 12-25 days but typically is around 16-18. You’ll be infectious for the last week of this.
Prodrome: These are the early signs which usually appear typically 3-5 days before the characteristic swelling of salivary glands or other areas develops. Symptoms can include:
Acute phase: This causes telltale swelling in the salivary glands which will occur in 30-40 per cent of people, usually lasting 7-10 days. Other areas that can show signs of infection and swelling include the testes, ovaries, pancreas, eyes, nervous system, joints and kidneys. This is the time when complications can occur, so it’s important to manage the symptoms.
Recovery: Symptoms gradually improve, though adults may feel a little more run down for a few weeks after, says Dr Gary Bartlett, a locum GP in North West England. 
The mumps virus  belongs to a family called paramyxoviruses that are a common source of infections in children – another in this family is measles. It starts in your nose, mouth and throat and then moves to glands at either side of your face causing them to swell. It can also enter the fluid that surrounds your brain and spine and that’s how it can spread to other parts of the body (see below).
Most mumps infections will pass within 1-2 weeks and won’t be serious. But in rare cases serious complications can occur. These include:
Encephalitis: “A risk in children with mumps is that they will go on to develop encephalitis, which is inflammation of the brain,” says Prof Hunter. This is potentially fatal, affects about one in 1,000 cases of mumps in children and requires hospitalisation immediately. 
Viral meningitis: Another risk is the chance of developing viral meningitis, where the virus moves into the outer areas of the brain. It occurs in one in four cases of mumps and comes with symptoms like sensitivity to light, neck stiffness and headache. But unlike bacterial meningitis, it’s not usually considered life-threatening, though still important to report symptoms. 
Inflamed testes: Viral infections like mumps are more severe when you’re older. “About half of males who contract mumps post-puberty will get inflammation of the testes, called ‘orchitis’ which can be incredibly painful,” says Prof Hunter. About half will get some shrinking of the testes, one in 10 will experience a drop in their sperm counts and in rare cases, infertility.” 
Inflamed ovaries: “Mumps can also cause inflamed ovaries which leads to severe abdominal pain in women,” says Prof Hunter. This affects about one in 15 women who get mumps post-puberty, but the symptoms usually pass with the infection.
Temporary deafness: “The infection can affect your ears so you can get temporary deafness following mumps,” says Prof Hunter. This occurs in about one in 25 cases and will only be permanent in about one in 20,000 cases. 
Miscarriage: In the past it was thought mumps could cause miscarriage if it was contracted in the first trimester. There isn’t much evidence to support this, but the NHS advises pregnant women to avoid close contact with people who have an active mumps infection and contact their GP if they’re been in contact with someone with the virus.
Though there is no treatment for mumps other than managing symptoms. Dr Bartlett encourages people to report to their doctors anyway. “Mumps is a notifiable disease and any cases of suspected mumps have to be reported to public health as they may need to initiate specific follow up as well as manage any outbreaks,” he says. “Plus, your doctor can rule out other more serious conditions like glandular fever and tonsillitis.” 
Dr MacDermott says to “let the surgery know before you go in so they can sit you in a separate room”.
Be aware of the red flags to report immediately as something more serious could be going on. These include:
“The biggest risk will be to those who haven’t been vaccinated,” says Dr MacDermott. “Living in crowded environments or being in close contact with infected people can also increase your risk.” The only way to prevent mumps is to get vaccinated, Prof Hunter adds.
The MMR vaccine (measles, mumps and rubella) course is given first as a single dose given to 12 month old babies and then as a second dose to children just before starting school. 
In the last five years, there has been a continued decline in uptake for the MMR vaccination. In 2022-23 for example, 89.3 per cent of children had received their first dose of the vaccine and 92.5 per cent of children received their second jab.  
Current numbers are well below The World Health Organisation’s target of 95 per cent for herd immunity, says Prof Hunt.
For young adults who missed their MMRs as children, NHS England launched a catch-up campaign in March this year. “All you have to do is turn up to your GP surgery and ask for an MMR vaccine, it’s that easy,” says Dr Bartlett.  
“Mumps can be very painful because of the inflammation it causes, whether it’s in the salivary glands, the testes, ovaries [causing back pain] or elsewhere in the body,’ says Prof Hunter. ‘But there’s no treatment except for the symptoms.’ 
You can relieve symptoms with ibuprofen or paracetamol, rest, drinking plenty of fluids and applying hot and cold compresses to the swollen glands as well as eating soft foods like soups, scrambled eggs and mashed potatoes.
Once you get mumps, you will have built up immunity, so it’s unlikely you will get it again. “But reinfections can occur, though they’re probably very rarely that severe and may not even show symptoms,” says Prof Hunter.
Emily Cleary, 45, is a journalist who lives in Buckinghamshire with her husband and two children, aged nine and 11. She contracted mumps five years ago after a family holiday 
“When I was growing up the MMR vaccine wasn’t available so I assumed I’d had the mumps as a child, like the other kids at my school. But when I hit 40, it hit me like a tonne of bricks – I hadn’t. 
“After a family holiday I got a terrible headache and neck pain. One morning a few days later, I woke up and barely recognised myself in the mirror. My face had ballooned and with the lower part of my face swollen and raw, my glands felt like they were about to burst.
“The doctor confirmed I had mumps and told me to isolate myself, take pain relief and drink lots of fluids until it passes. 
“In the coming months, I experienced debilitating post-viral fatigue and would catch every bug going. Once I accidentally burned my hands with hot water and all my glands swelled up. Even going up stairs was a challenge. I now know the older you are, the worse mumps can be as your immune system loses its strength over time. It took a good seven months to get back to the level of health I had before I had the mumps.
“Having mumps isn’t always just a few days off work. It’s debilitating and can come with potential complications. Plus, you could be spreading it without knowing [during the asymptomatic phase]. My message for everyone is this: get vaccinated.” 
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