Reconsider vaccination programme against mumps

Mumps is a very contagious illness caused by the mumps virus. It usually affects children. Affected children develop fever, pain in the throat and in the the glands that produce saliva. These glands, and especially the parotid glands near the ear, get swollen.

Mumps is spread from child to child by contact with fluids from the mouth, nose, and throat when an infected child coughs, sneezes, or talks. Children are especially contagious one to seven days before symptoms appear. The virus can also stay alive on surfaces like doorknobs, eating utensils, and drinking cups.

In an online survey between December 8 to 15, 2022, 73 doctors around the country reported to have attended to children with mumps recently. Nearly 20 districts, spread all around the country in the east, west, central and north including Kampala, Wakiso, Mukono, Masaka, Kyenjojo, Fort Portal, Lira, Soroti, Serere, Mbale, Agago, Adjumani, Gulu, Kiryadongo, Jinja, Kabarole, Busia and Mbarara reported cases. The most affected are Kampala and Wakiso followed by Mukono, Mbarara, Kyenjojo and Soroti. Although in the other districts, many of the doctors indicated that they each saw between one and five cases, in Kampala, Wakiso, Mukono, Mbarara, Kyenjojo and Soroti, several doctors and especially paediatricians, reported seeing more than five cases each and some, several cases daily.  The perception is that initial cases may have been between July and October 2022 but the numbers markedly increased in late October and by November and December, it spread countrywide.

Mumps is usually a mild illness. If your child is exposed to the virus, they may have minor symptoms that resemble a cold. Many feel tired and achy, have a fever, and swollen salivary glands on the side of the face. The current outbreak in Uganda also has some uncommon symptoms and signs including swelling of other salivary glands below the chin.

To date, there is no cure for mumps but the infection should pass within one or two weeks. Treatment focuses on alleviating symptoms.

Give your child plenty of fluids and soft foods that are easy to chew.

 The child should eat foods that don’t need a lot of chewing. Do not give sour foods or liquids. The salivary glands are very sore during mumps. Eating these foods will usually cause them to hurt more.

Soothe the swollen parotid glands with either warm or cool compress. This will reduce the pain and the swelling.

You can also give medicines such as paracetamol, to bring down the fever or ease pain if your child remains uncomfortable. Do not give antibiotics. Since mumps is a virus, antibiotics are not effective. People with mumps are usually most infectious from a few days before their parotid glands swell until a few days afterwards. For this reason, it’s advisable to avoid work or school for five days after your symptoms first develop if you’re diagnosed with mumps. The good thing, children are currently out of school.

Although most symptoms of mumps are mild and many recover completely within two weeks, serious complications can occur. Mumps may lead to meningitis or encephalitis, two potentially fatal conditions. Meningitis is swelling of the membranes around the brain and spinal cord and encephalitis is inflammation of the brain. Mumps may also inflame and damage the pancreas, leading to pancreatitis and a long-term risk of the child developing diabetes. Inflammation of the testis can result in infertility.

The Measles, Mumps and Rubella or MMR vaccine offers protection from the virus that causes mumps. However, in Uganda, the public health system does not offer the MMR vaccine but the Measles and Rubella or MR vaccine and so, we have no vaccination programme against mumps. This decision should be reconsidered.

Dr Richard Idro is the Associate        Professor of Paediatrics and Child Health, Makerere University Consultant Paediatrician, Mulago hospital.