Mumps, also known as parotitis or epidemic parotitis, is a viral disease that spreads from one person to another through saliva droplets that come out of the mouth during coughing, sneezing, talking, or laughing. The virus primarily affects the parotid salivary glands, located between the ear and the jaw, but it can also spread to other parts of the body.

Some people may not show symptoms or may have very mild symptoms, but they can still transmit the virus to others, leading to chain infections in family, school, or work environments.

Today, I want to tell you about some myths and facts about mumps, but first, it is very important to know in detail what they are, their possible complications, and why vaccination is so important.

What exactly is mumps and how does it spread?

Mumps is primarily an infection caused by the mumps virus and belongs to the paramyxovirus family. This virus has a particular interest in the salivary glands, but it can also reach other organs such as the pancreas, central nervous system, and testes in post-pubertal males.

Transmission occurs mainly through saliva or respiratory mucus droplets expelled from the mouth and nose of an infected person:

  • coughing or sneezing near someone,
  • talking or laughing at close range,
  • sharing cups, forks, bottles, or mugs with an infected person,
  • using napkins or tissues contaminated with saliva.

A person with mumps is particularly contagious for several days before and a few days after symptoms appear. This period, when the disease is not yet recognized, is one of the reasons mumps spreads so easily in schools, universities, and enclosed spaces.

What are the symptoms of mumps?

The symptoms of mumps appear between 12 to 25 days after a person is exposed to the virus; this period is called the incubation period. In most cases, the infection starts with mild respiratory symptoms or mild flu-like symptoms.

The most common symptoms include:

  • Mild fever, which can often be persistent.
  • Headache and general discomfort.
  • Muscle aches and a feeling of intense fatigue.
  • Loss of appetite and reluctance to eat.
  • Discomfort while swallowing and chewing, especially at the lower corners of the ears.
  • Swollen and painful salivary glands, especially the parotids located in front of and below the ears.

Primarily, a painful sensation while swallowing, talking, or chewing is felt, and shortly after, swelling becomes noticeable in one or both cheeks. This increase in the size of the glands can create a very characteristic facial appearance, making the jaw look swollen or "square."

20 to 40% of infected individuals may have very mild or no symptoms at all. Still, these individuals can continue to spread the virus. About half may show obvious respiratory symptoms (mild cough, throat discomfort, slight fever), with or without visible swelling of the salivary glands.

In males who have passed puberty, 25-40% may experience testicular pain and swelling (orchitis), which we will later associate with reproduction.

Possible complications of mumps you need to know

Although most cases of mumps are self-limiting diseases, it is important to remember that they can lead to significant complications if not properly controlled or if they occur at higher risk ages.

The most commonly reported complications are as follows:

  • Meningitis (inflammation of the membranes surrounding the brain and spinal cord). It usually presents with severe headache, vomiting, neck stiffness, or neurological signs. Although its onset can be frightening, the prognosis in the context of mumps is generally good and leads to complete recovery.
  • Meningoencephalitis (inflammation spreads to brain tissue). It can occur during or after mumps and is associated with severe headache, explosive vomiting, and neurological findings.
  • Pancreatitis (inflammation of the pancreas). It presents with pain in the upper abdomen, vomiting, and food intolerance. Diagnosis is confirmed by laboratory tests showing inflammation in the pancreas.
  • Orchitis in adolescent and adult males (painful inflammation of one or both testicles). It comes with swelling, severe pain, and sometimes redness in the scrotum. Although it is concerning due to its relationship with reproduction, complete infertility is rarely seen as a complication.
  • Oophoritis (inflammation of the ovaries) in women usually presents with lower abdominal pain, but its impact on female reproduction is much less significant.
  • Deafness occurs very rarely when the virus affects the inner ear.
  • Arthritis or other joint inflammations are seen with pain and stiffness in some joints, particularly in adult women.

In males who have passed puberty, orchitis associated with mumps can result in partial atrophy of the affected testicle. If only one testicle is affected (which is the most common), reproductive ability is usually preserved, as the other testicle compensates for sperm and hormone production. When both testicles are affected, the risk of reduced reproductive capacity increases, but complete infertility remains a rare condition.

Is there any prevention method for mumps?

There is no specific vaccine for mumps, but there is a very effective combination vaccine: the measles, mumps, and rubella vaccine (also known as MMR), which provides protection against measles, mumps, and rubella.

This vaccine is routinely administered during childhood according to the official vaccination schedule of each country or region. Procedures may vary slightly, but the most common is:

  • the first dose at around 12 months,
  • and one or two booster doses between the ages of 3 and 6, according to the applicable schedule.

Historically, some schedules have recommended three doses (for example: one at one year old, another at around 4.5 years old, and a final one during adolescence, at age 11). Nowadays, most schedules consider two doses administered correctly during childhood to be sufficient. For example, in Spain, the applicable schemes generally include two doses: one at around 12 months and the other between 3 and 4 years, which has significantly increased community protection.

Aside from vaccination, it is also important to take some hygiene measures to reduce the risk of transmission:

  • avoiding close contact with symptomatic individuals,
  • not sharing cups, forks, toothbrushes, or bottles,
  • covering the mouth and nose when coughing or sneezing,
  • washing hands frequently, especially after wiping the nose or touching the face.

Myths and facts about mumps

Below, we compile current information about the myths and facts frequently heard regarding this disease, including information on transmission, reproduction, outbreaks in young adults, and vaccination.

Both salivary glands always swell

False. In the case of mumps, usually only one salivary gland swells, especially in parotitis, and it does not affect both sides simultaneously. In fact, in about half of the cases, the inflammation is initially unilateral and the other side may swell a few days later or may not swell at all.

It is better to infect children to get the virus

False. The idea of "having mumps in childhood" and thus "gaining lifelong immunity" is still circulating. However, this practice carries a unnecessary risk. Mumps can lead to serious complications even in childhood, and it is never predictable which child will develop more severe forms.

It is much safer and more responsible to vaccinate to prevent the disease, and mass transmission should not be encouraged. If your child has been infected, the appropriate actions are:

  • The child should stay at home and not go to school during the contagious period,
  • The whole family should review the vaccination schedule and complete the vaccination process if necessary,
  • Increase hygiene at home (disposable tissues, hand washing, not sharing utensils).

Vaccinated individuals never get infected

False. The triple virus vaccine is very effective, but it is not perfect. Additionally, protection depends on having received the correct number of doses and how each individual's immune system responds.

If you have been vaccinated only once in your life, your chances of contracting mumps are higher than those with a complete vaccination schedule. Older schedules recommended three doses, whereas nowadays, many schedules consider two properly administered doses sufficient (one dose around one year of age and one dose between 3-6 years).

Over time, some studies have observed that immunity against mumps shows a decrease compared to measles or rubella. Therefore, in recent outbreaks, cases have been seen in young adults who were vaccinated in childhood. In such cases, health authorities may recommend booster doses for certain groups, such as university students, healthcare personnel, or individuals exposed to an outbreak.

When all recommended doses appropriate for the age group are received, the likelihood of contracting the disease significantly decreases, and when infected, it usually has a milder course.

Can someone get mumps?

This belief carries important nuances. Traditionally, it is said that childhood exanthematous diseases, such as chickenpox, mumps, or measles, are experienced only once because permanent immunity is gained against the same virus after infection.

In classic mumps cases, caused by the mumps virus, a person who has had it once generally obtains long-term protection. However, in some clinical series, it has been reported that other viral or bacterial infections can lead to mumps-like inflammations in the salivary glands. Therefore, some individuals may think they have had mumps "twice," whereas one incident may have been triggered by another microorganism.

In cases of overnutrition, immune deficiencies, or very debilitating diseases, the immune response may be inadequate and allow for a new infection. Such cases are considered exceptional.

Is the risk of infection for children greater than for adults?

False. Any unvaccinated or incompletely vaccinated person has a high likelihood of becoming infected when in contact with an infected person, regardless of age. However, children's health is monitored more carefully because they are particularly vulnerable, and school is an environment where the virus spreads easily.

However, in recent years, it has been observed that the most affected individuals during many outbreaks are adolescents and young adults. The reasons for this are:

  • some have not completed their vaccination schedule,
  • others have lost some of their immunity over time,
  • and generally, they live in closed and crowded areas (universities, dormitories, workplaces).

Therefore, it is important for adults to check whether they have completed the paperas vaccination schedule and, especially for those in risk groups or exposed to outbreaks, to consult with health professionals about whether they have received a booster dose.

Adults should not receive the paperas vaccine

False. Adults without proof of vaccination (those who have not had the disease or do not have vaccination records) should be vaccinated and, in most cases, must be.

In general, it is recommended that:

  • Unvaccinated adults or those who do not remember having paperas should receive at least one dose of the triple virus vaccine.
  • Some groups, such as university students, healthcare personnel, and international travelers, should receive two doses of the vaccine or provide reliable proof of immunity, as these groups are at higher risk of exposure and transmission.

Some epidemiological references use the year of birth 1957 as a criterion to assume immunity due to natural exposure in certain countries; however, this depends on local recommendations and the epidemiological situation, so it is important to check the public health guidelines in your area or consult your healthcare professional to verify whether you need the vaccine.

Women of reproductive age, provided they are not pregnant and have no medical contraindications, should also check their vaccination status before a potential pregnancy. Live vaccines are not administered to pregnant women or individuals with severe immune deficiencies unless specified in very particular circumstances by a specialist.

Vaccines are not safe

False. The triple virus vaccine is very safe and effective after years of mass use in millions of people. Side effects are usually mild and short-lived.

The most common mild reactions include:

  • mild fever lasting one or two days,
  • redness and swelling at the injection site,
  • and temporary mild joint pain in some adult women.

As with any medication or vaccine, there is a small risk of more serious reactions, but the frequency is extremely low. On the other hand, the risk of contracting measles, paperas, or rubella without vaccination is much higher, both in the short and long term.

The triple virus vaccine should not be administered to pregnant women or individuals with severe immune deficiencies. For other healthy individuals, it is a fundamental tool to individually protect and provide herd immunity to the community.

Paperas and male reproductive health: myths, real risks, and nuances

One of the most common fears is the possible relationship between paperas and male infertility. This concern stems from the fact that in males who have passed puberty, the virus can cause orchitis, which is the painful inflammation of one or both testicles.

When orchitis is a consequence of paperas, the testicle may experience the following conditions:

  • low testosterone during the inflammatory process,
  • decrease in sperm count and quality,
  • and in some cases, partial atrophy of the affected testicular tissue.

These effects become more pronounced when the infection occurs after puberty, as the reproductive organ is fully developed. However, complete and permanent infertility solely due to paperas is a rare complication. A more commonly encountered situation is a moderate decrease in fertility, especially if orchitis affects both testicles.

Some studies have also examined the likelihood of antibodies against sperm occurring in individuals who have had orchitis due to mumps, which can affect fertility. However, the existing data is not definitive, and it is not possible to say that this immune response is a common cause of infertility due to mumps.

In practice, many men who experience testicular inflammation during adolescence or adulthood can achieve pregnancy naturally, without the need for assisted reproductive treatments. In case of doubt, specialists recommend a semen analysis to evaluate sperm count, motility, and morphology.

Treatment and Care for Mumps

Since mumps is caused by a virus, there is no antibiotic to treat it. Treatment is primarily symptomatic, aimed at alleviating discomfort while helping the body to overcome the infection.

The most common treatment and care measures are:

  • Analgesics and antipyretics (always according to the pediatrician or doctor's recommendation) should be given for pain and fever.
  • Applying hot or cold compresses to the area with swollen glands can relieve pain.
  • Providing a soft and light diet (purees, yogurt, soups) that does not require chewing can reduce pain while eating.
  • Avoiding acidic juices or foods because they can increase saliva production and exacerbate pain.
  • Ensuring adequate fluid intake is important; drink frequently and in small amounts.
  • In the case of orchitis, rest, local cold compresses, and sometimes supporting the scrotum with supportive underwear are recommended.

In cases of severe pain or complications, the doctor may evaluate the use of other medications and decide whether closer observation is necessary. If there are alarm symptoms such as severe headache, recurrent vomiting, neck stiffness, difficulty waking up, severe abdominal pain, or severe testicular pain, immediate emergency care should be sought.

Did you understand what mumps is and the myths and facts surrounding it? Do you have more questions about this disease? If you are not vaccinated or are unsure whether you have completed all your doses, it is a good idea to consult your healthcare provider and update your vaccination to reduce the risk of infection or spreading it to others; mumps can occur without complications, but underestimating the risks and neglecting to take precautions can become a serious health issue.