Beware of resurgence of mumps in AP, Telangana; long term complications include hearing loss, infertility, DKA

Hyderabad: Due to the period of transition between seasons, along with viral fevers, there seems to be a resurgence of the highly contagious viral infection mumps in some states, including Andhra Pradesh and Telangana. As per doctors, this outbreak is notably the first during the post-Covid era.

Mumps, caused by the Paramyxovirus, is characterised by swelling and pain in the salivary glands, with potential complications ranging from meningitis to deafness and reproductive organ inflammation, has resurfaced in Andhra Pradesh and some other states, said consultant neonatologist and paediatrician at Ankura Hospital, Vijayawada, Dr Vijay Kumar.

The doctor also elaborated on the causes, clinical manifestations, diagnostic approaches, management strategies, and crucially, the importance of vaccination in preventing such outbreaks.

“A noteworthy aspect of mumps is the substantial underreporting, with over 90 per cent of cases going unreported. The current outbreak highlights the need for improved surveillance and reporting mechanisms to better understand and control the spread of the virus,” pointed out Dr Vijay Kumar.

Reasons for resurgence

Factors that contribute to the resurgence of mumps are:

Cyclical Trend: Mumps tends to follow a cyclical pattern, with outbreaks occurring every 3 to 4 years. Understanding this pattern is crucial for implementing timely preventive measures.

Vaccine Inclusion: The absence of the mumps vaccine in the National Immunisation Schedule exacerbates the vulnerability of certain populations. Advocacy for the inclusion of the mumps vaccine in routine immunisation programmes becomes imperative.

Pandemic-related Challenges: The disruption caused by the Covid-19 pandemic has led to a loss of follow-up vaccinations, creating an immunity gap. Addressing this fallout and reinstating routine vaccinations is crucial in preventing the resurgence of preventable diseases.

High Communicability: Mumps is highly contagious, emphasising the need for swift and effective preventive measures to curb its transmission.

Complications from mumps

The consequences of mumps extend beyond the initial discomfort, with long-term sequelae being a cause for concern.

Sensorineural Hearing Loss: Persistent hearing loss is identified as a potential complication, emphasising the need for early detection and intervention.

Sterility: Reproductive organ inflammation leading to sterility is another serious concern. This highlights the importance of prioritising preventive measures to safeguard reproductive health.

Diabetic Ketoacidosis (DKA): Notably, cases of DKA have been observed in diabetic patients following mumps infection. This underscores the interconnectedness of different health conditions and the need for targeted monitoring and care.

Identifying symptoms

The incubation period of Paramyxovirus is 10 to 14 days. Prompt recognition of symptoms becomes crucial for timely intervention. Two to 12-year-olds are identified as the most susceptible, emphasising the importance of paediatric vaccination efforts.

Clinical Features: Symptoms include fever, swelling of parotid glands, abdominal pain, vomiting (indicative of pancreatitis or oophoritis), and in severe cases, confusional states and irritability (signs of aseptic meningoencephalitis).

Diagnosis and management

Definitive diagnosis can be achieved through RT-PCR testing. While mild cases can be managed on an outpatient basis with antipyretics, analgesics, and hydration, severe cases such as meningoencephalitis or pancreatitis require in-patient care. Quarantine measures are also implemented for mild cases to prevent further transmission.

Prevention of outbreaks

Isolation: Swift isolation of the infected individuals is crucial in limiting the spread of the virus within communities.

Immunisation: The cornerstone of prevention lies in vaccination. The MMR (Measles, Mumps and Rubella) vaccine, with a single dose providing 60 per cent immunity and two doses offering 90 per cent immunity against mumps, is a powerful tool in preventing outbreaks.