Mumps Virus

  • Diagnosis
  • Background
  • Lab Tests
  • References
  • Related Content

Indications for Testing

  • Atypical presentation of secondary complications from suspected mumps
  • Epidemiologic evidence during suspected outbreak

Laboratory Testing

  • Limited role for laboratory testing – usually a clinical diagnosis
  • CDC mumps laboratory testing recommendations
    • Serology
    • Culture  – saliva, buccal swab, throat, urine, or cerebrospinal fluid
      • Gold standard
      • May be useful to have for genotyping in outbreaks
    • RT-PCR – buccal or oral swab
      • Negative test does not rule out mumps – vaccinated individuals typically shed virus in smaller amounts for shorter time
      • Best if collected in first 3 days of illness (CDC)

Differential Diagnosis

Mumps is an acute, contagious disease of short duration, usually self-limiting, and characterized by swelling of the parotid gland.

Epidemiology

  • Prevalence – multiple outbreaks since 2003, each involving >1,000 people
  • Age – highest incidence at 16-24 years
  • Transmission
    • Highly contagious and transmitted by droplets spread from the upper respiratory tract

Organism

  • Paramyxoviridae family; Rubulavirus genus
  • Single-stranded RNA virus
  • 12 genotypes based on sequence of SH gene
  • Immunity after infection appears to be lifelong
    • Silent reinfection occurs infrequently

Clinical Presentation

  • Incubation period – 18-21 days
    • 25-30% of all infections are silent
  • Most common clinical feature is bilateral or unilateral parotitis
  • Secondary complications
    • Testes
      • Orchitis, particularly in teenagers, can lead to decreased fertility or infertility
    • Ovaries – oophoritis
    • Central nervous system – aseptic meningitis, encephalitis
    • Rare – pancreatitis, peripheral neuritis, uveitis, otitis, myocarditis

Indications for Laboratory Testing

Tests generally appear in the order most useful for common clinical situations.
Click on number for test-specific information in the ARUP Laboratory Test Directory

Mumps Virus Culture 0065056
Method: Cell Culture/Immunofluorescence

Mumps Virus Antibody, IgM 0099589
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Limitations

IgM and IgG testing best performed with paired specimens

Testing immediately post-exposure is of no value without a later convalescent specimen

Follow Up

If equivocal, repeat testing in 10-14 days may be helpful

Mumps Virus Antibody, IgG 0050390
Method: Semi-Quantitative Chemiluminescent Immunoassay

Limitations

IgM and IgG testing best performed with paired specimens

Follow Up

If equivocal, repeat testing in 10-14 days may be helpful

Mumps Virus RNA Qualitative, Real-Time PCR 2009387
Method: Qualitative Real-Time Polymerase Chain Reaction

Additional Tests Available

Mumps Virus Antibody IgM, CSF 0054443
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Comments

Confirm mumps as the etiology of meningoencephalitis

Mumps Virus Antibody IgG, CSF 0054442
Method: Semi-Quantitative Chemiluminescent Immunoassay

Comments

Confirm previous episode of mumps meningoencephalitis

Encephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, CSF 2008916
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay

Encephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, Serum 2008915
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay

Viral Culture, Respiratory 2006499
Method: Cell Culture

Guidelines

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Recommended Immunization Schedules for Persons Aged 0 Through 18 Years. United States, 2015. Centers for Disease Control and Prevention. Atlanta, GA [Last Updated Jul 2011; Accessed: Nov 2015]

General References

Andersen E. Mumps--new face on an old disease. AAOHN J. 2006; 54(10): 425-6. PubMed

Hviid A, Rubin S, Mühlemann K. Mumps. Lancet. 2008; 371(9616): 932-44. PubMed

Rota J, Rosen J, Doll M, McNall R, McGrew M, Williams N, Lopareva E, Barskey A, Punsalang A, Rota P, Oleszko W, Hickman C, Zimmerman C, Bellini W. Comparison of the sensitivity of laboratory diagnostic methods from a well-characterized outbreak of mumps in New York city in 2009. Clin Vaccine Immunol. 2013; 20(3): 391-6. PubMed

Senanayake S. Mumps: a resurgent disease with protean manifestations. Med J Aust. 2008; 189(8): 456-9. PubMed

Shanley J. The resurgence of mumps in young adults and adolescents. Cleve Clin J Med. 2007; 74(1): 42-4, 47-8. PubMed

VanBeek C, Haas M. Anti-PLA2R-associated membranous nephropathy: a review with emphasis on diagnostic testing methods. Clin Nephrol. 2015; 84(1): 1-9. PubMed

Wilson K, Meier J, Ward D. Salivary gland disorders. Am Fam Physician. 2014; 89(11): 882-8. PubMed

References from the ARUP Institute for Clinical and Experimental Pathology®

Shirts B, Welch R, Couturier M. Seropositivity rates for measles, mumps, and rubella IgG and costs associated with testing and revaccination. Clin Vaccine Immunol. 2013; 20(3): 443-5. PubMed

Medical Reviewers

Last Update: February 2016