Last updated: May 31, 2023

Summarytoggle arrow icon

Mumps is a highly contagious viral infection that is transmitted via airborne droplets. The incidence is now very low in the US because of the combined measles, mumps, and rubella (MMR) vaccine. The condition primarily affects children between the ages of five and fourteen. Classically, it manifests with parotitis, which initially occurs unilaterally, but typically progresses to involve both sides. The lateral cheek and jaw area usually show marked swelling and the ears may protrude. Other symptoms include low-grade fever, malaise, headache, and possible swelling of other salivary glands. The diagnosis of mumps is largely based on clinical findings. Many cases, however, present with nonspecific features and are not easily recognizable as mumps. If possible, diagnosis should be confirmed with laboratory tests. Treatment is symptomatic. Rare complications include orchitis, aseptic meningitis, hearing loss, and pancreatitis. Mumps is a self-limiting disease, followed by lifelong immunity. The prognosis in uncomplicated cases is very good. The mumps vaccine is a combination vaccine that protects against measles, mumps, and rubella (MMR vaccine); the MMRV vaccine also protects against varicella. Immunization is recommended for all children, in addition to adults without evidence of immunity to measles, mumps, and/or rubella. Immunization offers the best protection against future exposure.

Epidemiologytoggle arrow icon

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

  • Pathogen: Mumps virus from the Paramyxoviridae family
  • Transmission [4]
    • Humans are the sole host and the virus is transmitted via airborne droplets.
    • Direct contact with contaminated saliva or respiratory secretions
    • Contaminated fomites
  • Infectivity [4][5]
    • Highly infectious
    • Affected individuals are contagious ∼ 3 days before and up to 9 days after disease onset (when the parotid gland becomes swollen).

Asymptomatic cases are also contagious.

Pathophysiologytoggle arrow icon

Clinical featurestoggle arrow icon

  • Incubation period: 16–18 days [6]
  • Prodrome
  • Classic course: inflammation of the salivary glands, particularly parotitis ; [5][7]
    • Duration of parotitis: at least 2 days (may persist > 10 days)
    • Symptoms
      • May initially present with local tenderness, pain, and earache
      • Unilateral swelling of the salivary gland (lateral cheek and jaw area); During the course of disease, both salivary glands are usually swollen.
      • Redness in the area of the parotid duct
      • Possible protruding ears
      • A flat, red rash that begins on the face and disseminates to the rest of the body can occur.
    • Chronic courses are rare.
  • Subclinical presentation [6]
    • Nonspecific or predominantly respiratory symptoms
    • Asymptomatic (in 15–20% of cases) [4]

Diagnosticstoggle arrow icon

Laboratory tests, if available, should be conducted to confirm the suspected cases (especially if presentation is atypical or there is a mumps outbreak). [4][6][7]

Differential diagnosestoggle arrow icon

Differential diagnosis of parotid swelling [7]

Features Mumps Acute purulent sialadenitis Sialadenosis (sialosis) Sialolithiasis (salivary stones) Tumors of the salivary glands
Parotid swelling
  • Usually bilateral
  • Usually unilateral
  • Usually bilateral
  • Partial swelling of the gland
  • Usually unilateral
  • Painful
  • Painful
  • Usually painless
  • Painful while eating
  • Usually painless
  • Present
  • Present
  • Absent
  • Usually absent
  • May be present
Other findings
  • Possible redness of the gland
  • Protruding ears
  • Possible pus discharge
  • Sudden pain while eating
  • Possible malignant symptoms of infiltrated structures (e.g., facial palsy)

The differential diagnoses listed here are not exhaustive.

Treatmenttoggle arrow icon

Mumps is usually self-limited with a good prognosis (unless complications arise). Treatment is mainly supportive care.

  • Medication for pain and fever (e.g., acetaminophen)
  • Bedrest
  • Adequate fluid intake
  • Avoidance of acidic foods and drinks
  • Ice packs to soothe parotitis
  • Isolate the patient. [8]

Mumps is a nationally notifiable disease; report all cases to the appropriate health departments. [5]

Complicationstoggle arrow icon


  • Definition: inflammation of the testis
  • Epidemiology: most common complication of mumps in postpubertal male individuals (20–30% in unvaccinated postpubertal and 6–7% in vaccinated males) [6][9]
  • Clinical features
    • Sudden onset of fever, nausea, vomiting
    • Swollen and tender affected testicle(s); primarily unilateral, although bilateral in ∼ 15% of cases
  • Complications: : may lead to atrophy and, in rare cases, hypofertility

Other complications [4]

The MEN of the PANamanian ORCHestra know how to throw a good PARty: MENingitis, PANncreatitis, ORCHhitis, and PARotitis are the most important complications of mumps.

We list the most important complications. The selection is not exhaustive.

Preventiontoggle arrow icon

Vaccination [10][11][12]

Administer a live attenuated mumps vaccine; (i.e., MMR vaccine, MMRV vaccine) according to the ACIP immunization schedule. See the following:

Exposure control [8][13]

Referencestoggle arrow icon

  1. Mumps Cases and Outbreaks. Updated: March 6, 2017. Accessed: March 18, 2017.
  2. Conly JM, Johnston BL. Is mumps making a comeback?. Can J Infect Dis Med Microbiol. 2007; 18 (1): p.7-9.
  3. Hupp JR, Ferneini EM. Head, Neck, and Orofacial Infections: A Multidisciplinary Approach. Elsevier Health Sciences ; 2015
  4. Gupta RK, Best J, MacMahon E. Mumps and the UK epidemic 2005. BMJ. 2005; 330 (7500): p.1132-1135.doi: 10.1136/bmj.330.7500.1132 . | Open in Read by QxMD
  5. Mumps - For Healthcare Providers. Updated: October 24, 2016. Accessed: March 18, 2017.
  6. Epidemiology and Prevention of Vaccine-Preventable Diseases - Mumps. Updated: July 30, 2015. Accessed: March 18, 2017.
  7. Hviid A, Rubin S, Mühlemann K. Mumps. The Lancet. 2008; 371 (9616): p.932-944.doi: 10.1016/s0140-6736(08)60419-5 . | Open in Read by QxMD
  8. AAP Committee on Infectious Diseases. Red Book: 2021–2024 Report of the Committee on Infectious Diseases. American Academy of Pediatrics ; 2021
  9. Masarani M, Wazait H, Dinneen M. Mumps orchitis. J R Soc Med. 2006; 99 (11): p.573-575.doi: 10.1258/jrsm.99.11.573 . | Open in Read by QxMD
  10. Adult Immunization Schedule by Age Recommendations for Ages 19 Years or Older, United States, 2023. Updated: February 10, 2023. Accessed: March 24, 2023.
  11. CDC Adult Immunization Schedule by Medical Condition and Other Indication. . Accessed: June 20, 2022.
  12. Child and Adolescent Immunization Schedule. Recommendations for Ages 18 Years or Younger, United States, 2023. Updated: February 10, 2023. Accessed: March 24, 2023.
  13. Centers for Disease Control and Prevention (CDC).. Updated recommendations for isolation of persons with mumps.. MMWR Morb Mortal Wkly Rep. 2008; 57 (40): p.1103-5.

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