What is mumps disease in children treatment. Parotitis in children - symptoms and treatment, prevention, photos. Signs of an aggressive course of parotitis

Mumps - this is the scientific name for a childhood disease, popularly referred to as mumps. The causative agent is a virus from the paramycovirus family. It affects the central nervous system and glandular organs (pancreas and salivary glands, testes).

At risk are children under the age of 15 years, the peak falls on the period from 3 to 7 years. Boys are affected twice as often as girls. And for them, this infection is fraught with serious complications in autumn. It is transmitted by airborne droplets, so whole outbreaks of the epidemic in kindergartens and schools are not uncommon.

The more parents are aware of this unusual disease, the more reliably they will be able to protect their babies from it.

The main reason is paramycovirus. If we talk about how mumps is transmitted, this is the familiar airborne route, that is, during a conversation, sneezing or coughing.

You can get infected from a child who does not even have any signs of the disease yet. The fact is that a person is already a source of paramycovirus 9 days before the first symptoms appear and then 9 days after they appear (i.e., on average, 18 days of active infection are obtained).

During an epidemic, up to 70% of the children's team becomes infected. Why is the pig so selective? Firstly, after a disease, a persistent, lifelong immunity to it is formed. Re-infection is very rare. Secondly, 20% of children are not attacked by paramycovirus due to some individual characteristics.

Based on this, doctors suggest that there are a number of factors contributing to infection. These include:

• problems with immunity;
• avitaminosis;
• seasonal weakening of the body in winter and early spring;
• lack of vaccination.

So if a mumps epidemic has begun in a kindergarten or school, it is very difficult to protect a child from infection. The risk of infection is reduced if he has been vaccinated and has good immunity. And, of course, those who have already suffered the disease should not worry.

Medical terminology. Glandula parotidea is the Latin word for the parotid salivary gland, which is why its inflammation was called parotitis.

Classification

Depending on the state of immunity and the activity of the paramycovirus, mumps in children can proceed in different ways. Based on this, there are several classifications in pediatrics.

Manifestant parotitis

1. Uncomplicated: only the salivary glands (one or more) are affected.
2. Complicated: not only the salivary glands are affected, but also other organs, so meningoencephalitis, orchitis, mastitis, pancreatitis, myocarditis, and arthritis are diagnosed along with the mumps.

According to the severity of the current

1. Mild form (erased or atypical): mild symptoms, no consequences.
2. Moderate: pronounced signs of intoxication, enlarged salivary glands.
3. Severe: severe symptoms.

Allocate still inapparent parotitis, i.e. asymptomatic. On the one hand, the child is sick, but does not feel any particular discomfort, feels as usual - and this cannot but please the parents. On the other hand, it is a source of infection, infects others, while remaining in the shadows. After all, it is very difficult to diagnose this form of mumps in children.

Curious fact. Animals don't get mumps.

Symptoms

The disease has a fairly long incubation period, which largely depends on the state of the child's immune system. Usually, the first symptoms of mumps in children after infection begin to appear on the 11-13th day (after 2 weeks), less often - on the 19-23rd (i.e., only after 3 weeks).

To prevent the spread of the epidemic, if there are 2-3 sick people in the children's team, quarantine is declared for a period of 21 days.

About a day before the swelling of the parotid glands, characteristic of the disease, prodromal phenomena can be observed - these are the first signs of mumps:

• weakness, broken state;
• malaise;
• headaches and muscle pain;
• slight chills;
• lack of appetite;
• insomnia.

The very next day, all these signs intensify and are supplemented by a whole series of symptoms. It will be useful for parents to know how mumps manifests itself in children, so as not to confuse it with other diseases.

Intoxication:

• arthralgia;
• chills;
• myalgia;
• headache;
• in severe forms, asthenia, tachycardia, low blood pressure, anorexia, and prolonged insomnia can be observed.

Temperature:

• with mild forms of mumps, it can be subfebrile (up to 38 ° C);
• with moderate severity - already febrile (38-39 ° C);
• with severe - high (40 ° C), and it can stay at this level for 2 weeks or more;
• the duration of the fever is from 4 to 7 days, the peak falls on the first and second days.

Salivary gland damage:

• dry mouth;
• ear pain;
• Filatov's symptom: the most painful points are in front of and behind the earlobe, as well as near the mastoid process;
• when chewing and talking, the pain radiates to the ears;
• gland tumor;
• the most striking symptom of mumps in children is a significant (visually detectable) increase in the salivary glands, most often on both sides, and the swelling usually extends to the neck;
• symptom of Mursu - inflammation of the mucous membrane in the area of ​​​​the excretory duct of the parotid gland affected by the virus: the skin in this place is tense, shiny;
• swelling increases over 3 days, remains in the achieved volume for another 2-3 days, and then slowly decreases (it takes another week or even more);
• parallel edema of the sublingual and submandibular glands is possible.

Damage to the male genital organs:

• in boys, in 20% there is a lesion of the spermatogenic epithelium of the testicles, which just provokes infertility in the future;
• inflammation of the testicles occurs with a complicated form of mumps;
• the child will constantly complain of pain in the gonad;
• successive increase in testicles in size, their swelling and redness.

In addition, you need to keep in mind how mumps proceeds in children of different ages. The older they are, the more severe the disease is. The period of puberty is considered especially dangerous, when the organs of this sphere can fall under the attack of the virus.

In adults, the disease is treated mainly in a hospital, because it is most often not possible to avoid complications. At the first suspicion of mumps, the child should immediately be shown to the doctor.

About the name of the disease. The face of a child with mumps, with swelling of the parotid spaces and neck, becomes puffy and takes on a characteristic shape. Therefore, for a long time there has been such a name for the infection - mumps. It is also sometimes referred to as a muzzle.

Diagnostics

Sometimes only an external examination and the results of routine tests - blood and urine - are enough to confirm the diagnosis. But sometimes the symptoms of mumps are disguised as other diseases, and the doctor has to prescribe a number of additional studies.

In addition, during the course of the disease, the child will have to take regular tests to identify complications.

Laboratory methods:

• blood and urine tests;
• flushes from the pharynx;
• study of the secretion of the parotid salivary gland;
• sampling of cerebrospinal fluid (mandatory only if concomitant meningitis and other CNS lesions are suspected).

Immunofluorescence methods:

• the study of cellular structures allows you to get faster results.

Serological methods:

• enzyme-linked immunosorbent assay;
• simple reactions (RSK and RNGA);
• intradermal allergen test.

Diagnosis of mumps in children is usually not difficult. All additional studies are prescribed extremely rarely in the presence of complications. The examination is carried out either by a pediatrician or a therapist. He also prescribes treatment.

Likbez. If a child with mumps has been prescribed RSK tests (complement fixation reaction) or RIGA (indirect hemagglutination reaction), it will be necessary to prepare him in advance for blood sampling from a vein.

Treatment

After confirming the diagnosis based on the tests, the doctor will determine the severity of the disease and prescribe how to treat mumps in children - at home (in 90% of cases) or in a hospital (if there is a risk of complications).

The therapeutic course, the main task of which is to prevent complications, comes down to the following activities:

1. Isolation for 9 days after the onset of the first symptoms.
2. Bed rest for 10 days.
3. Prednisolone for a week: Dosages start at 40-60 mg, but decrease by 5 mg daily.
4. Other corticosteroids may be an alternative to prednisone.
5. If there is a risk of further development of meningitis, a spinal puncture is prescribed with the extraction of cerebrospinal fluid.
6. Dehydration therapy in moderation.
7. Antipyretics (paracetamol, ibuprofen), and at a very high temperature, an injection of analgin with papaverine is given.
8. Plentiful warm drink.
9. Antiviral / immunostimulatory drugs (eg, groprinosin).
10. Dry heat on the swollen area.
11. Antispasmodics (drotaverine, no-shpa) for pain relief.
12. Enzyme preparations as a prevention of pancreatitis (mezim, creon).

Therapeutic diet

Children with mumps are prescribed a therapeutic diet to avoid pancreatitis, which is a common complication after this disease. Its main principles:

• do not overeat;
• limit the use of white bread, pasta, fats, cabbage;
• the basis of the diet should be dairy and vegetable products;
• rice, potatoes, black bread are recommended.

Usually the treatment of mumps in children is reduced to complete rest, isolation and improvement of the general condition. If complications and concomitant diseases occur, the therapeutic course changes direction to them.

By any means to avoid the dangerous consequences of parotitis is the main task of doctors at this stage. Despite the fact that they are rare, their danger to the later life of the child is very great.

According to statistics. Boys who fell ill with mumps and did not comply with bed rest were later diagnosed with orchitis 3 times more often than those who exactly followed all the recommendations of doctors.

Complications

Mumps is famous not so much for its symptoms or course, but for its consequences, and especially for boys. Indeed, the defeat of the testes by the virus may subsequently affect their ability to become fathers. Among the most common complications of this disease, doctors call the following:

• orchitis, aspermia, infertility and testicular atrophy are the most common and most dangerous consequences of mumps in boys, the risk of which increases with age;
• damage to the middle ear, which can result in deafness;
• serious disturbances in the functioning of the central nervous system;
• serous meningitis;
• meningoencephalitis;
• inflammation of the thyroid gland;
• pancreatitis;
• dysfunction of the pancreas.

If the child has been ill with mumps, the prognosis with vaccination is favorable. Dangerous consequences, although diagnosed, are not so common. Lethal outcomes are very rare: about 1 case per 100,000. But in order to minimize all risks, it is better to vaccinate on time and no longer be afraid of a mumps epidemic.

Prevention

The vaccine is a safe and guaranteed means of preventing mumps in children. According to the vaccination schedule, two injections are required:

• at the age of 1-1.5 years;
• in the period from 2 to 6 years.

The mumps vaccine is safe and side effects are rare and mild. The introduction of the drug causes moderate pain, low temperature, swelling in the injection area.

There is no substantiated evidence that there is any association between mumps vaccination and neurological complications. The drug is developed on the basis of chicken cells, but is approved for administration to children who are allergic to eggs.

Despite regular vaccination, mumps epidemics constantly break out in children's groups. Without an appropriate injection at 1 year old, children suffer the disease very hard, and in this case, boys cannot avoid serious complications that will subsequently affect their whole life.

Parents should keep this in mind before writing a waiver for another vaccination. Mumps is exactly that disease, which is much more difficult to treat than to prevent.

Mumps infection refers to anthroponoses. The infection is transmitted from sick person to person. Moreover, the carrier may even have an erased or subclinical (without symptoms) form of the disease. The virus “migrates” by airborne droplets; even a short conversation with a sick person is enough for infection. If the sick person does not have catarrhal symptoms (runny nose, cough, etc.), the virus cannot be transmitted over long distances, only 1-2 meters. However, in such cases, children who sit at the same desk, or communicate while playing in the yard, etc., can become infected.

A less significant way of transmission of the infection (nevertheless, there are such cases) is through toys, contaminated household items, etc. A few hours before the onset of symptoms, the patient is already dangerous to others. From 3 to 5 days, the greatest risk of infection from a sick child. The patient is considered non-infectious after the 9th day of illness - it is impossible to isolate the virus from the body.

Susceptibility to mumps infection is about 85%. More than others, children 3-6 years old are at risk. In recent years, active immunization has been used, therefore the incidence of children aged 1-10 years has decreased. However, the share of infected adolescents and adults has increased. Rare cases of the disease among children under one year old, because they receive antibodies from the mother, which are active until 9 or 10 months. The connection of mumps infection with congenital fibroelastosis of the endocardium is allowed. The disease in these cases manifests itself in a child during the first 2 years of life, manifesting itself as symptoms of left ventricular hypertrophy and progressive heart failure.

Patients who have had an infection have strong immunity. At the end of the first week of illness, TgM class antibodies appear, which stay in the body from 60 to 120 days. Later, antibodies of the IgG class are detected, the activity of which increases by the third or fourth week and persists throughout life. There are no recurrences of the disease.

What provokes / Causes of Parotitis in children:

The virus belongs to the family . The particles contain RNA surrounded by a shell. The envelope consists of a matrix protein (M), a lipid bilayer, and an outer glycoprotein layer. has no anti-gene variants.

The reproduction of the virus occurs in cultures of monkey cells, chicken embryos, hamsters, guinea pigs, etc. The greatest sensitivity among laboratory animals is observed in monkeys.

In the external environment, the virus is stable. It can be deactivated with 1% Lysol solution or 2% formalin solution. In an environment with a temperature of 18-20 ˚C, the virus lives for several days. If the temperature is lower, the life of the virus is extended to 6-8 months.

Pathogenesis (what happens?) during Parotitis in children:

The infection enters the child's body through the mucous membrane of the mouth and nasopharynx. Then the virus "migrates" into the bloodstream, spreads to the salivary and other glands. The virus actively multiplies in the salivary glands, where it accumulates. Secondary viremia occurs due to a massive release of the virus from the glands in which it has accumulated. This leads to damage to the pancreas, central nervous system, genital organs and many others.

Symptoms parotitis in children can manifest themselves in the first days of the disease - all at once or in turn. Due to secondary viremia, some symptoms may appear in the middle of the disease rather than at the beginning.

Immunity

Mumps refers to acute diseases with a short duration of the virus (about 5-7 days). The virus cannot be isolated from the body at a later date. By this time, the patient's blood has a fairly high titer of IgM class antibodies. Cellular immunity factors and secretory immunoglobulins also protect the body.

Pathomorphology

The interstitial tissue of the salivary glands, testicles, pancreas, and central nervous system are the first to undergo changes in tissue structure. Also, morphological changes can occur in other organs (in rare cases). The foci of inflammation are mostly near the salivary excretory ducts, blood vessels. The glandular tissue of the organ is practically not subject to the pathological process. But there may be inflammation in the testicles. Necrosis may begin in the glands, accompanied by blockage of the tubules, which can lead to atrophy (impairment or cessation of function) of the testicle.

Symptoms of parotitis in children:

The incubation period for mumps infection lasts from 12 to 26 days. In rare cases, it can last a minimum of 9 days, a maximum of 26 days.

Clinical manifestations depend on the form of the disease. The most common manifestation of parotitis is lesion of the parotid glands. The disease usually has an acute onset, accompanied by a rise in temperature to 38-39 ˚C. If the cases are mild, then the temperature is normal or slightly elevated. The level of temperature in the following days depends on how widespread the infectious process is. The temperature curve has a wave-like character (it rises then decreases). The temperature rises when the infection attacks other salivary glands or organs. Along with the temperature, symptoms of intoxication begin to appear. The child develops headaches and muscle pain, malaise, loss of appetite. Young children become moody. Parents observe sleep disturbance.

Among the first symptoms of parotitis in children fix pain in the region of the parotid salivary gland, which is aggravated by chewing and talking. By the end of the first day or at the beginning of the second day (less often), there is an increase in the parotid salivary glands. At first, the process concerns only one side. The second side is affected in 1-2 days. A swelling is visible in front of the ear, which descends along the ascending branch of the lower jaw and behind the auricle, lifting it up and out.

But the increase can not always be determined visually, sometimes palpation is necessary for this. On palpation, doctors note the softness or doughy structure of the salivary gland. Palpation causes pain. According to N. F. Filatov, such painful points are distinguished: in front of the earlobe, in the region of the apex of the mastoid process and at the site of the mandibular notch.

Within 2-4 days, the parotid glands increase. After that, the dimensions gradually return to normal. Together with the parotid or after them, the submandibular (submaxillitis) and sublingual (sublinguitis) salivary glands are affected.

In every 4th patient with parotitis, inflammation of the submandibular gland (the so-called submaxillitis) is observed. Most often it is accompanied by lesions of the parotid salivary glands. It almost never appears at the onset of the disease.

Severe forms of the disease can lead to the fact that swelling of the fiber may appear in the area of ​​\u200b\u200bthe gland and spread to the neck. In rare cases, the so-called sublinguit- isolated lesion of the sublingual salivary gland. In this case, swelling appears under the tongue of the patient. Affected glands are usually enlarged for 5 to 7 days. Then pain disappears, swelling subsides. Inflammation ends on the 8th-10th day of illness. But there are times when the glands are inflamed for 2-3 weeks. The temperature periodically rises and falls again.

Damage to the genital organs with mumps infection

The virus can attack the testicles, ovaries, prostate, and mammary glands. Adolescents are prone to orchitis (25 cases out of 100). Orchitis leads to persistent testicular dysfunction, and hence to male infertility in the future. In those who have orchitis, spermatogenesis is impaired (about 50% of those who have been ill), and in 1/3 of those who have been ill, signs of testicular atrophy are recorded. Orchitis may begin to appear 1-2 weeks after the onset of inflammatory processes in the salivary glands. But it happens that mumps infection has a primary localization in the testicles.

Inflammation of the testicles appears due to infection on the epithelium of the seminiferous tubules. Pain receptors are irritated, which leads to the occurrence of pain syndrome. The pressure inside the tubules rises, and this threatens to disrupt the microcirculation and functionality of the organ.

One of the initial symptoms of orchitis with parotitis is an increase in temperature to 38-39 ° C. Often a sick child feels chills. Symptoms of intoxication appear immediately - weakness, intense pain in the groin (attempts to walk cause more severe pain), headache. Localization of pain occurs mostly in the scrotum and testicles. The testicle enlarges and becomes more dense. Palpation leads to increasing pain. On the skin of the scrotum, reddish vessels are visible, overflowing with blood, and the skin may also acquire a bluish tint.

Not always the process extends to 2 testicles. The swelling is expressed for 5 to 7 days, then begins to subside. After 1-2 months, signs of atrophy are revealed, the testicle decreases in size and becomes softer.

A rare form of parotitis is thyroiditis. It usually manifests itself as an increase in the thyroid gland, fever, pain in the neck and tachycardia.

There is also a lesion of the lacrimal gland - dacryoadenitis, it manifests itself as pain in the eyes and swelling of the eyelids.

Damage to the nervous system

Very rarely, CNS involvement is the only manifestation of mumps. Often the nervous system is affected by infection after the glands. If the defeat of the central nervous system is still the only manifestation, then the salivary glands are almost not touched by the virus, they do not hurt. Clinically, the disease manifests as meningoencephalitis, serous meningitis, and in rare cases, neuritis or polyradiculoneuritis.

Serous meningitis most often fixed on the 7-10th day of illness after the symptoms of mumps infection begin to appear less or disappear.

Mumps meningitis has an acute onset, fever. The patient has headaches, repeated vomiting. Young children are sleepy and lethargic. In rare cases, on the contrary, excitation, as well as convulsions and delusional states, can be observed. From the first days of the disease, meningeal syndrome appears, which manifests itself as positive symptoms of Kernig, Brudzinsky (appear as a result of irritation of the meninges, hemorrhage under the membranes). If the forms of the disease are mild, then meningeal signs are weakly expressed (may be absent). The disease has such manifestations: single vomiting, headache, slightly elevated temperature. The definitive diagnosis of mumps meningitis is based on the results of spinal puncture.

In some cases, meningitis with parotitis can be combined with encephalitis (the so-called meningoencephalitis). Cerebral symptoms in such cases occur simultaneously with meningeal symptoms or after two or three days. Among the clinical manifestations of meningitis are: repeated vomiting, severe headaches, delusions, impaired consciousness, convulsions. Pathological reflexes and hyperkinesis are also likely. Usually the course of the disease is favorable. Clinical symptoms subside after 3-5 days. The phenomena of meningitis disappear after a week (maximum - after 10 days). The cerebrospinal fluid normalizes slowly, changes in it can persist for up to 3-5 weeks.

The recovery process may be delayed in some cases (rarely). In such cases, psychosensory disorders persist for a long time, which manifest themselves in memory loss, increased fatigue, headaches and areflexia (absence of one or more reflexes).

Rarely found in mumps infection neuritis and polyradiculoneuritis. When the parotid gland increases dramatically, it can lead to compression of the facial nerve, to paralysis. On the side of the affected facial nerve, in this case, the function of the facial muscles is disturbed: the eyebrow is somewhat lowered, the forehead folds are smoothed out (as well as the nasolabial fold), the palpebral fissure does not close.

In mumps infection, lesions of the cochlear nerve with hearing loss have been described.

Mumps can develop mumps pancreatitis, associated with damage to other organs. The frequency of pancreatitis, as far as can be judged from the specialized medical literature, ranges from 3% to 72%. The diagnosis of pancreatitis is established only by an increase in the level of amylase in the blood.

With parotitis, pancreatitis, as it should be, occurs 5-9 days after the onset of the disease. Pancreatitis is the only manifestation of the disease in very rare cases.

Mumps pancreatitis in typical cases has an acute onset, manifested by pain. Abdominal pain ranges from mild to very severe. The pain is felt in the epigastric region, the left hypochondrium, sometimes it is girdle and radiates to the back, the right hypochondrium. In addition to pain, nausea and vomiting are also often manifested, the cold becomes more frequent, the body temperature rises. On palpation of the abdomen, pain and swelling are noted.

A blood test at the height of the disease shows an increased amount of amylase, lipase, trypsin. Diastase activity is increased in the urine. Fecal analysis shows a significant increase in the amount of unchanged muscle fibers, fatty acids and extracellular starch. In peripheral blood changes are not typical.

The course of mumps pancreatitis is favorable. Symptoms begin to subside 10-12 days after the onset of manifestations. First, the pain disappears, then the patient's well-being gradually improves. But the function of the pancreas is restored only in the third or fourth week from the onset of the disease.

Diagnosis of parotitis in children:

If the cases are typical, the diagnosis is quite simple. In atypical variants of the disease, mumps infection is more difficult to diagnose. Also, the diagnosis is complicated if the parotid salivary glands are not involved in the process, or if the lesions of any organ are isolated. With these forms of the disease, a great influence in the diagnosis is given to the anamnesis - there would be cases of the disease in a kindergarten, school, in the family.

A clinical blood test is sometimes not used to diagnose mumps infection. It usually has leukopenia.

To confirm the diagnosis by ELISA, specific antibodies of the TgM class are detected in the blood, which indicate that the infection is active. In mumps infection, IgM class antibodies are detected in all forms, even with atypical or isolated infection localization (manifestations of orchitis, meningitis or pancreatitis). This is of exceptional importance in diagnostically difficult cases.

Later, specific antibodies of the IgG class appear, which persist for years.

Differential diagnosis. The defeat of the salivary glands with parotitis is distinguished from acute parotitis with sepsis, abdominal neck.

Treatment of parotitis in children:

Treatment of parotitis in children takes place at home in most cases of the disease. If the form of the child's illness is severe, he is subject to hospitalization. Children are usually admitted to the hospital if they develop serous meningitis, orchitis, or pancreatitis, as described above. Specific treatment has not been developed. Bed rest is needed in the acute period of the disease (for 5-7 days). It is believed that the frequency of orchitis increases due to physical exertion, because boys over 10 years of age are strongly advised to stay in bed.

When clinical symptoms appear, the patient is prescribed a more strict diet, which begins with hungry days (1-2 days). Then the diet expands, but with a minimum of carbohydrates and fats. The diet is predominantly protein. After 10-12 days, a sick child can be transferred to diet No. 5. In severe cases, intravenous drip fluid with proteolysis inhibitors (kontrykal, gordox, trasilol) may be prescribed. To relieve pain, analgesics and antispasmodics (for example, analgin, papaverine, no-shpu) are used. Enzyme preparations are prescribed for digestive disorders: pancreatin, panzinorm, festal, etc.

Hospitalization is recommended for patients with orchitis. To relieve inflammation, glucocorticosteroid hormones are used. To relieve pain, analgesics and desensitizing drugs are prescribed. If the edema is significant and pressure on the parenchyma of the organ needs to be eliminated, sometimes they resort to a surgical method - dissection of the albuginea.

If doctors suspect, a spinal puncture is used for diagnosis. It is rarely used to reduce intracranial pressure. Lasix is ​​administered for the purpose of dehydration. In severe cases of the disease, infusion therapy is used (20% glucose solution, 1.5% Reamberin solution, B vitamins, polyoxidonium).

Prevention of parotitis in children:

Insulation

Children with mumps are isolated from the kindergarten / school until the clinical manifestations disappear (for a maximum of 9 days). Among contact separation for a period of 21 days (3 weeks), children under the age of 10 years who have not previously had mumps and have not received active immunization are subject to separation. If the date of contact with a sick person is precisely known, children are isolated from the 11th to the 21st day of the incubation period. Final disinfection in the focus of infection is not carried out, but the room where the patient was staying should be ventilated and wet cleaning should be carried out using disinfectants. This will help eradicate the infection.

Children who have had contact with a person with mumps are monitored (examination and temperature measurement are shown).

Active immunization is considered a reliable method of prevention. Use a live attenuated mumps vaccine.

Combined vaccines against mumps, measles and rubella (Priorix and MMR) are used in our country. Vaccination is mandatory for children at the age of 1 year, if the child did not have mumps. Revaccination is carried out at the age of 6 years. If there are epidemiological indications, adolescents and adults are vaccinated. 0.5 ml of the vaccine is injected once under the skin in the area under the shoulder blade or in the outer surface of the shoulder.

After vaccination and revaccination, strong (in some cases, lifelong) immunity is formed. The vaccine is slightly reactogenic. There are no direct contraindications to the introduction of the mumps vaccine.

Which doctors should you contact if you have Parotitis in children:

Infectionist

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Other diseases from the group Diseases of the child (pediatrics):

What it is? Mumps is an acute viral intoxication of the body caused by paramyxovirus mumps. In the people, the disease is known as mumps, since an infected person looks like this animal (see photo). In addition to mumps, paravixovirus infections include measles and parainfluenza.

The main route of entry of the virus is the upper respiratory tract (airborne droplets). Also, the disease can be transmitted by contact - through the personal items of an infected person (towel, toys, bedding, etc.).

• Everyone can become infected with the mumps virus, but most often the pathology is detected in children, since their immune system provides less active resistance than in adults.

According to studies, the percentage of infected people from contact with a patient with mumps is about 50%, that is, susceptibility to the virus is quite high.

The main period when the virus is most dangerous to others is 24-48 hours before the onset of the first symptoms and 10 days after the onset of the disease. Persons over 20 years of age in their majority (about 85%) have antibodies to the infection in their blood, which explains the insignificance of the spread of pathology among the adult population.

Symptoms of mumps, photo in children

parotitis photo in children

According to various medical sources, there is no generally accepted classification of pathology forms. There are manifest forms (uncomplicated, complicated and depending on the severity of the course of the disease), inapparent forms and residual-type phenomena provoked by the mumps virus (infertility, diabetes mellitus, testicular atrophy in men, malfunctions of the central nervous system, hearing impairment or loss).

Parotitis:

An acute viral disease is manifested by general intoxication of the body, fever, pathological disorders in the glandular organs, in particular, the parotid salivary glands (one or both). There are also malfunctions in the functioning of the central nervous system. Soreness in the parotid glands affected by the virus is aggravated by chewing and talking.

The incubation period of mumps lasts from 11 to 23 days, after which the activated virus manifests itself with the following clinical signs:

• general malaise and weakness;
• excessive fatigue;
• high temperature and fever (up to 39°C, in especially severe cases up to 40°C);
• lack of appetite;
• dryness in the mouth;
• aching pain in the ears and submandibular glands.

The clinical picture of mumps and its severity is different. Depending on the severity of painful manifestations, mumps is divided into 3 varieties:

1. Light(atypical or erased) mumps - high temperature lasts no more than two days, the symptoms are mild, only the parotid salivary glands are slightly affected, the patient feels only a slight malaise;
2. Medium heavy parotitis - in addition to the salivary glands, the remaining glands are affected, an increase in body temperature is observed for 3 to 6 days, there are severe headaches, sleep disorders and loss of appetite are observed;
3. Heavy mumps - the temperature (up to 40 ° C) lasts about 7 days, the virus penetrates into the most important systems of the body, including the central nervous system, there is a strong swelling of the diseased glands and a pronounced clinical picture of mumps.

Parotitis in children, features

Mumps most often occurs in children aged 3 to 15 years. Babies, like adults, are much less likely to become infected with the virus. Boys carry the disease 1.5 times more often than girls. The general symptoms of the disease in people of all ages are similar.

Mumps in children, the symptoms of which were not diagnosed in a timely manner, and appropriate prevention and therapy were not carried out, or treatment turned out to be late, can lead to serious complications: meningitis, encephalitis, arthritis, deafness, pancreatitis, infertility.

Paramyxovirus spreads throughout the glandular system, including the male gonads. This explains its danger to representatives of the strong half of humanity.

The consequences of parotitis in boys can be catastrophic: prostatitis, viral orchitis, epididymitis, and in the future - complete infertility. According to statistics, up to 30% of male patients with testicles affected by the virus suffer from dangerous pathologies.

Parotitis treatment - drugs, nutrition

photo, treatment of mumps in children

The main goal of the treatment of the disease is the prevention of possible complications. Hospitalization is provided on the basis of epidemiological indicators, as well as for patients in whom the disease is severe.

• In children's institutions in which a case of mumps infection was detected, quarantine is established for a period of 21 days. The usual treatment for mumps is done at home.

Doctors prescribe antibiotics, novocaine blockade, antihistamines, and high calcium supplements. With a high temperature and severe pain in the head, it is possible to take antipyretic and analgesic drugs.

From the menu of a patient with mumps, heavy, spicy, fried, floury, sweet and fatty foods are excluded, while the diet is significantly reduced. Children are shown a dairy-vegetarian diet with a predominance of rice, rye bread, boiled potatoes, fresh fruits.

It is advisable to serve all dishes in a liquid or pureed form, since swallowing difficulties are most often observed (broths, puree soups, vegetable and fruit purees, liquid boiled cereals, soufflés). With a mild form of the disease, patients need to drink as much clean water as possible.

Warming the inflamed glands with compresses

Traditional healers claim that help from mumps is invaluable. On the swollen glands, gauze slightly soaked in warm camphor oil (several layers), a layer of parchment paper is applied and the head / neck is wrapped with a handkerchief or woolen scarf.

• The procedure time is about 2.5 hours.

Since the inflamed parotid glands require additional warming, in the absence of a high temperature, an alternation of alcohol and camphor compresses is recommended.

Remember that an increase in body temperature of both an adult and a child is the strictest contraindication to any warming compresses.

Prevention - vaccination against mumps

Combined vaccination against measles, rubella, mumps is given to children under the age of 12 months. Vaccination is carried out for those patients whose parents have not abandoned the practice of implementing preventive measures. Children who have reached the age of six are revaccinated.

• As medical practice shows, vaccination reduces the risk of contracting the listed viral infections by up to 80%.

The reaction from vaccination is strictly individual, with the slightest complications, an urgent consultation of the observing pediatrician is required. Epidemic parotitis, its treatment and prevention is in the competence of doctors: therapists / pediatricians and infectious disease specialists. In general, experts say that the prognosis for the treatment of mumps virus is favorable.

Be healthy!

Mumps is a common disease that is included in the group of exclusively childhood diseases, along with chickenpox, rubella and measles. In adults, it occurs in isolated cases. Thanks to effective vaccination against mumps (mumps), cases of infection have become rare. Babies from 3 to 7 years old are susceptible to the occurrence of this disease, but in boys, according to statistics, the disease is much more common than in girls.

Infants in their first year of life never suffer from this disease, as they receive antibodies from their mother to protect themselves from infection with the virus. In the summer, as a rule, mumps in children does not appear, in 99% of cases the onset of the disease occurs in the winter, when the possibility of infection with various infectious diseases increases due to weakened immunity and the high prevalence of various viruses.

Today, the problem of infection is solved with the help of special ones that reduce its risk to 5%.

The disease affects the glandular tissue of the lymph nodes, primarily those located behind the child's ears, as well as the salivary glands. In boys, the disease is severe and can cause a lot of serious complications that affect the organs of the genitourinary system, especially the testicles.

Mumps transferred in childhood in most cases is the cause of male infertility. Often, mumps is called mumps or mumps, as the disease is characterized by acute inflammation localized in the behind-the-ear glands. The disease is severe, accompanied by severe pain in the head and muscles of the body, as well as general intoxication.

The disease has a viral etiology, so you can become infected with it through contact with an already sick child. The mumps virus is resistant to environmental changes and temperature levels. Even at sub-zero air temperatures in winter, more than 90% of the pathogen retain their viability for several months.

Infection of children most often occurs during walks and active games with peers in the fresh air, if one of them is already infected.

The disease has a long incubation period, up to 23 days, during which the viruses actively multiply and can spread. Thus, a child can become infected after a normal walk or during play from other children who are not yet aware of their disease and that they are the source of the infection.

Symptoms

The main symptoms of the disease:

• headache;
• chills;
• temperature rise;
• pain in the joints and muscles;
• dry mouth;
• weakness;
• the appearance of a tumor in the neck.

Most often, mumps begins suddenly, with a sharp increase in body temperature, the appearance of weakness, severe headaches. Mumps fever is not always observed, but a high temperature (up to 40 ° C) usually lasts for about a week.

The main sign of mumps, which makes it possible to distinguish it from other viral diseases, is inflammation of the salivary glands near the ears, which causes a strong visible swelling of the cervical region.

Often the inflammatory process spreads to the sublingual, as well as submandibular glands and lymph nodes. Palpation of the swelling that has appeared causes severe pain to the child.

Sometimes the face of a sick baby can take the form of a pear - the inflamed glands greatly increase, the proportions of the face are disturbed.

The process can take place in a unilateral form, but in most cases, a maximum of 2 days after the onset of the disease, the lesion spreads to the other side of the head. Each case of the disease may have its own course, but in boys the symptoms are always very pronounced.

Children with mumps usually complain of pain in the ear area, which intensifies at night, preventing sleep. In many babies, such pains are accompanied by tinnitus, difficulty opening the mouth. A sick child cannot chew on his own, so he is transferred to liquid food.

As a rule, in children, severe pain persists for about 5 days, after which it gradually weakens, and at the same time, the swelling of the inflamed glands begins to subside. On average, the disease lasts about a week, and only in particularly acute cases it can take up to 13-15 days.

Diagnosis of mumps

Parotitis can take two forms:

• simple, when the disease affects only the salivary glands;
• complicated when the inflammation passes to other organs.

Diagnosis of a simple form occurs on the basis of visible symptoms, with a study of the anamnesis and the results of the tests obtained.

To identify possible complications, many additional studies are being carried out, during which not only general analyzes of urine and blood, but also saliva, as well as secretory secretions are studied, the material is taken from the pharynx.

In recent years, an immunofluorescent research technique has been increasingly used for diagnostics, which makes it possible to see the mumps virus in the tissues of the nasopharynx.

It is this diagnostic method that is the fastest, but the most informative in terms of determining the type of virus is the enzyme immunoassay method.

Features of the treatment of parotitis

If no special complications are observed during the course of the disease, then the treatment takes place on an outpatient basis, at home, but the sick child should be isolated from contact with other children.

No special treatment is required for mumps, but it is important that the baby stays in bed throughout the duration of the disease. No medication is needed, except for antipyretics and pain medications when needed.

You can give your baby more vitamins and various means to strengthen the immune system, but all appointments should be made only by a doctor.

The disease itself is not dangerous for a child, but the complications it causes always weaken the overall health of the baby and can have serious consequences, especially for boys. For this reason, mumps must be treated with the utmost seriousness and treated based on the symptoms, not letting everything take its course.

If the baby shows any signs of deterioration, it is urgent to consult a doctor for special treatment. In some cases, sick children are placed in a hospital.

Child's lifestyle during treatment

A sick baby should be isolated as soon as the first signs of the disease and severe symptoms appear. Infected children must be transferred to a separate room, where they will be treated. In this room, wet cleaning with disinfectants, treatment with a quartz lamp and ventilation should be carried out as often as possible.

In addition to a separate room, a sick baby should have personal dishes, towels, bed linen, which should be changed frequently and washed separately from the things of other family members.

During the treatment period, the baby should have toys that can be easily disinfected and treated with special means.

Diet is important. If the baby is hard and painful to chew, you can transfer it to mashed boiled vegetables, cereals, mashed soups, but you should limit the consumption of meat, it is better to replace it with boiled chicken. Fried, fatty and heavy meals, sour fruits and vegetables should be excluded from the menu.

When preparing food, the patient does not need to add spices and all kinds of spices to it. It is important to ensure that the baby drinks more warm liquids during the therapy period, for example, vitamin fruit drinks, compotes, fruit and vegetable juices, and good green tea.

To relieve a sore throat, you can sometimes gargle with a solution of ordinary baking soda. It will be possible for the baby to walk on the street only 2 weeks after full recovery.

Disease prevention

Preventive measures depend on the cause of the disease.

• Weakened immune system . Babies rarely get mumps because they receive strong but temporary protection from their mother. To avoid the disease, it is important to constantly strengthen the baby's immunity, not only maintaining the correct balance of vitamins and trace elements in his body, but also carrying out hardening procedures.
• . Many parents believe that such a disaster will not affect their baby, and therefore it is not necessary to give him routine vaccinations. However, the timely introduction of the vaccine can significantly reduce the risk of possible infection with mumps and the appearance of serious consequences of this disease.
• Violation of sanitary standards in a kindergarten or other educational institution. Unfortunately, this factor is not uncommon. According to the prescription, in the event of the appearance of mumps in a baby attending a kindergarten (school, sports section, special classes), the institution must be closed for temporary quarantine, during which a thorough disinfection is carried out in the premises. But this requirement in most cases is not met, which contributes to the spread of the disease.
• Negligent attitude of parents towards other people's children . It often happens that a baby with an already indicated malaise is sent to a kindergarten (school), without thinking that it will become a source of infection. But there is another side of the problem here. Not every parent considers it necessary to notify the educational institution that mumps has been identified in the baby, taking care only of their child and depriving them of the opportunity to protect other children from the disease.

Thus, several main criteria for preventing not only infection with the virus, but also its spread in the event of a disease, can be distinguished.

Popularly, a viral infection called mumps is known as mumps or mumps. According to statistics, a child, no matter whether it is a boy or a girl, endures the disease much more easily than an adult. You can become infected with mumps by contact or airborne droplets. Epidemic parotitis in children often occurs in the spring, and the first symptoms and signs of the disease may occur only 12 days after infection. For the most part, mumps proceeds without consequences, but in 5 cases out of 1000 it gives very serious complications.

What is parotitis in children

Respiratory viral infection parotitis (ICD-10 code - B26) is a danger due to the high risk of infection. Although mumps does not pose a threat to life, complications of the disease can lead to organ damage. The greatest incidence persists from 3 to 6 years. After an infection, a stable lifelong immunity is formed. Infection is characterized by seasonality - the peak incidence occurs in the spring, at the end of summer the disease is almost not recorded.

The causative agent of mumps

You can become infected with mumps through close contact with a sick person. The causative agent of mumps is the RNA virus Parotits epidemica, which has an irregular spherical shape. In the external environment, it is relatively stable: at room temperature it lasts for several days, and at minus temperatures - up to six months. The mumps virus has specific mechanisms of tissue damage:

• with hemagglutinating activity, it causes swelling of the parotid glands and the formation of microthrombi in the capillaries;
• with hemolytic activity destroys blood cells;
• neuraminidase activity facilitates the penetration of viral particles into the cell, promotes their reproduction.

How infection occurs

Mumps disease in children often affects the nervous system and glandular organs. The virus enters the body through the mucous membranes of the throat and nose. First, it settles on the surface of cells, destroys them, and then penetrates into the blood vessels, spreading throughout the body. If the mumps disease develops in boys, then simultaneously with the nervous and glandular tissues, the testicles and prostate can be affected, if in girls, then the disease affects the ovaries. Along with this, there may be a general allergization of the body, which lasts several years after recovery.

Incubation period

Mumps in a child begins acutely. From the moment of infection with the virus to the onset of the disease in children, it takes from 12 to 22 days, in adults - 11-35 days. In some children, 1-2 days before the development of symptoms, prodromal phenomena are observed: muscle and headaches, dry mouth, discomfort in the parotid salivary glands. The fever may last for a week.

Symptoms of parotitis

The severity of the disease depends on the state of immunity in children. If the virus has entered a healthy body, then it is threatened with an asymptomatic or mild course of the disease. The situation will be greatly complicated by the lack of vaccination against mumps or a shortly transferred other infection. What are the main symptoms of mumps in children:

• prodromal period: lethargy, apathy, weakness, causeless drowsiness;
• during the reproduction of the virus, the salivary parotid glands swell;
• there is a sharp increase in body temperature to 38–40 degrees, symptoms of intoxication of the body appear, as with influenza or SARS;
• simultaneously with swelling of the parotid glands, the child feels their soreness;
• the submandibular, sublingual glands become inflamed, swelling and redness of the tonsils are observed;
• in the case of unilateral inflammation, pain occurs when chewing.

Boys

In older boys of school age, other organs may be involved in the inflammatory process. Orchitis (testicular disease) and prostatitis (inflammation of the prostate gland) are often observed. With orchitis, one testicle swells more often. The skin on the scrotum becomes red and warm to the touch. With prostatitis, the pathology is localized in the perineum. During a rectal examination, a small patient feels acute pain, the doctor determines a tumor-like formation.

Symptoms of nonspecific parotitis

Sialadenitis (chronic non-specific mumps of a non-infectious nature) is a very common pathology in children. This is an independent disease that is not associated with an epidemiological component. An important feature of the disease is the cyclical course: relative calm is replaced by an exacerbation phase, in which the following symptoms are observed:

• pain when chewing;
• swelling in the area of ​​the salivary parotid gland;
• unpleasant taste in the mouth;
• the allocation of cloudy viscous saliva or pus with purulent mumps;
• decrease in saliva volume;
• feeling of fullness in the ears;
• increase in body temperature.

The first signs of mumps in children

The main danger of mumps is that the first signs appear a week after infection, and the child is considered healthy all this time, infecting others at the same time. The disease develops rapidly. The first signs of mumps:

• loss of appetite, refusal to eat;
• feeling of general malaise;
• attempts to open the mouth are accompanied by severe soreness behind the ears.

Classification of mumps

The course of parotitis takes place in various clinical forms. Since there is no generally accepted classification of the disease, doctors use another variation of it:

• manifest: complicated (with meningitis, arthritis, nephritis and others) and uncomplicated form, when only the salivary glands are affected;
• residual, developing against the background of mumps: deafness, CNS disorders, testicular atrophy, infertility, diabetes;
• inapparat variety (virus carrier).

Complications of the disease

Often the consequence of mumps is inflammation of the pancreas, thyroid or gonads. Other complications of mumps in children:

• inflammation of the meninges (with meningitis manifested);
• inflammation of the testicles (orchitis);
• hearing loss, sometimes leading to complete deafness;
• inflammation of the joints;
• prostatitis;
• oophoritis;
• nephritis;
• thrombocytopenic purpura;
• myocarditis.

Diagnostics

With a typical course of the disease, the diagnosis is clear to the doctor already when examining the child. To confirm the viral nature of mumps, additional laboratory tests are carried out. In the asymptomatic course of the disease, the following tests are especially important:

• detection of antibodies;
• blood test for CPR to identify the pathogen;
• a set of analyzes to assess the work of internal organs.

Treatment of mumps in children

The main rule in treatment is to isolate patients from others. Therapy is carried out at home with bed rest. The child is placed in the hospital only with a severe form of mumps. An important stage of therapy is a diet, in which preference is given to sparing nutrition with stews or boiled dishes. For treatment, antipyretic and analgesic drugs are used. Antibiotics are not prescribed, but the child is prescribed a course of physiotherapy. In severe cases of the disease, all prescribed drugs are administered intravenously through a dropper.

Drug therapy

It is possible to remove inflammation of the salivary glands in uncomplicated mumps in children with complex therapy, in which the following drugs are used:

1. Nurofen suspension. It has anti-inflammatory, antipyretic, analgesic effect. Assign to children from 3 months. According to the instructions, at one time you need from 5 to 10 mg / kg of the baby's weight. The frequency and duration of treatment is prescribed by the doctor. The average dose is 5 ml of syrup every 7 hours until the symptoms disappear. In case of an overdose, side effects from the gastrointestinal tract may occur: nausea, vomiting, epigastric pain.
2. Groprinosin. Tablets with antiviral and immunostimulating action. Dosage - 50 mg / kg of body weight per day. Drink should be in 3-4 doses for 7-10 days. In case of an overdose, the concentration of uric acid in the serum of urine and blood may increase.

Diet food

If a child has inflamed salivary glands, it is difficult for him to chew, so a sparing diet is indicated. With parotitis, it is better to give preference to liquid porridge, pureed soup and plenty of drink (herbal infusions, plain water). After each meal, you need to rinse your mouth with a solution of furacilin or soda. Cabbage, white bread, pasta, fats, sour juices should be excluded from the menu. Products that will help you recover faster:

• liquid pureed soup in chicken broth;
• any liquid porridge;
• mashed potatoes;
• steam cutlets;
• chicken meat;
• fruits and vegetables in the form of purees or puddings;
• steam / boiled fish;
• dairy;
• seeds, nuts, legumes.

Hospitalization of patients

If the mumps disease in children is severe, when other glandular organs and the nervous system are involved in the process, then hospitalization is prescribed. They can be sent to the hospital if the child lives in unfavorable social conditions, in a family hostel or in an orphanage to prevent infection of other people. When parotitis is introduced into institutions, vaccination is carried out for all unvaccinated and unill children.

From the moment of the last sick person in schools, kindergartens and children's homes, a 21-day quarantine is imposed. Vaccination is not mandatory, but recommended, because vaccination not only protects against the disease, but also facilitates the course of the infection if the child was vaccinated already in the incubation period. Revaccination is prescribed 4 years after the first vaccination, which contributes to the production of specific antibodies by the body, which prevent re-infection of mumps by 100%.

Prevention of mumps in children

In addition to standard preventive measures, isolation of the patient for 9 days is important. As the main prophylaxis, a vaccine is used, which is injected subcutaneously into the outer part of the shoulder or under the shoulder blade once at a dose of 0.5 ml. The vaccine also includes antibodies against rubella and measles. Mumps vaccines:

• monovaccines: Mumps cultural live vaccine, Imovax Orion;
• divaccine: Live mumps-measles vaccine;
• three-component: Trimovax, Ervevax, Priorix, MMR.

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