—A.A. Milne, Now We Are Six
The major viruses described in this chapter are mumps, measles, rubella, and the human parvovirus B19, which are from different virus families and genetically unrelated, but share several common epidemiologic and clinical characteristics, including: (1) worldwide distribution, with a high incidence of infection in nonimmune individuals; (2) humans as sole reservoir of infection; and (3) person-to-person spread primarily by the respiratory (aerosol) route.
The other diseases discussed in this chapter are roseola infantum and rubella-like rashes caused by many different viruses that are mainly common illnesses occurring in early life. Key characteristics of these major viruses are summarized in Table 10–1.
TABLE 10–1Comparison of Mumps, Measles, Rubella and Other Exanthems |Favorite Table|Download (.pdf) TABLE 10–1 Comparison of Mumps, Measles, Rubella and Other Exanthems
|FEATURE ||MUMPS ||MEASLES ||RUBELLA ||PARVOVIRUS B19 ||ROSEOLA |
|Virus type ||Paramyxovirus, enveloped, helical, single-stranded RNA ||Paramyxovirus (Morbillivirus) enveloped, helical, single-stranded RNA ||Togavirus (Rubivirus) enveloped, icosahedral, single-stranded RNA ||Parvovirus, naked capsid, icosahedral, single-stranded DNA ||Human herpesviruses 6 or 7, enveloped, icosahedral, double-stranded DNA |
|Transmission ||Respiratory ||Respiratory ||Respiratory ||Respiratory ||Oral secretions |
|Incubation period (days) ||12-29 (average 16-18) ||7-18 (average 9-11) ||14-21 (average 16) ||4-12 ||Unknown |
|Symptoms ||Fever, parotitis ||Fever, cough, conjunctivitis, Koplik spots ||Fever (low grade), upper respiratory symptoms ||Mild fever, malaise, headache, myalgia, itching ||High fever, occasional late sudden rash |
|Characteristic rash ||None ||Widespread, maculopapular ||Faint, macular ||Macular, reticular, often faint ||Transient, faint macular |
|Duration of illness ||7-10 days ||3-5 days ||1-3 days ||1-2 weeks ||3-5 days |
|Severity and/or complications ||Meningitis, encephalitis, pancreatitis, orchitis, oophoritis ||Bacterial superinfection, encephalitis, keratitis, reactivation of tuberculosis, subacute sclerosing panencephalitis (rare) || |
|Aplastic crisis (in chronica hemolytic diseases), arthritis, arthralgias || |
|Fetal infection ||Noa ||Noa ||Yes—multiple defects ||Yes—stillbirth, fetal hydrops ||Noa |
|Vaccine ||Live attenuated ||Live attenuated ||Live attenuated ||No ||No |
Mumps virus, a member of paramyxovirus family and genus, is a negative sense single-stranded RNA, helical, enveloped virus with glycoprotein spikes, HN and F that replicates in the cytoplasm by using viral RNA polymerase. Mumps is transmitted through respiratory tract and replicate in the respiratory tract epithelium and local lymph nodes followed by fever and swelling of parotid glands (parotitis) unilateral or bilateral. The incubation period is 12 to 29 days and the symptoms persist for 7 to 10 days. The development of viremia allows the virus to travel to all body organs, including salivary glands and central nervous system. The complications of mumps include aseptic meningitis, encephalitis, pancreatitis, orchitis, and oophoritis. Pathogenesis involves cell necrosis and inflammation with predominantly infiltration of mononuclear cells. Humoral and cell-mediated immunity are involved in containing the infection; however, IgG persists for lifelong. ...