Mumps Virus

  • Diagnosis
  • Background
  • Lab Tests
  • References
  • Related Topics

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
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

Recommended Use 

Confirm mumps infection

Collect during first 3 days of illness; if collecting urine, collect first morning void

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

Recommended Use 

Confirm acute infection

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

Recommended Use 

Determine patient's immune status to mumps

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

Recommended Use 

Can be used for molecular confirmation of mumps infection

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 JS, Rosen JB, Doll MK, McNall RJ, McGrew M, Williams N, Lopareva EN, Barskey AE, Punsalang A, Rota PA, Oleszko WR, Hickman CJ, Zimmerman CM, Bellini WJ. 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 SN. Mumps: a resurgent disease with protean manifestations. Med J Aust. 2008; 189(8): 456-9. PubMed

Shanley JD. 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 KF, Meier JD, 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 BH, Welch RJ, Couturier MR. 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

Couturier, Marc Roger, PhD, D(ABMM), Medical Director, Microbial Immunology, Parasitology and Fecal Testing, and Infectious Disease Rapid Testing at ARUP Laboratories; Assistant Professor of Clinical Pathology, University of Utah

Hillyard, David R., MD, Medical Director, Molecular Infectious Diseases at ARUP Laboratories; Professor of Clinical Pathology, Adjunct Professor of Biology, University of Utah

Schlaberg, Robert, MD, MPH, Medical Director, Microbial Amplified Detection, Virology, and Fecal Chemistry; and Assistant Medical Director, Virology and Molecular Infectious Disease at ARUP Laboratories; Assistant Professor of Clinical Pathology, University of Utah

Last Update: August 2016

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