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Mumps is an acute, contagious disease generally characterized by swelling of the parotid gland. The most common complications from mumps infection include orchitis, oophoritis, mastitis, pancreatitis, hearing loss, meningitis, and encephalitis. 1 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 9: mumps. Last reviewed Sep 2023; accessed Jan 2025. Centers for Disease Control and Prevention. Mumps cases and outbreaks. Last reviewed Jan 2025; accessed Jan 2025. Centers for Disease Control and Prevention. Clinical overview of mumps. Last reviewed Jan 2025; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 9: mumps. Last reviewed Sep 2023; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
Quick Answers for Clinicians
Timing is very important when considering the proper laboratory tests to order for mumps diagnosis. For diagnostic tests like reverse transcription polymerase chain reaction (RT-PCR) and viral culture, testing should be performed when the patient’s viral load is at its peak (≤3 days from the onset of symptoms) to minimize the risk of a false-negative result. 4 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
Diagnosis of a breakthrough case of mumps in a vaccinated individual can be challenging. Viral load is generally low, and infection is cleared quickly in patients who are vaccinated. This means that diagnostic tests like reverse transcription polymerase chain reaction (RT-PCR) are more likely to produce false-negative results, even if specimens are taken early in the disease course. 4 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
It is recommended that all children receive two doses of the measles, mumps, and rubella (MMR) vaccine. 5 Centers for Disease Control and Prevention. Vaccines and immunizations: measles, mumps, and rubella (MMR) vaccination: what everyone should know. Last reviewed Jan 2021; accessed Dec 2022. Centers for Disease Control and Prevention. Recommendation of the Advisory Committee on Immunization Practices for use of a third dose of mumps virus-containing vaccine in persons at increased risk for mumps during an outbreak. Last reviewed Jan 2018; accessed Dec 2022. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
Indications for Testing
If mumps is suspected based on clinical presentation or recent exposure, laboratory testing should be performed. 1 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 9: mumps. Last reviewed Sep 2023; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 9: mumps. Last reviewed Sep 2023; accessed Jan 2025.
Laboratory Testing
The sensitivity of RT-PCR, culture, and serologic testing is heavily impacted by the amount of time since symptom onset. Therefore, the selection of appropriate laboratory testing strategies is time-dependent. The table below describes the optimal timing for RT-PCR, culture, and serologic testing and details the appropriate specimen types for various clinical situations.
Days Since Symptom Onset | Recommended Test | Potentially Useful Additional Tests |
---|---|---|
≤3 | RT-PCR or viral culture (buccal/parotid swab) | RT-PCR (urine)a IgG serology (acute phase)b |
>3 | RT-PCR or viral culture (buccal/parotid swab) IgM serology | RT-PCR (urine)a IgG serology (convalescent phase)b |
aUrine should be added as an additional specimen type in patients without parotitis who present with orchitis, oophoritis, mastitis, pancreatitis, hearing loss, meningitis, or encephalitis. bObservation of seroconversion and/or a fourfold increase in titer from paired acute and convalescent sera can confirm past mumps infection in unvaccinated patients. Sources: CDC, 2022 4 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. |
RT-PCR and Viral Culture
RT-PCR or viral culture can be used to confirm an acute mumps infection. 1 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 9: mumps. Last reviewed Sep 2023; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
A buccal/parotid swab is the preferred sample type; however, when patients without parotitis present with orchitis, oophoritis, mastitis, pancreatitis, hearing loss, meningitis, or encephalitis, collecting a urine specimen in addition to the buccal/parotid swab is recommended. 4 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
Serology
IgM
The detection of mumps IgM antibodies is suggestive of an active mumps infection, but RT-PCR or culture tests are required for a definitive diagnosis, particularly in vaccinated patients. 1 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 9: mumps. Last reviewed Sep 2023; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Serology to diagnose mumps. Last reviewed Jun 2024; accessed Jan 2025.
IgG
IgG antibodies may confirm a mumps diagnosis if paired acute and convalescent sera show a fourfold rise in IgG titer. However, this method is not recommended for vaccinated individuals because IgG is likely to already be elevated in the acute-phase sample. 4 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
Detection of IgG antibodies against mumps provides presumptive evidence of previous infection or vaccination. However, the presence of mumps-specific IgG antibodies does not necessarily prove protection from mumps infection. 4 Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025. Centers for Disease Control and Prevention. Vaccine and immunizations: special situations. Last reviewed Jul 2024; accessed Jan 2025.
ARUP Laboratory Tests
Qualitative Polymerase Chain Reaction
Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Semi-Quantitative Chemiluminescent Immunoassay
References
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CDC - Manual for surveillance: mumps
Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 9: mumps. Last reviewed Sep 2023; accessed Jan 2025.
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CDC - Mumps cases and outbreaks
Centers for Disease Control and Prevention. Mumps cases and outbreaks. Last reviewed Jan 2025; accessed Jan 2025.
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CDC - clinical overview of mumps
Centers for Disease Control and Prevention. Clinical overview of mumps. Last reviewed Jan 2025; accessed Jan 2025.
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CDC - Manual for surveillance: laboratory support
Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Last reviewed Mar 2024; accessed Jan 2025.
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CDC - Vaccines: measles, mumps, and rubella
Centers for Disease Control and Prevention. Vaccines and immunizations: measles, mumps, and rubella (MMR) vaccination: what everyone should know. Last reviewed Jan 2021; accessed Dec 2022.
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CDC - Recommendation ACIP: use of a third dose of mumps virus-containing vaccine
Centers for Disease Control and Prevention. Recommendation of the Advisory Committee on Immunization Practices for use of a third dose of mumps virus-containing vaccine in persons at increased risk for mumps during an outbreak. Last reviewed Jan 2018; accessed Dec 2022.
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CDC - Mumps: use of serology
Centers for Disease Control and Prevention. Serology to diagnose mumps. Last reviewed Jun 2024; accessed Jan 2025.
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CDC - Vaccine recommendations ACIP: special situations
Centers for Disease Control and Prevention. Vaccine and immunizations: special situations. Last reviewed Jul 2024; accessed Jan 2025.