Recognition
- Prodrome (1-2 days): Low-grade fever, malaise, headache, myalgia, loss of appetite
- Parotitis: Painful swelling anterior to and below the ear (parotid region), pushing the earlobe upward and outward. May be unilateral initially, becoming bilateral in ~70%
- Fever: Typically 38-40C. Peaks with parotid swelling
- Incubation: 16-18 days (range 12-25 days)
- Contagious period: Several days before parotitis through 5 days after swelling onset
- Distinguishing feature: Mumps swelling is anterior to the ear and pushes the earlobe up. Cervical lymphadenopathy is below the jaw
- Orchitis signs: Testicular pain, swelling, and fever occurring 4-8 days after parotitis onset (20-50% of post-pubertal males)
- Subclinical: 20-30% of infections are asymptomatic but still contagious
- Reportable disease in Ontario
MT Relevance
- Systemic contraindication: Acute mumps contraindicates massage — the client is febrile, contagious, and in pain
- Local contraindication: Even in recovery, the swollen parotid and surrounding cervical region is a local contraindication until fully resolved
- Return to treatment: Massage may resume once the client is afebrile and all swelling has fully resolved, typically 10-14 days after symptom onset
- Orchitis awareness: Male clients recovering from mumps orchitis may have residual testicular sensitivity. Avoid abdominal/hip techniques that could cause referred discomfort
Required Actions
- Refer to a physician immediately if mumps is suspected — reportable disease
- Do not treat during active infection or while swelling persists
- Be aware that clients may be contagious before swelling appears (virus is shed in saliva before parotitis onset)
Key Takeaways
- Mumps is caused by Mumps virus (paramyxovirus). Spread by respiratory droplets and saliva. Incubation 16-18 days.
- Hallmark sign: painful parotid swelling pushing the earlobe upward and outward.
- Serious complications in post-pubertal individuals: orchitis (20-50% of males), meningitis, sensorineural deafness.
- Mumps is a reportable disease in Ontario. Refer immediately if suspected.
- Acute mumps is a systemic contraindication. Local contraindication to the neck/jaw persists until swelling fully resolves.