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Epidemic parotitis (or a mumps) – an acute disease of virus character which develops owing to impact on a paramyxovirus human body. At an illness severe fever, the phenomena of the general intoxication of an organism is shown, one or several sialadens increase. Often at parotitis other bodies are surprised, and also defeats of the central nervous system are possible. This disease was described for the first time still by Hippocrates.
Symptoms of a mumps are shown at the person owing to influence of a virus from group of paramyxoviruses. It is possible to catch only from the person who is sick with a manifest or inapparantny form of parotitis. The person becomes infectious for people around in 1-2 days before he shows the first clinical symptoms of an illness of a mumps, and also in the first five days of a disease. After symptoms of an illness disappear, the person becomes noncontagious. Transfer of a virus at adults and children happens in the airborne way. However till today specialists do not exclude a possibility of transfer of a virus through the contaminated objects. At people the high susceptibility to an infection is noted. The virus gets to an organism through a mucous membrane of upper respiratory tracts.
Most often the disease affects children, and, males have parotitis about one and a half times more often. Most often the mumps develops at children between 3 and 7 years. In general about 90% of cases of an illness are diagnosed for children and teenagers who were not 15 years old yet. Most often the virus affects people during the spring period – in March and April. The smallest quantity of cases is noted in August and September. The illness can carry as sporadic character, and to be shown by epidemic flashes. The general incidence managed to be lowered after there was usual a practice of mass immunization of the population a live vaccine. After the person had a mumps, he develops lifelong immunity to a disease.
At infection with parotitis duration of an incubation interval makes from 11 to 23 days, but most often it proceeds 15-19 days. Some patients note that approximately in 1-2 days prior to manifestation of the first symptoms they observed the prodromal phenomena: a small fever, a headache, muscle pain, dryness in a mouth, and also discomfort in the field of sialadens.
As a rule, the mumps at children and adults begins sharply. Initially the person is disturbed by a fever, at it temperature considerably rises. In development of an illness fever can remain about 1 week. At the same time the patient suffers from a headache, weakness, sleeplessness. To reduce such manifestations, the symptomatic treatment practices. But sometimes symptoms of a mumps at children and adult patients are shown at normal body temperature. The main symptoms of parotitis is an inflammation of sialadens. As a rule, parotid glands are surprised, however, submaxillary and hypoglossal sialadens sometimes inflame. Morbidity at a palpation is noted them, and also a swelling.
In the presence of the expressed increase in a parotid sialaden face contours change: it becomes pear-shaped. From defeat the ear lobe rises, skin on a swelling stretches and shines, but its color does not change. Bilateral defeat is most often noted, however there are also hemilesions.
The patient feels a sensation of discomfort. In near ear tension and pain which amplifies at night is felt. If the tumor squeezes an Eustachian tube, then emergence in ears of noise and pain is possible. The so-called symptom of Filatov – the expressed pain is noted when pressing behind an ear lobe. This symptom is considered one of the most precursory and important symptoms of a mumps.
Sometimes pain prevents the patient to chew food. Decrease in hearing, dryness in a mouth can be noted. Pain abates by the end of the first week of a disease. Also at this time puffiness of sialadens gradually disappears.
Parotitis at adult patients is shown by more expressed symptoms. Sometimes patients are disturbed by the catarral and dispepsichesky phenomena, and the acute period of an illness passes heavier, than at children. Hypostasis can extend to a neck and remains longer – about two weeks. It is easy to determine such signs as visually, and by a photo.
At parotitis most often complications is defeat of ferruterous bodies and TsNS. The illness a mumps at children most often is complicated by serous meningitis, and, at men meningitis develops three times more often than at women. Effects in the form of defeat of TsNS are shown in most cases after defeat of sialadens. But sometimes there is a single-step development of parotitis and defeat of a nervous system. At some patients except symptoms of meningitis also encephalitis symptoms are shown.
One more complication of a mumps – an orchitis. It is more often noted at adult patients. Symptoms of an orchitis appear the 5-7th day of parotitis: repeated fever, severe pain in testicles and a scrotum, increase in testicles is noted. Immediate treatment of this state is required, otherwise the small egg atrophy can develop. The children's illness a mumps can provoke at adults not only a parotitis orchitis, but also its further complication – a priapism (the long erection of a penis which is not connected with excitement).
But the situation when the mumps develops at boys at teenage age is especially dangerous. Symptoms of an illness a mumps are sometimes shown by development of an inflammation of a small egg or an ovary. As a result, approximately at every tenth boy who had in the childhood a mumps at adult age infertility is observed.
Except the specified complications after a mumps acute pancreatitis which symptoms are observed for the 4-7th day of an illness can develop. Arthritis is also in certain cases shown. Full deafness can become heavy complication of a disease. Parotitis at pregnant women can become the reason of anomalies of a fruit. As a rule, at such children heart is surprised. If the disease develops at the woman or the girl, then as complications damages of ovaries and mammary glands can be observed.
Diagnosis of epidemic parotitis at manifestation of typical symptoms comes easy for the specialist. At other diseases of infectious character defeat of parotid sialadens for the second time, besides it is purulent. But at attentive survey of the patient the doctor easily differentiates other diseases.
Laboratory methods are applied to definition of existence in an organism of a virus. The most informative is allocation from parotitis virus blood. It is found also in other liquids — washouts from a throat, a secret of a parotid sialaden, urine.
The immunofluorescent methods allowing to reveal viruses on cellular culture 2-3 days later are applied. At the same time standard methods define existence of a virus only in 6 days.
Treatment of parotitis can be carried out in house conditions. Hospitalization are subject only those patients at whom the severe disease is noted. If at the child or the adult epidemic parotitis develops, it is isolated by houses for 10 days. Prevention of a disease assumes quarantine for 21 days in those child care facilities where the case was recorded. The virus of parotitis cannot be destroyed by means of a certain drug. As measles, a rubella, and parotitis, are treated by removal of the main symptoms of an illness. At parotitis at children and adults anesthetics and febrifugal drugs are used. UVCh-therapy, ultra-violet radiation helps to remove symptoms of epidemic parotitis. Dry heat on area of sialadens is shown. After food every time of the patient has to rinse a mouth surely. It is possible to use warm water or soda solution. It is possible to rinse periodically a mouth also broth of a camomile, a sage.
In view of lack of special treatment it is necessary to understand that vaccination is the main method allowing to avoid a disease. Therefore the inoculation has to be made to children agrees with the general schedule of vaccination.
It is necessary to remember that origins of complications after parotitis are, first of all, non-compliance with rules of a bed rest. It is necessary to adhere to it regardless of weight of symptoms of an illness.
As a rule, when chewing patients with parotitis feel pain and discomfort. Therefore in days of an illness it is necessary to eat the ground or semi-fluid food. It is necessary to include easy food of mainly plant origin, and also dairy products in a diet. You should not eat acid fruit as they annoyingly influences sialadens.
If at the patient complications develop, then its hospitalization in that case is required. The most dangerous complications are meningitis and an inflammation of a small egg. Special danger is constituted by the complicated mumps at boys as effects can be very serious.
If as complication the orchitis develops, then at the first signs Prednisolonum is appointed to 5-7 days or other corticosteroids. Treatment by corticosteroids practices also at meningitis. At acute pancreatitis it is important to keep to a rigid diet. Atropine, a papaverine, and also drugs which inhibit enzymes is appointed.
To warn parotitis at children and adults, the only effective method of prevention – vaccination is applied. The parotitis inoculation is carried out to children aged from 12 till 15 months (it agrees with a vaccination calendar). In 6 years the revaccination is carried out. The vaccine or is entered into an outside surface of a shoulder, or under a shovel subcutaneously. If the child who earlier did not have parotitis had contact with that at whom symptoms of a mumps were shown, it can be imparted urgently a parotitis vaccine. Parotitis, and also measles and a rubella are warned by compulsory vaccination in view of high probability of manifestation of complications. Direct contraindications to carrying out vaccination are not noted by a parotitis vaccine.
The child who received mumps inoculation it agrees with a vaccination calendar, can ache with this illness. However parotitis after an inoculation proceeds exclusively benign. Besides, the virus from such person in environment is not allocated, therefore, such patient is not infectious for people around.
To prevent infection with a virus during pregnancy, the woman at a stage of her planning has to make tests on definition of antibodies to parotitis. If antibodies are present at an organism, then it speaks about existence of immunity to a mumps at the woman who is going to become a mother. In the absence of such antibodies it is necessary to carry out mumps inoculation even before pregnancy.
Section: Infectious diseases