HEALTH NOTES.

Hauraki Plains Gazette, Volume XXXVIII, Issue 5154, 20 July 1927, Page 4

HEALTH NOTES.

MUMPS. TRANSMISSION AND TREATMENT. (Contributed by the Department of Health.) Mumps is a genera' Infectious and contagious disease. As a rule, it first attacks the parotid gland, which is the largest salivary gland, and is situated in front and below the ear. The other salivary glands (the submaxillary and sublingual) are also highly affected. The organism which causes mumps has not been isolated, but the infective agency has been proved to exist in the saliva of patients sufleiing from the disease. The virus enters the blood stream, and henco other glands of the body (such as the thyroid, pancreas, and reproductive glands) may be secondarily injected. The disease occurs in all climates, and spreads rapidly from individual to individual, especially where people are massed together, as in institutions, schools, and camps. Coloured races are affected more readily and severely than are- white. In most cases constitutional symptoms are mild, and the disease is not severe. This is especially so in children. Though in later life complications may be troublesome at air ages the death rate is very low. The most usual period for attack is between five and fifteen years of age during school life, but cases occur at any time from infancy to extreme old age. Girls and boys are equally liable to attack, but in adult life more men are affected as a rule than women, probably owing to their greater exposure to risk of contagion. MODE OF TRANSMISSION. The disease is a contagious one,, being transmittcxl directly from person to person. Infection is contained in the patient’s saliva, and is conveyed by coughing, sneezing, etc. A third and healthy person may transmit the disease if his -hands, face, or clothing have become contaminated with tiie virus from an acute case of mumps, or possibly he may be himself a carrier of the virus. Rarely inanimate objects, such as books, clothing, e-tc., may act as carriers, presumably because- they have been contaminated by infected saliva. In scrupulously clean households and hospitals, however, it is probably true that infection is transmitted only from person to person. PERIOD OF INFECTION. The disease may be communicated in the early stages—viz., before the typical swelling of the glands occuis. The period of greatest infectivity lasts on an average for five to seven days, by which time the gland has;, as a rule, reached its normal size. During the convalescence of the patient there is less danger of infection, although in exceptional cases infection has been known to be transmitted Mix weeks after the development of the disease. One attack of, mumps produces immunity, which in- the majority of cases endures for years, and even for life. A small proportion of people, however, suffer from the disease two or even more times. CAUSE AND SYMPTOMS. The organism which causes mumps has never been isolated, but the agency of the saliva of. patients in carrying infection has been proved. The average duration of time from exposure to infection to development of the disease is eighteen days. In the average or mild cases of mumps the enlargement of the parotid gland is noted as a swelling below and in front of the ear. More rarely both parotid glands ar,e affected. Stiffness of the jaw and pain on opening the mouth accompany the .swelling; a mild rise of temperature lasts a.bout two days ; and the swelling gradually subsides and disappears in four or five days. Unless other complications develop, such as involvement of the reproductive glands, recovery is complete a.t the end of seven or eight days. Initial symptoms of the- disease are similar to those which usher in any infectious d'sease —headache, loss of appetite, thirst, mild rise in temperature, pains in the back and limbs, a feeling of chilliness, or a distinct chill, and in children convulsions occasionally occur. Bleeding from the nose hasj been noted in a number of epidemics.

The swollen parotid gland is visible below and in front of the ear. The

lobule of the ear is raised and occupies the centre of the swelling, which may reach backwards behind the ear.. In more severe cases, where other

salivary glands also are involved, the swelling may reach down to the col-lar-bone, obliterating the normal curvei of the neck. The enlargement of the gland increases for two to four days, remains stationary for two to four days, and by the end of seven to ten days, lias, as a rule, subsided. More rarely, however, the; gland does not resume its normal size for three or four weeks. The skin over the swelling is tense and not reddened. Pain is a constiuit symptom, and is caused by attempts to move the jaw, as in eating or speaking. Some patients complain of earache. Relapses during convalescence are not unknown, and the second parotid gland is. as a rule, affected in the relapse. TREATMENT. The problem is to make the patient comfortable, prevent complications as far us possible, and to.protect othe-i persons from infection. During the acute stage the patient should be kept in bed for a few days, as this diminishes the liability of complications-, The- diet should be light, the mouth should be kept clean and moist by a simple antiseptic wash. Soothing applications to the swelling give relief. When complications occur, appropriate treatment is indicated, and rest in bed isi essential.

To protect other persons the patient must be isolated as soon as the diagnosis is made, and should not bepermitted to asisociate with others until all symptoms have disappeared and the glands have been normal for about a week. For ordinary mild cases the period'of quarantine should not be less than two weeks. In complicated cases it is necessarily extended. Persons who have been exposed to infection should be kept under observation for a period of three weeks.