Mumps—Child Care and Schools

What is mumps?

• Mumps is a viral illness with swelling of 1 or more of the salivary glands.

• It is uncommon in children with up-to-date immunizations.

What are the signs or symptoms?

• Swollen glands in front of and below the ear or under the jaw (no swelling or symptoms in one-third of infections), which can cause difficulty chewing or swallowing.

• Fever.

• Headache.

• Earache.

• In teenaged boys, painful swelling of the testicles may occur. Girls may have swelling of the ovaries, which may cause abdominal pain.

• Complications include meningitis, deafness (usually permanent), kidney inflammation (glomerulonephritis), pancreas inflammation (pancreatitis), and inflammation of joints.

What are the incubation and contagious periods?

• Incubation period: Usually 16 to 18 days, but may range from 12 to 25 days after exposure.

• Contagious period: From 2 days before to 5 days after onset of swelling of glands. Mumps virus has been isolated up to 14 days after swelling of glands.

How is it spread?

• Respiratory (droplet) route: Contact with large droplets that form when a child talks, coughs, sneezes, or sings. These droplets can land on or be rubbed into the eyes, nose, or mouth. The droplets do not stay in the air; they usually travel no more than 3 feet and fall onto the ground. This is the most common mode of spread.

• Contact with respiratory secretions or contaminated objects from children who have the mumps virus.

How do you control it?

• Mumps is a vaccine-preventable infection. Immunize according to the current schedule—when a child is 12 to 15 months of age and with a second dose at 4 to 6 years of age.

• Review immunization status of all children and staff members.

• Unlike for some infections, such as measles, mumps vaccine given after an underimmunized child is already exposed to mumps has not been shown to prevent infection. However, vaccinating nonimmune contacts of a child with mumps may prevent ongoing transmission and stop a possible outbreak. Additional doses of the measles, mumps, rubella vaccine may be considered during outbreaks. Refer to the local or state departments of public health for current recommendations.

Mumps in a child

CENTERS FOR DISEASE CONTROL AND PREVENTION

A child's face with puffy cheeks and the skin at and under the jawline swollen and protruding from the neck and onto the upper chest.

Considerable swelling under the jaw and in the cheeks in a child with mumps

CENTERS FOR DISEASE CONTROL AND PREVENTION

Profile view of a shirtless, seated child, leaning their head slightly to the left to show swelling in the cheeks and jaw that obscures the neck and reaches the upper chest.

What are the roles of the educator and the family?

• Report the infection to the staff member designated by the early childhood education (ECE) program or school for decision-making and action related to care of ill children and staff members. That person, in turn, alerts possibly exposed family and staff members and parents of underimmunized children to watch for symptoms and notifies the Child Care Health Consultant.

• Report the infection to the local health department. The health professional who makes the diagnosis may not report that the infected child is a participant in an ECE program or school, and this could lead to delay in controlling the spread.

• Refer to the individual's health professional and involve the Child Care Health Consultant to provide education to staff members and families.

• Ensure up-to-date immunization of children, staff members, volunteers, and family members, according to the current immunization schedule.

Exclude from educational setting?

Yes.

• Mumps is a highly contagious illness for which routine exclusion of infected children is warranted.

• Exclusion of underimmunized children may be considered in consultation with local public health authorities. If children who are unimmunized and exposed are excluded for this reason, they may be readmitted on receiving mumps immunization at the discretion of the local health department. If they remain unimmunized or underimmunized because of an accepted exemption, they should be excluded until at least 26 days after onset of gland swelling in the last case of mumps.

Readmit to educational setting?

Yes, when all the following criteria are met:

• Five days after onset of swelling of glands

• When the child is able to participate and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group