The article will deal with one of the managedinfection - epidemic parotitis or in the people of the disease of mumps. Since the 60s of the last century, when mass preventive vaccination began, infection has decreased significantly. What are the symptoms of the disease of mumps in children and adults, what are its consequences and how effective is vaccination - these and other questions will be answered in the article.
This disease is caused by the pathogenparamyxovirus (paramyxovirus parotidis), whose reservoir is only an infected person. People are highly susceptible to this pathogen, more often the disease is registered in children. In this case, mumps suffer more often than boys (1.5 times more often than girls). Infants receive immunity from the mother for a disease that lasts up to five years. Most often, children of preschool age are ill, but there is also an infection of adults. In this case, the older the patient, the course of the disease is accompanied by more severe clinical symptoms and an increased risk of complications. The transferred disease gives a permanent lifelong immunity to infection. In connection with a clearly expressed external symptomatology, epidemic parotitis is called mumps or mumps.
Since the time of Hippocrates, this disease is knownhumanity, and its name is due to the fact that the sick person looks like a pig on the outside (shown in the photo). Pig disease affects primarily the salivary parotid glands, the glandular tissue of which is inflamed and swollen. The disease is transmitted only from the patient by airborne droplets. Household mode of transmission of the disease is completely excluded. Seasonality of morbidity is associated with the ability of the pathogen to maintain contagiosity in the cold and damp seasons of the year. In this case, the virus is easily deactivated by drying, exposure to ultraviolet and disinfectant solutions.
The disease can occur in three manifest forms:
Depending on the severity of the symptoms, the diseaseThe mumps can be mild, moderate and severe. Parotitis is dangerous for its complications. The consequences of mumps can be deafness, testicular atrophy in men, infertility, diabetes.
During the course of the disease, the following periods are distinguished:
Острый период паротита сопровождается повышением temperature, chills, weakness and headache, noise in the ears, pain when swallowing and opening the mouth. The visible sign of the disease is an increase in salivary parotid glands, sometimes involving the submaxillary and sublingual glands in the inflammatory process. Palpation is painful, inflammation begins as one-sided, but by the 2nd-3rd day of illness it passes into a two-sided phase. Puffiness starts to go off on the 4th-5th day, and only in adults does the disease lead to puffiness for up to 2 weeks. In uncomplicated course, after a week the symptoms go away and the patient can be considered recovered.
On the 5th-7th day of the disease in 10% of cases other organs are involved in inflammation.
При поражении поджелудочной железы появляются symptoms of acute pancreatitis - pain in the upper abdomen, dyspepsia, vomiting, nausea. Such complication is more typical for adult patients and occurs in a ratio of 1 to 14 cases.
Paramixovirus can affect the inner ear.The patient has a constant noise in the ears, dizziness, impaired coordination and balance. Most often this is a one-sided lesion that can lead to a decrease or loss of hearing.
A rare complication - involvement in the inflammation of the thyroid gland - can lead to the degeneration of tissues, atrophy and oncology.
In severe cases, inflammation spreads toshells of the brain, causing their edema and the appearance of meningeal symptoms (temperature above 39 degrees, photophobia, vomiting, convulsions). In 10% of cases, the disease leads to the development of serous meningitis.
With the involvement of genitals in boys candevelop orchitis - edema 2-3 times the testicles, accompanied by their compaction and pain in the groin. The consequences of the disease mumps for boys 12 years are particularly serious. They have irreversibly affected sex cells, which leads to irreversible infertility. In other cases, swelling of the testicles takes place on the 7th day, but inadequate treatment of the mumps disease in men in a period of 1 to 3 months can develop testicular atrophy, spermatogenesis and secondary infertility. In some cases, post-infectious infertility in men is treatable, which requires considerable effort and material costs.
In women, in rare cases (in every twentieth), the development of ovarian inflammation is possible, occurring almost asymptomatically. There is a risk of infertility.
The registration of the disease in a pregnant woman in the first trimester is an indication for the interruption of pregnancy.
Diagnosis of mumps with pronouncedclinical symptoms usually do not cause complications. But the final diagnosis is made on the basis of confirmed laboratory tests. A modern arsenal of diagnostic methods includes:
Дифференцирование диагностики паротита очень it is important, because under the external symptoms can hide completely different diseases. For example, sometimes the swelling of the mucous salivary glands and lymphatic okolohlotochnyh nodes accompanies no less dangerous diseases - lymphadenitis in toxic diphtheria. Such symptoms may be accompanied by infectious mononucleosis and herpesvirus infections.
If you have acute symptoms in your child, you should call the pediatrician at home. The appearance of symptoms of mumps disease in adults often leads them to admission to dentists or ENT doctors.
Most patients do not require hospitalization.It is performed only in the case of severe complications of the mumps disease. The treatment is aimed at preventing the development of complications, reducing and alleviating the symptoms. Patients are prescribed bed rest, dairy and vegetable diet, antipyretic and anti-inflammatory drugs. With severe intoxication of the body, it is possible to carry out intravenous injection of detoxification drugs (saline solution, 5% glucose solution). Polyvitamin complexes are prescribed.
Treatment at home involves quarantine up to 10 days. In children's institutions, if quarantine is detected, quarantine is declared for up to 3 weeks.
There is no specific prevention of mumps.Since paramyxovirus is similar to the influenza virus, the general prophylactic measures are the same as for the spread of viral infections of a general nature. The general strengthening of the body, the elimination of contacts with patients significantly reduce the risk of the disease.
The most reliable way to prevent the disease is mumpsin children - vaccination. It is performed for the first time at the age of 1 year by an integrated vaccine against mumps, measles and rubella. The second immunization is indicated for children 6-7 years old, who did not recover mumps.
The opinion of experts in this issue is ambiguous.There is an opinion that only boys of the pubertal period (the onset of puberty) should be vaccinated, who did not get mumps in childhood. The rationale for this point of view is the immunity acquired by the boy after mumps at an early age, intravital, while the vaccine will ensure its presence for several years.
Supporters of compulsory immunization of all children inat an early age they appeal to the fact that no one is insured against the complications of the course of the mumps. And if it is possible to avoid even a small probability of diabetes, deafness or atrophy of the testicles in a child, then it should be used.
Modern vaccines contain weakenedparamyxovirus and protein component based on chicken or quail eggs or cattle protein. The characteristics of vaccines are taken into account in the presence of allergies in the child. There are monovaccines and polivaccines. Complex vaccines have long been a priority in Western countries.
Прививки в России проводятся в соответствии с the immunization schedule - in 1 year of life and in 6-7 years. The vaccination is effective and in the first 2 days after contact with the patient, in this case the risk of complications and severe course of the disease is reduced.
The effectiveness of immunization with modern means is quite high - immunity persists for several years, sometimes for life. But contra-indications for children nevertheless are:
All the side effects of the vaccine are associated withpeculiarities of mumps (temperature rise, respiratory and catarrhal manifestations, swelling of the glands). These manifestations may appear on the 10-12th day after vaccination, stay for 1-2 days and go by yourself.
Today, vaccination of children against mumps is not mandatory, and parents have the right to refuse to vaccinate their child. It is only a responsible approach to this issue, given the following facts:
Distrustful attitude towards vaccination in modernsociety has long become a global global problem. It is formed under the influence of the following aspects: distrust of the vaccine itself (its effectiveness or its supplier), the arrogance of the average person (underestimation of the risks of the disease), the inconvenience of the organization of vaccination (geographical distance, stress or high cost). Which of the listed factors influences the decision of a specific parent and are you ready to say that you made a decision, not based on false conclusions?
Mistrust of vaccines in humans has existed sincetheir inventions. According to surveys, 1/5 of the population is ready to admit the existence of a medical conspiracy, according to which immunization is supported by government health authorities despite the presence of side effects. You can argue about this for a long time, but every parent will have to take responsibility for the health of their child. We only recall that in the world today, thanks to vaccines, diseases of cholera, rabies, black smallpox, a form of meningoencephalitis, and even more than 10 diseases have been eliminated as completely eliminated dangerous infections. Vaccine production is a very complex process, and modern certification methods are very strict. In any case, the choice remains an individual matter.
