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Paediatrics

Mumps

Mumps is an acute mumps-virus infection classically causing painful parotid swelling; it remains vaccine-preventable and notifiable in England, and complications such as meningitis, orchitis, pancreatitis or hearing loss need active assessment.

In a nutshell

Mumps is an acute viral infection causing painful parotid swelling, often bilateral but sometimes unilateral or absent. Complications include meningitis/encephalitis, orchitis, pancreatitis and hearing loss. Suspected mumps in England is routinely notifiable; arrange current UKHSA testing, exclude from school/work for at least 5 days after swelling starts, give supportive care, escalate red flags urgently and check the current MMRV/MMR vaccination status.

Classic presentation

A teenager with fever, malaise and painful parotid swelling who has incomplete vaccination, with no neurological or testicular red flags.

Key points

  • Parotitis is usually bilateral but can be unilateral or absent, especially in vaccinated people.
  • Phone ahead before attendance because mumps spreads easily.
  • Notify suspected cases through the statutory UKHSA route and arrange oral-fluid or current local testing.
  • Exclude from school, nursery or work for at least 5 days after parotid swelling begins.
  • Severe headache, neck stiffness, altered consciousness, seizure, severe abdominal pain or painful testicular swelling needs urgent assessment.
  • Use the current MMRV/MMR national schedule; the Green Book was updated for MMRV in 2026.

First-line investigation

Clinical assessment for parotitis and complications plus UKHSA/HPT-arranged oral-fluid or other confirmatory testing.

Management

Assess and notify

  • Assess parotid swelling, hydration, neurological state, abdominal symptoms and testes where relevant; phone ahead before attendance.2,1
  • Notify suspected mumps through the routine statutory route and liaise with the health protection team for current oral-fluid or other testing.3,4

Treat symptoms and reduce spread

  • Give fluids, rest, soft foods and current BNF-based analgesia/antipyretics; exclude from school, nursery or work for at least 5 days after swelling starts.2,7

Act on complications

  • Urgently assess severe headache, stiff neck, photophobia, confusion, seizure, persistent vomiting, severe abdominal pain, dehydration, new hearing loss or painful testicular swelling.2,6

Prevent recurrence

  • Check the current national MMRV/MMR schedule for the patient and contacts and offer catch-up vaccination when indicated; follow the 2026 Green Book and local immunisation service guidance.1,2,8

Exam traps

  • Mumps can be unilateral or have no obvious parotitis; vaccination does not make it impossible.
  • Mumps orchitis is not the same as torsion: acute severe unilateral testicular pain needs urgent surgical assessment.
  • Do not wait for testing before advising isolation and public-health notification.
  • The current English routine schedule is MMRV-based from 2026; do not quote an obsolete MMR-only timetable as universal UK policy.
  • Parotitis with meningism or altered consciousness is not uncomplicated mumps.

Illustrations

Bilateral parotid swelling in mumpsClinical photograph of parotid-region swelling broadening the lower face and obscuring the angles of the jaw; retain source attribution while image-quality remediation remains separate.Heinrich Weingaertner, Wikimedia Commons · CC-BY-SA-3.0

Key sources

  1. UKHSA, Mumps: the Green Book chapter (UKHSA immunisation guidance last updated 14 April 2026; revised for the MMRV routine schedule)Updated 14 Apr 2026
  2. NHS, Mumps (NHS clinical and public information last reviewed 9 July 2025; symptoms, supportive care, 5-day exclusion, complications and vaccination)Updated 9 Jul 2025
  3. GOV.UK, Notifiable diseases and how to report them (Current statutory reporting guidance; mumps is listed as a routine notifiable disease in England)
  4. UKHSA, MMR oral-fluid testing instructions for health protection teams (UKHSA pathway for oral-fluid testing of suspected measles, mumps or rubella cases)
  5. UKHSA, Mumps: confirmed cases and notifications (England surveillance publication updated 2 October 2025; describes oral-fluid IgM/PCR confirmation and notification data)Updated 2 Oct 2025
  6. NICE NG51, Sepsis: recognition, diagnosis and early management (NICE acute-illness escalation source when a child with suspected mumps is toxic or deteriorating)
  7. BNF for Children, current analgesic prescribing information (UK paediatric prescribing source; use current product monographs and local protocols for medicine choice and dose)
  8. BNF for Children, current vaccine prescribing information (UK vaccine prescribing source; use the current UKHSA Green Book and national schedule for vaccine timing)

This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.