According to reports, children in Kerala are seeing an alarming increase in mumps. The health department estimates that, compared to the 2,324 cases registered overall in 2023, there have been over 70,000 cases this year, a more than 30% rise in only one year. Because numerous people seek treatment from systems of medicine other than modern medicine, also known as conventional or mainstream medicine, the health department believes there would be more cases in number.
Malappuram and Kannur stand out among the impacted regions, with more than 13,643 and 12,800 mumps cases reported this year, respectively. The other affected areas are Thrissur, Idukki, and Alappuzha. Palakkad has recorded more than 5,000 cases while Thiruvananthapuram has over 1,575 cases and Kasaragod has exceeded 6,678. Since the majority of infections in these areas were recorded in children aged 5 to 15, schools have been shut as a preventative precaution and mask-wearing has been enforced.
What is mumps?
Mumps is a contagious viral illness, caused by paramyxovirus, that causes swelling in the salivary glands, usually in the cheek and jaw area. Mumps is typically spread through direct contact with saliva or respiratory droplets from an infected person and is said to be as contagious as the flu. The average incubation period is 16 to 18 days, but it can also range from 12 to 25 days.
What are the symptoms?
Symptoms of mumps appear two to three weeks following the viral exposure, and it is possible for some people to experience very few symptoms or none at all.
The early symptoms might resemble symptoms of flu, like:
- Fever
- Headache
- Muscle aches or pain
- Tiredness
- Decreased appetite
Within a few days, the salivary glands often begin to swell with symptoms like:
- Swelling of one or both glands on the sides of the face
- Pain or tenderness around the swelling
- Swelling of glands below the floor of the mouth, which is less often
What are the associated complications and treatment?
Complications are more common in those who have not received the vaccination, which might include:
Orchitis, the swelling of testicles, is extremely painful. This complication is increasingly prevalent in a mumps infection caused after puberty. Both the testicle’s size and fertility may decrease as a result of an enlarged testicle.
Oophoritis, the swelling of ovaries, is a complication that also causes fever, vomiting, discomfort, and upset stomach. The likelihood of this problem increases after puberty. Fertility appears to be unaffected by the disease.
Encephalitis, the swelling or inflammation in the brain, can harm the active tissues. Seizures, loss of muscular control, and altered consciousness are possible outcomes of this complication.
Meningitis is the swelling or inflammation of the membranes around the brain and spinal cord. Headache, fever, and stiff neck are possible symptoms. Mumps-related meningitis seldom results in chronic issues.
Loss of hearing is an issue related to mumps that may develop gradually or all at once. Following the sickness, hearing normally improves.
Pancreatitis, or swelling of the pancreas, can result from mumps. Fever, vomiting, upset stomach, and discomfort or soreness around the stomach are some possible symptoms.
Although there isn’t a specific treatment for mumps, it could be eased by applying compresses, maintaining hygiene, taking painkillers like ibuprofen or paracetamol to lessen fever and pain, drinking lots of water, and getting plenty of bed rest.
Why is mumps on the rise?
Speaking to The Week, Dr. M. Venugopal of City Hospital in Kochi explained that the increase in mumps cases is due to children not receiving the vaccination.
“The measles-rubella (MR) vaccine should be administered to children in two doses, the first at 9–12 months and the second at 16–24 months, in accordance with the Universal Immunization Programme (UIP) schedule, India’s public health programme that provides free immunisations,” he said. However, the MR vaccination does not cover mumps; it solely protects against measles and rubella. “The mumps-measles-rubella (MMR) vaccination, which provides protection against mumps, is only accessible in private hospitals since the government no longer provides it,” he added.
“Since the MMR vaccination has been stopping the resurgence of mumps, a disease that was nearly eliminated like polio, the Indian Academy of Pediatrics (IAP) has been advocating for its use,” he noted, further explaining that it is recommended that children receive the MMR vaccination in two or three doses, “the first at nine months, the second at fifteen to eighteen months, and the third around four to six years of age.”
Why isn’t the mumps vaccination included in India’s UIP?
“The MMR vaccine only offers 78% protection against mumps, although offering 93% protection against measles and 97% protection against rubella,” said Dr. Venugopal. He elaborated that the Union Health Ministry excluded the vaccination in 2016, citing its limited efficacy and the belief that mumps would not become serious. “This is unethical and medically incorrect,” he concluded.
What could be done to contain the outbreaks?
“The only way to stop the rise of mumps is to either bring back the MMR vaccine or properly inform people that it is accessible in private hospitals, which might not be too expensive,” Dr. Aneseya P. Varghese of Ann’s Children’s Clinic in Ernakulam suggested while speaking to THE WEEK. She also pointed out that since many individuals rely on government services for free vaccines for many reasons, including financial constraints, they are unaware that mumps is a real illness and that there is a vaccine to prevent it.
“Other than vaccination, isolation—avoiding contact with sick individuals until they are completely recovered—could be used to stop the spread of mumps along with maintaining basic hygiene, but none of these strategies would be as effective as immunisation. Therefore, it comes down to raising awareness or reintroducing the vaccine to contain the outbreaks,” she said.
Bottom line
Given the sharp rise in cases, Kerala has reportedly requested free MMR vaccinations for children from the Union during a discussion between the Centre and the Directorate of Health Services (DHS) officials. The state has also emphasized the need to treat the outbreak with urgency. Although no deaths have been reported, the state highlighted potential long-term health complications for those affected by mumps. Central officials have supposedly responded that the matter could be raised at a high-level meeting.