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Mumps
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===Common symptoms=== The [[incubation period]], the time between the start of an infection and when symptoms begin to show, is about 7β25 days,<ref name=su >{{cite journal |vauthors=Su SB, Chang HL, Chen AK |date=5 March 2020 |title=Current Status of Mumps Virus Infection: Epidemiology, Pathogenesis, and Vaccine |journal=Int J Environ Res Public Health |volume=17 |issue=5 |pages=1686 |doi=10.3390/ijerph17051686 |pmc=7084951 |pmid=32150969 |doi-access=free }}</ref><ref name=davison >{{cite journal |url=https://www.ncbi.nlm.nih.gov/books/NBK534785/ |title=Mumps |vauthors=Davison P, Morris J |date=13 August 2020 |website=NCBI |publisher=StatPearls |pmid=30521206 |access-date=30 October 2020}}</ref> averaging 16β18 days.<ref name=levine >{{cite journal |vauthors=Levine DA |date=December 2016 |title=Vaccine-Preventable Diseases In Pediatric Patients: A Review Of Measles, Mumps, Rubella, And Varicella |url=https://www.ebmedicine.net/topics/infectious-disease/pediatric-mmr-varicella |journal=Pediatr Emerg Med Pract |volume=13 |issue=12 |pages=1β20 |pmid=27893360 |access-date=30 October 2020}}</ref> 20β40%<ref name=kutty >{{cite journal |vauthors=Kutty PK, Kyaw MH, Dayan GH, Brady MT, Bocchini JA, Reef SE, Bellini WJ, Seward JF |title=Guidance for isolation precautions for mumps in the United States: a review of the scientific basis for policy change |journal=Clinical Infectious Diseases |date=15 June 2010 |volume=50 |issue=12 |pages=1619β1628 |doi=10.1086/652770 |pmid=20455692 |doi-access=|s2cid=15656133 }}</ref> of infections are asymptomatic or are restricted to mild respiratory symptoms, sometimes with a fever.<ref name=rubin >{{cite journal |vauthors=Rubin S, Eckhaus M, Rennick LJ, Bamford CG, Duprex WP |date=January 2015 |title=Molecular biology, pathogenesis and pathology of mumps virus |journal=J Pathol |volume=235 |issue=2 |pages=242β252 |doi=10.1002/path.4445 |pmc=4268314 |pmid=25229387}}</ref><ref name=kessler >{{cite journal |vauthors=Kessler AT, Bhatt AA |date=15 November 2018 |title=Review of the Major and Minor Salivary Glands, Part 1: Anatomy, Infectious, and Inflammatory Processes |journal=J Clin Imaging Sci |volume=8 |pages=47 |doi=10.4103/jcis.JCIS_45_18 |pmc=6251248 |pmid=30546931 |doi-access=free }}</ref> Over the course of the disease, three distinct phases are recognized: prodromal, early acute, and established acute. The prodromal phase typically has non-specific, mild symptoms such as a low-grade fever, headache, malaise, muscle pain, loss of appetite, and sore throat.<ref name=rubin /><ref name=cdc >{{cite web |url=https://www.cdc.gov/vaccines/pubs/pinkbook/mumps.html |title=Mumps |author=<!--Not stated--> |website=Centers for Disease Control and Prevention (CDC) |publisher=CDC |access-date=30 October 2020 }}</ref><ref name=pmh >{{cite web |url=http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002524/ |title=Mumps |author=<!--Not stated--> |website=National Center for Biotechnology Information |publisher=A.D.A.M. Medical Encyclopedia |archive-url=https://web.archive.org/web/20141017215609/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002524/ |access-date=30 October 2020 |archive-date=17 October 2014 }}</ref> In the early acute phase, as the mumps virus spreads throughout the body, systemic symptoms emerge. Most commonly, parotitis occurs during this time period. During the established acute phase, orchitis, meningitis, and encephalitis may occur, and these conditions are responsible for the bulk of mumps morbidity.<ref name=rubin /> The parotid glands are salivary glands situated on the sides of the mouth in front of the ears. Inflammation of them, called parotitis, is the most common mumps symptom and occurs in about 90%<ref name=who >{{cite journal |vauthors=<!--No authors listed--> |date=1 June 2012 |title=Mumps virus nomenclature update: 2012 |url=https://iris.who.int/bitstream/handle/10665/241923/WER8722.PDF| journal=Wkly Epidemiol Rec|volume=87 |issue=22 |pages=217β224 |pmid=24340404 |format=PDF |access-date=30 October 2020}}</ref> of symptomatic cases and 60β70% of total infections.<ref name=davis >{{cite journal |vauthors=Davis NF, McGuire BB, Mahon JA, Smyth AE, O'Malley KJ, Fitzpatrick JM |date=April 2010 |title=The increasing incidence of mumps orchitis: a comprehensive review |journal=BJU Int |volume=105 |issue=8 |pages=1060β1065 |doi=10.1111/j.1464-410X.2009.09148.x |pmid=20070300 |s2cid=20761646 |doi-access=free }}</ref> During mumps parotitis, usually both the left and right parotid glands experience painful swelling,<ref name=davis /> with unilateral swelling in a small percentage of cases.<ref name=kessler /> Parotitis occurs 2β3 weeks after exposure to the virus, within two days of developing symptoms, and usually lasts 2β3 days, but it may last as long as a week or longer.<ref name=rubin /><ref name=cdc /> In 90% of parotitis cases, swelling on one side is delayed rather than both sides swelling in unison.<ref name=davis /> The [[parotid duct]], which is the opening that provides saliva from the parotid glands to the mouth, may become red, swollen, and filled with fluid. Parotitis is usually preceded by local tenderness and occasionally earache.<ref name=davison /><ref name=gupta >{{cite journal |vauthors=Gupta RK, Best J, MacMahon E |date=14 May 2005 |title=Mumps and the UK epidemic 2005 |journal=BMJ |volume=330 |issue=7500 |pages=1132β1135 |doi=10.1136/bmj.330.7500.1132 |pmc=557899 |pmid=15891229}}</ref> Other salivary glands, namely the [[Submandibular gland|submandibular]], and [[sublingual gland]]s, may also swell. Inflammation of these glands is rarely the only symptom.<ref name=rubin />
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