Although this disease often has a slight course, in some cases it can lead to serious complications, especially in adults or fragile people
Anna and Mario bring their little girl, Emma, to make the call of the Mprv vaccine (measles, parotitis, rubella and chickenpox). In the waiting room at the vaccinations office, in addition to them there are a grandfather and his grandchild. “Of course, how the times have changed …” comments the Lord. “When I was a child, even if a friend or the son of the neighbor took one of these diseases, they took us to their house to make us play together, so we also got sick and developed immunity in a natural way”.
Fortunately, today this practice has been overcome thanks to the progress of medicine and the spread of vaccines. In fact, if once the voluntary contagion was seen as a way to immune, today we know that getting these diseases involve risks, especially for the most vulnerable subjects.
Mario, for example, recalls the bad experience of having contracted the mumps (the so -called “mumps“) in adulthood, fortunately for him without serious consequences.
But because it is so important vaccinate against the mumps? Are the ears not just a passenger annoyance? Although it often has mild effects, this disease can lead to serious complications, especially in adults or fragile people.
The causes of parotitis
Parotitis, commonly known as “ears” or “Epidemic parotitis”is an infectious disease of viral origin that mainly affects the salivary glands, in particular the parotidlocated behind the jaw and under the ears. Responsible for the infection is the parotite virus, belonging to the family of Paramyxovirus.
This pathology was widespread before the introduction of the MPR vaccine (Morbillo-Parotitis-Rosolia), thanks to which the incidence was significantly reduced within the countries where the vaccine became part of the vaccination calendar.
However, parotitis has not completely disappeared and can still affect non -vaccinated subjects or in which the effectiveness of the vaccine has decreased over time.
Symptoms of parotitis
The period of Incubation of the ears varies between 12 and 25 days, with an average of about 16-18 days.
As for the Symptoms of parotitisthe disease often begins with moderate fever (up to 39 ° C, but cases of parotitis without fever can also occur), headache, muscle pain, tiredness and loss of appetite. The most characteristic symptom is the painful swelling of one or both the parotid glands, which gives the face a swollen and characteristic appearance (called “full moon” jargon). The maximum swelling can be reached in about three days and can last up to 10.
Other symptoms of the ears include high fever, difficulty chewing or swallowing, general fatigue and malaise.
In some cases, parotitis can manifest itself slightly or even asymptomatic, which makes it possible to transmission of the infection also by subjects who do not show evident symptoms.
Diagnosis of parotitis
There diagnosis of parotitis It is mainly based on the clinical observation of characteristic symptoms, in particular the swelling of parotids. However, since other infections can cause similar symptoms, in some cases it is necessary to resort to laboratory exams to confirm the diagnosis.
The most used exams for the diagnosis of parotitis include the search for specific antibodies for the ears virus and the detection of the presence of the virus in the blood, in saliva or in the cerebrospinal liquid in the event of complications.
What are the complications of parotitis?
As already mentioned, although parotitis generally has a benign course, in some cases it may involve complications, especially in adults or in unvaccinated people. The main includes:
- Orcitethat is, painful inflammation of the testicles that can, in rare cases, lead to infertility.
- Oophoreitisor inflammation of the ovaries, rarer and usually without consequences on fertility.
- Viral meningitis. If the virus reaches the central nervous system, it can cause an inflammation of the meninges, even if in most cases it is self -limiting.
- Encephalitisthat is, brain inflammation, rare but potentially serious.
- Pancreatitisan inflammation of the pancreas that can cause abdominal pain and, in rare cases, metabolic disorders.
- Neurosensory deafnessor permanent loss of hearing (rare cases).
Contagiousness of parotitis
The parotitis virus is transmitted through the respiratory droplets emitted with cough or sneezing and through direct contact with the saliva of an infected person.
The period contagiousness of parotitis It starts about 6 days before the appearance of the symptoms and can last up to 9 days later. The risk of transmission is particularly high in closed environments, such as schools and communities. Parotitis is more common in children between 5 and 9 years old, but it can also affect teenagers and unchanged adults.
Parotite therapy and care
There is no specific treatment, so the parotitis therapy It is mainly linked to the painful symptoms for which analgesics are used.
The care of parotitis also passes through rest and a diet that allows you to avoid discomfort during chewing. Fundamental, especially in children, is to drink enough to prevent dehydration.
In the most serious cases with complications, hospital hospitalization may be necessary to monitor patient conditions.
The morbillo-parotitis-rosolia-vacollo vaccine
The vaccine for ears It is not administered alone. The most effective method to prevent parotitis is to resort to the morbillo-parotitis-rosolia (MPR) vaccine, often administered in combination with the chickenpox vaccine (Mprv).
In Italy, the vaccination calendar includes two doses: the first at 12-15 months and the second at 5-6 years. Vaccination is highly effective: two doses offer protection greater than 88% against parotitis. However, over time, immunity can decrease, which is why outbreaks also occur between teenagers and vaccinated young adults. If an antibody dosage is performed which confirms the lack of vaccination coverage, a further call can be used.
Parotitis in pregnancy
Parotitis infection during the First quarter of pregnancy It is associated with a significant increase in the risk of spontaneous abortion, estimated at around 25%. However, there is no evidence that parotitis in pregnancy causes fetal malformations.
Since the vaccine uses an attenuated virus, it is not recommended in pregnancy, for this reason women in fertile age should verify their vaccination state before a possible gestation and, if necessary, undergo vaccination.
Conclusions
Although the ears have, in most cases, a benign course, it must be emphasized that they can cause significant complications (parotitis in adults or in fragile subjects).
Vaccination represents the most effective tool to prevent infection and its potential consequences, ensuring lasting protection against the disease.
