Mumps Mumps (epidemic parotitis, mumps) referred to mumps is common in children and adolescents respiratory diseases, are acute upper respiratory tract infections, caused by the mumps virus, highly contagious. Clinical features are fever and non-suppurative parotid gland swelling, and violations of various glands or nervous system, liver, kidney, heart, joints and other organs. The predilection of this disease of children, can also be found in adults. Parotid gland infection causes swelling of the salivary glands of the cheek and neck pain. Rare complications include meningitis, meningoencephalitis, encephalitis and meningitis, as well as deafness, arthritis, orchitis, oophoritis, pancreatitis, kidney, liver, thyroid inflammation, although no one will be infected , but not vaccinated school-age children most vulnerable to pollution, winter and spring high. [Etiology] Mumps virus belongs to the Vice mucus virus family, are spherical, the size of about 80 ~ 300nm. Is a single-stranded RNA virus (ssrna). Virus envelope hemagglutinin antigen with (v), shell with soluble antigen (s). s have the corresponding antigen and antibody antigen v, s whether the protective effect of antibodies is controversial, v antibody has a protective effect. Virus hemagglutinin of the outer membrane, could agglutinate chicken and guinea pig red blood cells, can produce hemagglutination inhibition antibody. In hela cells, human embryonic kidney and primary monkey kidney cells grew well. The virus cold, -50 ~ -70 ¡æ to live more than 1 year at 4 ¡æ, the energy can be stored 2 months, 37 ¡æ for 24 hours when, 55 ~ 60 ¡æ 20 ·ÖÖÓ death. Considerable resistance to low temperature. Sensitive to UV and general disinfectant. Strong UV only live half a minute, formaldehyde solution, 30% to Sur, 75% ethanol, 2 to 5 minutes exposure to inactivated. Only one serotype of the virus. Human nature is the only virus host. [Epidemiology] Mainly by droplets. Direct contact with infected saliva. (A) the source of infection of patients and latent infection early. Virus present in saliva of patients with a longer time, cheek swelling cheek swelling the first 6 days to 9 days after the saliva of patients can be isolated from the virus, so two weeks is highly contagious. Infected with mumps virus, mumps free performance, while other organs such as brain or testis and other symptoms, the saliva and urine can also be detected in the virus. Of a pandemic about 30 to 40% of patients with only upper respiratory tract infection subclinical infection, is an important source of infection. Need to isolate. 9 days after symptom onset in patients not allowed to school or to work. Transmitted from one week before the onset of symptoms to 9 days after onset of symptoms. Patients within 48 hours after the onset of symptoms the most contagious. (B) transmission of the virus spread by droplets in the saliva (saliva and contaminated clothing can also be transmitted) the contagious than measles, chicken pox is weak. Pregnant women infected with the disease can infect the fetus through the placenta, resulting in fetal malformation or death, also increased the incidence of abortion. (C) susceptibility generally susceptible, the susceptibility decreased with increasing age. 90% of cases occur in 1 to 15 years of age, especially for children aged 5 to 9. Infants less than 1-year-old mother of delivery may have body immunity, rarely sick. 80% of adults who have had overt or latent infection. No gender differences in pediatric patients, more men than women after puberty onset. Illness can have a lasting immunity. (D) the distribution of the disease prevalent features of the global, year-round disease, but in winter, spring based. Was popular or may be distributed. In the children's collective body, forces and poor sanitary conditions could easily lead in the crowd outbreak. The popular rule is the source of infection with the accumulation of susceptible increase in the formation of the cyclical nature of fashion, pop wave duration can be 2 to 7 months in between. Vaccination is not the line in the region, every 7 to 8 year cycle fashion trend. [Pathogenesis and pathological changes] Mumps virus first invaded the upper respiratory tract and eyes with film, in a large number of local proliferation of epithelial tissue into the blood circulation after the time (initial viremia), the involvement of the parotid gland and some tissue blood flow in these organs were proliferating, again into the blood (secondary viremia) affected salivary gland, testis, ovary, pancreas, liver and central nervous system. The virus has a special affinity for the parotid gland, it is non-suppurative inflammation of the parotid gland as the main lesion. The glands were swollen red, oozing, bleeding lesions and leukocyte infiltration. Epithelial edema, necrosis, acinar blood vessels between the congestion phenomenon. Parotid duct was catarrhal inflammation, and glandular stroma surrounding ducts in serous fibrin exudation and infiltration of lymphocytes, often caused by glandular tissue congestion, increase of internal pressure, leading to swollen glands. Salivary gland, testis, ovary, pancreas, also have similar inflammatory changes. Part of the parotid duct obstruction, retention of amylase in saliva can enter the blood circulation through the lymphatic system and excreted from the urine, leading to increased serum and urinary amylase. Brain lesions were acute viral meningitis can be disease, including nerve cell degeneration, necrosis and inflammation; occasionally subventricular cell necrosis, scarring of the brain aqueduct stenosis, the formation of brain water. Adolescent patients complicated by orchitis. Testicular seminiferous epithelium was significantly congestion, bleeding spots and lymphocytic infiltration. Can be seen in the interstitial edema, serous exudate fibrin. [Clinical manifestations] Clinical manifestations were fever, parotid gland swelling, pain, fear of eating into the acid. Include fever, neck, submandibular, preauricular salivary gland swelling and pain. After puberty, the male patients, 25% of testicular swelling, one-third of infected persons may be asymptomatic. Incubation period of 8 to 30 days, an average of 18 days. Most of more acute onset, no prodromal symptoms. Fever, chills, headache, sore throat, poor appetite, nausea, vomiting, body pain, parotid gland swelling and pain several hours, became clear, body temperature can reach 39 ¡æ or more, adults are generally more serious. The most characteristic parotid gland swelling. Generally earlobe as the center, forward, back, under development, shaped like a pear-shaped, the edge is unclear; local skin tight, shiny but not red, touch of tough and flexible, with touch of pain; speech, chewing (especially acid into the diet), the stimulated salivary flow, leading to the pain got worse; side of parotid gland swelling is usually 1 to 4 days after the involvement of the contralateral, and bilateral swelling by about 75%. Submandibular or sublingual gland may also be involved. Height of the surrounding tissue with severe edema who parotid gland, distorts, and difficulty swallowing occur. Tube opening in the early stage of parotid gland swelling, purulent discharge has never been squeezed from the parotid gland opening overflow. Most of parotid gland swelling in 1 to 3 days to reach the peak for 4 to 5 days and gradually subsided back to normal. Takes about 10 to 14 days. Submandibular and sublingual glands may also be involved at the same time, or appear alone. Submandibular gland enlargement, showed enlargement of the anterior mandibular swelling of the glands can be touched. Sublingual gland swelling tongue and floor of the mouth visible swelling and the emergence of difficulty swallowing. Mumps infection before the March pregnancy, often cause fetal death and abortion, and may cause congenital endocardial elastic fibers hyperplasia. [Laboratory] (A) of the blood leukocyte count normal or slightly lower, the relative increase in post-lymphocytes. White blood cell count of complications may be increased. (B) Determination of serum and urine amylase 90% of serum amylase in patients with mild and moderate increase, will help diagnosis. Amylase levels are often associated with parotid gland swelling increased in proportion. Parotid gland swelling in patients without meningitis, urinary amylase can also be increased. In addition to detection of suspected pancreatitis complicated by amylase, serum lipase determination will help confirm the diagnosis. (C) Serology 1. Low titer of neutralizing antibody tests, such as 1:2, suggest specific immune response. Neutralizing antibody specificity, but not for routine use. 2. Complement fixation and hemagglutination inhibition test and the recovery of early determination of double complement fixation and serum hemagglutination inhibition antibody, there can be diagnosed by a significant increase (more than 4 times the potency). Adsorption of foreign law by enzyme-linked immunosorbent and indirect fluorescent immunoassay igm antibodies, can be used for early diagnosis. 3. Virus isolation in patients with early saliva, urine, blood, cerebrospinal fluid isolate the virus. 4. Renal involvement can occur when the urine protein in urine, red white, and even a similar change in Urine. [Complications] (A) of the reproductive system complications of mumps virus a good body of violations of mature gonads, it is more common in young adult patients late, rare in children. 1. Incidence of testicular inflammation in patients with adult males accounted for 14 to 35%. Usually after the age of 13 to 14 the incidence was significantly higher. Common in about one week after cheek swelling, sudden high fever, chills, testicular swelling and pain, with severe tenderness, severe scrotal skin, a significant edema, a yellow sheath cavity effusion, most violations of the side of the lesion, acute symptoms of about 3 5, the entire 10 days or so. Disease in about 1 / 3 to 1 / 2 of cases occur in different degrees of testicular atrophy. Because the tumor often unilateral, even if both sides are only part of the seminiferous tubes involved. It rarely causes infertility. 2. The incidence of ovarian inflammation in patients with adult women accounted for about 5 to 7%. Mild symptoms, does not affect the pregnancy. Mainly as a sudden, chills, fever, lower abdominal or lumbosacral pain, menstrual cycle disorders, severe swelling of the ovaries can be touched, accompanied by tenderness. Does not affect fertility. (B) of the pancreatitis rate of about 5%, rare in children. Often occurs in about 1 week after the parotid swelling to the upper abdominal pain and tenderness, muscle tension as the main symptoms. With vomiting, fever, abdominal distension and constipation, and sometimes palpable enlargement of the pancreas. Pancreatitis symptoms are usually gone in a week. Elevated serum amylase activity can not be the sole basis for diagnosis, serum lipase value of more than 1.5¦Ì% (normal 0.2 ~ 0.7¦Ì%), suggest recent pancreatitis exists. (Iii) Nervous system complications 1. The incidence of meningitis or meningoencephalitis 5 ~ 25%, in some areas up to 35%. Department of the virus is generally believed that the central nervous system caused by direct invasion. Parotid gland swelling and swelling of the first 6 days or 2 weeks after the emergence of more commonly occur within 1 week. Clinical manifestations of acute high fever with severe headache, vomiting, drowsiness or unconsciousness, and other positive meningeal irritation, cerebrospinal fluid examination showed viral encephalitis or meningitis change. Prognosis is usually good, serious cases can cause death of the individual. 2. Multiple neuritis, myelitis even in 1 to 3 Zhou Fasheng mumps, the prognosis is good. Swelling of the parotid gland may cause temporary paralysis of facial nerve compression. Sometimes balance disorders, trigeminal neuritis, hemiplegia, paraplegia, ascending paralysis. Occasionally after meningoencephalitis due to aqueduct stenosis, concurrent hydrocephalus. 3. Deafness showed vomiting, rotating halo, tinnitus and other symptoms, mainly by listening endolymphatic labyrinthitis and neuritis due. Although the incidence rate is very low (about 1 / 15, 000), but can become permanent and complete deafness, but fortunately it occurred in the unilateral (75%), it can still retain some of the hearing. (D) about 4 ~ 5% of myocarditis patients with myocarditis, prevalent in the course of 5 to 10 days. Showed pale, fast or slow heart rate, low heart sound blunt, irregular heartbeat, temporary enlargement of the heart. Systolic murmur. ECG shows sinus arrest, atrioventricular block, st-segment depression, t wave low, flat or inverted and so on. In severe cases, can be deadly. However, most only obvious clinical symptoms without ECG change. Occasionally pericarditis. (E) nephritis early separable from mumps virus in urine, so that the mumps virus can directly damage the kidneys, light a small amount of protein in urine, severe and acute glomerulonephritis, the performance of the same individual can occur in severe cases acute renal failure and death. But most of good prognosis. (Vi) other about 5 to 10%, such as mastitis, osteomyelitis, hepatitis, pneumonia, prostatitis, bartholinitis, thyroiditis, thymus inflammation, thrombocytopenia, urticaria, lacrimal gland inflammation, acute herpes conjunctivitis Dengjun rare. Arthritis occurred in the parotid gland swelling within 1 to 2 weeks, mainly involving the elbows, knees and other large joints, sustainable 2 days to 3 months, completely recovered. [Diagnostics] (A) the prevalence and clinical diagnosis based on history of exposure to the typical features of acute onset of parotid swelling, diagnosis is not difficult. Not a typical case of suspected cases, according to the following laboratory methods to further confirm the diagnosis. (B) for the laboratory diagnosis of parotid gland swelling or recurrent non-cases and suspected cases are not typical, diagnosis depends on serological and viral methods. 1. Double complement fixation test titer more than 4 times and can be diagnosed, or a serum titer of 1:64 by a diagnosis. S can be determined simultaneously when necessary antibody and v antibody. s antibodies showed that new infections increased, v increases and s antibody, said antibody does not increase the infection had previously received. 2. Convalescent serum hemagglutination inhibition test mumps virus can inhibit the agglutination of chicken red blood cells, and weak inhibition of the early serum, such as the inhibition titer increased 4 times or more that is positive. 3. Virus isolation when necessary, desirable patient saliva, blood, cerebrospinal fluid or urine, inoculated human embryonic kidney or cultured monkey kidney cell culture tubes for identification. As complicated procedures, the general rarely used. [Differential Diagnosis] (A) the side of suppurative parotitis often, local swelling and tenderness apparent mass limitations, there are fluctuations in the late sense of parotid gland swelling nozzle can be squeezed out pus. Secretion smear and culture can be found pyogenic bacteria. The total number of blood leukocytes and neutrophils significantly increased. (B) of the neck and preauricular lymphadenitis, enlargement is not the ear lobe as the center, limited to the anterior neck or ear, for the nuclear-like body of hard, clear edge, tenderness obvious, superficial may activities. Can be found in the anterior cervical lymph nodes or ear inflammation-related organizations, such as angina, boils and other sore ear. Leukocytes and neutrophils significantly increased. (C) symptoms of parotid gland enlargement in diabetes, malnutrition, chronic liver disease, certain drugs such as iodide, hydroxyl phenylbutazone, can cause such isoproterenol parotid gland enlargement. The characteristics are: symmetry, no swelling sense of touch of the soft, fatty tissue examination mainly. (D) caused by other viruses such as herpes simplex virus mumps, parainfluenza virus type 3, Ke Saji a group and b group viruses, influenza viruses can cause parotitis. Diagnosis was confirmed by means of serology and virology separation. [Therapy] No effective therapy for treating mumps, general antibiotics and sulfa drugs ineffective. Mainly full of water, enough to eat, bed rest, aspirin services to control infection. To try interferon, the role of the virus. Integrative Medicine is often used method of symptomatic treatment. (A) general nursing isolation of patients to make bed rest until the parotid gland swelling dissipated. Attention to oral hygiene, diet to liquid or soft diet is appropriate, to avoid acidic food, that fluid intake. (B) symptomatic treatment should be scattered wind relieving, heat detoxification. 60 to 90 grams with Ban Langen Shuijianbi or silver wings plus Daqingye 15 grams bulk Shuijianbi; Local coated tablets can be purple or indigo casual tone with vinegar, treated local, several times a day; or the British public with a thin,; Commelina communis, Narcissus root, purslane and other smashed external application, can reduce local pain. Oral tablets when necessary, to the pain, aspirin and other antipyretic analgesics. Severe meningoencephalitis, severe orchitis, myocarditis, can be short-term use of adrenal cortex hormones. Such as hydrocortisone, adult 200 ~ 300mg / day, or prednisone 40 ~ 60mg / day for 3 to 5 days, children reduce it. Orchitis treatment: adult patients diethylstilbestrol in the early stage of the disease, each time the number of 1mg, three times a day, with effect to reduce swelling and pain. Encephalitis meningoencephalitis therapy treatment may be handled. High fever, headache, vomiting, dehydration when the given amount of diuretics. Pancreatitis: fasting, infusion, repeated injection of atropine or anisodamine, early corticosteroids. [Prognosis] No re-infection, lifelong immunity after illness. [Prevention] (A) the management of the source of infection until the early isolation of patients until the complete regression of parotid swelling. Contacts generally do not quarantine, but the group of children in institutions, military, etc. should be kept for 3 weeks, should be immediately suspicious temporary isolation. (B) the general immune globulin passive immunization, adult blood or placental globulin had no role in the prevention of this disease. Convalescent patients or blood and immune globulin specific immune globulin can be expensive have a certain effect, but the source of difficulties, not easy to promote. (C) autoimmune live attenuated mumps vaccine effective, immunization intradermal injection, subcutaneous injection, nasal spray or aerosol can be inhaled by law, the vaccine can not be used for pregnant women, congenital or acquired immunocompromised persons and those who are allergic to egg white. In recent years, reported the use of foreign mumps vaccine (measles, mumps and rubella vaccine), though significantly reduced the incidence of mumps, but due to mumps vaccine virus infection should pay close attention. Have a preventive vaccine. In the 12-15 months vaccinated against measles, mumps, rubella vaccine to include mumps vaccine. The best prevention is vaccination at the appropriate age. Pregnant women, those with egg allergy vaccine by doctors can decide. (D) Drug use prevention Ban Langen 30 grams or 9 grams of decoction of honeysuckle, day 1 for 6 days. References: Mumps is commonly known as "mumps" is caused by a virus highly contagious acute respiratory disease. What are the performance of children got the mumps? ¢Ù fever, headache, sore throat, dry mouth, thirst, general weakness, crying and upset, do not want to eat. ¢Ú 1 to 2 days after illness, may have parotid enlargement. Surface of the skin tight, shiny, not red, fever, pain significantly. Sour mouth or eat something worse. First side of the parotid gland enlargement, and development of both sides. Sometimes the same time bilateral parotid gland enlargement. ¢Û 2 ~ 3 days after the prominent symptoms, body temperature can reach 39 ~ 40 ¡æ, in the buccal mucosa near the maxillary second molar, and can see the enlargement of the parotid gland orifices, no discharge of purulent secretions. About 7 to 14 days recovery. Mumps parotid gland enlargement is it? Parotid swelling caused by many reasons, so that the parotid swelling, the disease should be carefully after they asked to check the case of parotid gland swelling, swelling of the parotid gland may cause the reason is to determine whether the mumps. Some children go to the doctor because the swelling of the parotid gland, the first is mumps, with some medicine, swelling will be refunded. Who knows every part of the same long and swollen up, and even made several times repeated, which is probably not mumps, because mumps is caused by the mumps virus, life was rarely 2 times. If repeated, it is likely a virus or bacteria to other parotid swelling caused by mumps was mistaken. Therefore, in determining the disease, we must fully consider, in particular, is the second time also appeared the same situation, should be carefully analyzed, there is no other reason, such as suppurative parotitis, etc. may, in order to avoid misjudgment, delay treatment. Mumps and preauricular lymphadenitis What's the difference? Enlargement of the preauricular lymphadenitis only part of the preauricular area. Range of small, circumscribed edge of enlarged lymph nodes, can be touched by a hard touch the nuclear-like glands, tenderness obviously, no swelling of parotid gland orifices. Often accompanied by otitis media and other primary lesions. Mumps is a swollen part of the center lobe, diffuse swelling around the edge of the ill-defined, when the slightest touch by playing sexy, light tenderness, swelling of the parotid gland orifices. How to distinguish between purulent parotitis with mumps? Suppurative parotitis caused by bacterial infection, only one side of the parotid gland enlargement. Gland surface skin irritation around the edge of clear boundaries, a sense of volatility from time to time by touch, tenderness evident when the parotid gland squeezing pus out of the nozzle. Suppurative parotitis occurred in the case of lower body resistance. Mumps is a viral epidemic of parotid gland diseases. Occurred in the winter season, there a history of contact with mumps patients. Most of all sides of the parotid gland swelling, redness of skin surface of the gland, no sense of volatility, light tenderness, when the parotid gland squeezing pus out of the nozzle no. Liushen to cure mumps Spring and autumn, children susceptible to mumps. Simple treatment, a daily service Liushen 3 times, each 5 to 8, At the same time every day Liushen 10 20 crush, vinegar and mix thoroughly coated surface of the skin, 2 to 3 days to bear fruit. Mumps on the fetus it? Pregnant women are susceptible mumps. Incidence rate of pregnancy were 0.8 10/10000. Mumps virus infection in pregnant women after any impact on fetal development, has not been determined. Some people think that mumps can cause miscarriage, premature birth and congenital malformations, but some studies have shown that the incidence of these has nothing to do with the mumps. Mumps Mumps is an acute viral respiratory infections, commonly known as Mumps, mumps ear style, big mouth disease, pig wind and so on. Can occur throughout the year, the highest incidence in winter and spring of children aged 2 to 15, the threat seriously, and often popular in kindergartens and schools. Mumps can be a result of talking, coughing, sneezing and through saliva, droplets, a small number of patients can also be contaminated items (food, utensils and toys) indirect spread of acute onset. Incubation period is generally 16 to 18 days, the main symptoms of one or both parotid glands (the lower part of the preauricular and ear) swelling, the earlobe as the center forward, the next expansion, filled in between the mandible and mastoid process, edge is unclear, touch and flexible, and mild tenderness, swelling, local skin shiny, but not red, the surface can be fever, but it will not fester, mouth, pain when swallowing and eating, eating local food is more acidic pain. Side of the parotid gland swelling is usually the first, 1 to 4 days after the other side have been swelling, submandibular gland, sublingual gland, lymph node involvement and may be swollen. Also see severe jaw, neck or chest, before the swelling, which is due to the sublingual gland, submandibular gland is also involved in the reason. Children often have chills, fever, headache, sore throat, loss of appetite, general malaise, accompanied by severe chills, nausea, vomiting, lethargy, stiff neck, coma or convulsions and so on. Swelling at 3 to 4 days up to the peak, and then for 4 to 5 days after the waning, 6 to 7 days the body temperature gradually decreased, after treatment, symptoms can disappear for 10 days or so, and access to lifelong immunity. Mumps is self-limiting disease, currently no effective therapy, in recent years found that application of dipyridamole, ribavirin significant effect. Chinese Zijin available local application of Vinegar tablets. Once a child had mumps should be isolated immediately, the daily necessities, toys, stationery and other boiled or disinfected exposure; room to pay attention to ventilation; patients have to pay attention to rest in bed; given liquid diet, not to perfect, too sour, too sweet the spicy food; to drink plenty of water, in order to facilitate removal of toxins; to pay attention to oral hygiene to prevent secondary infection; such as hyperthermia, may be given appropriate antipyretics; complications such as antibiotics and sulfa drugs available symptomatic treatment . Found testicular swelling, tenderness, local cold wet towels available. Prevention of mumps and complications, should pay attention to in the winter and spring to strengthen the child's nutrition, warmth and cold exercise. Injection of live attenuated mumps vaccine can also play a preventive role. Placental globulin gamma globulin or no preventive effect against mumps, should be attention. Ban Langen after the onset of oral granules can be, and often salt water gargle, Chongbi. Mumps epidemic periods, not to focus on people in public places, to avoid contagious source. People tend to only pay attention to the parotid gland swelling has disappeared, but often ignore its more serious complications. High fever caused by the mumps, may cause coma, convulsions, cardiac arrhythmia, acute myocarditis and encephalitis, meningoencephalitis, orchitis, oophoritis, acute pancreatitis, acute glomerulonephritis, thyroiditis, deafness and so on. This is due to an infringement of the organ caused by the mumps virus. Very few patients can leave a mental decline, hearing impairment, motor paralysis of a permanent unilateral hearing loss or died of encephalitis. Mumps virus attacks the reproductive organs via the blood circulation, can cause orchitis male and female ovarian inflammation, these two diseases on reproductive function in the future will bring harmful effects. According to statistics, between 12 and 18-year-old patient suffering from mumps, about 20% of the concurrent orchitis. Once the onset of testicular inflammation, may be high fever, chills, testicular swelling, redness, pain, accompanied by severe tenderness. In addition to testicular swelling, the scrotal skin edema, sheath effusion, about one-third of the patients developed testicular atrophy, if only suffering from the side of the testicles, can cause oligospermia; if involving the testes can cause azoospermia disease. Recently, scholars have pointed out, mumps can affect even the loss of male infertility, testicular germ is not the ability, but rather generated by its own antibodies to kill sperm, a condition called autoimmune infertility. When the girl concurrent ovarian inflammation, abdominal pain, low back pain and other symptoms, can also cause infertility. 5 ~ 7% of adult female patients with mumps oophoritis, causing menstrual disorders, early menopause. Many infertile women, the inspection found that ovarian dysfunction, can not be normal ovulation, of whom some people who have had mumps. If men and women are at puberty, after suffering from mumps orchitis or oophoritis concurrent, for the future of reproductive function is particularly large. So, after puberty, mumps suffering, should be taken to avoid orchitis or oophoritis place. "Big mouth" of the mumps 3 pairs of salivary glands, parotid gland, sublingual gland and submandibular gland, the largest and one pair of the parotid gland. After the children got the mumps, face swollen like a fat face. Because the parotid gland is located at both sides of the cheek near the ear lobe, when mumps is swelling of the parotid gland lobe as the center, to spread around, so the mumps in the folk known as the "big mouth." Mumps is caused by the mumps virus violation of the parotid gland of acute respiratory infectious diseases, the patient is the source of infection, inhalation of droplets is the main route of transmission, contact with patients 2-3 weeks after onset. Mumps mainly for one or both sides under the ear lobe swelling, swelling of the parotid gland often has dome to the center edge of the ear lobe is unclear, the surface heat angular pain, mouth, or local pain when chewing. 1-3 days in the onset of parotid gland swelling, the most obvious, and then gradually subsided, about 2 weeks back to do completely swollen. 3-5 days in the early stages of disease, may have fever, fatigue, do not want to eat, and other systemic symptoms. Once mumps, children should be immediately isolated, bed rest. Diet should be soft, easy to digest, avoid the hot and sour and other spicy food. Because these foods are easy to stimulate salivary gland secretion, resulting in local pain intensified. To drink water, keep the mouth clean, rinse borax compound can also be used. Swelling of the parts used topical Chinese medicine, take indigo 15 grams, or proprietary wishful golden powder 15 grams, then mix thoroughly with water. Reduced after topical local pain, help reduce the swelling. While also serving Banlangen granules. Once the children with mumps should be isolated to the parotid gland swelling completely subsided only after the nursery or school to avoid spreading disease to other children. Because mumps in nurseries in the popular easy, so if it found that children, should strengthen the morning check the work of children in contact with suspected patients should be observed for 21 days, while preventive oral Banlangen granules. General continuous 3-5 days. It should be noted, no gamma globulin on the prevention of mumps. Mumps (mumps, epidemic parotitis) ... ... mumps equivalent medicine called "Mumps", commonly known as "frog blast", in medicine, it is toxic heat from the wind acute infectious disease caused by . Clinic with fever, ear pain is characterized under. Can occur throughout the year, spring fashion is easy. Incidence of any age can be, but the highest incidence in children aged 5-9. The general prognosis is good, a few children as a serious condition, visible coma, convulsions change card. After puberty, although suffering from the disease is rare, but infection often occurs and permits, testicular swelling and pain complicated by men, women complicated by the lower abdomen pain. Modern medicine, mumps is caused by the mumps virus in acute respiratory infection, characterized by non-suppurative parotid gland swelling and pain, and has a tendency to spread to the whole body organizations, and most had fever and mild discomfort, complications for the different levels of meningoencephalitis. Pathogens: mumps virus is a sticky virus group, ribonucleic acid (rna)-type, present in saliva, blood, urine and cerebrospinal fluid. Rapid death in UV light, ethanol, methanol solution for 2-5 minutes be killed. Modern medical pathology: the virus through nasal droplets into the mouth, the viremia located in the parotid gland, submandibular gland, sublingual gland, pancreas, gonads and other glands, and sometimes invasive nerve tissue. Involvement organization-based non-suppurative inflammation disease is characterized by symptoms, gland and surrounding tissue showed congestion, edema, or swelling and bleeding points. Etiology and pathology of Medicine: Chinese medicine, this disease is caused by the feelings of rheumatoid cult poison. Cult poison from the nose and mouth into the room after Gallbladder violations, toxic heat Accumulation meridians, stagnation leave and blood stasis. Pulse due to the Foot-Shaoyang starts from the inner canthus, on the arrival Tau Kok under the ears, around the ears and the line, so see diffuse swelling of parotid cheeks, hard and aching. Since the beginning of evil committed by lung and stomach, so accompanied by aversion to cold, fever, head and body pain, loss and symptoms of lung and throat health of stomach pain on the red witness, Shaoyang Jueyin compared with the table, Jue Yin Liver Meridian of Foot around the clock under the shade, heat and toxic by the Jue Yin Shao Yang Chuan, the visible swelling testes or ovaries. Such as temperature and toxic flaming, fleeing into the camps points, caught in the pericardium, Fan Wei invasion of the brain, you can place strong fever, headache, vomiting, convulsion Jue, delirium faint, and strong limbs (meningitis, encephalitis). In recent years, can still have heart and kidney Qi and Yin Hao Shang, causing palpitations, chest tightness, breathlessness and other evidence (concurrent myocarditis). However, most cases of mild disease, the prognosis is good. Summarized the basic pathogenesis of this disease were as follows: wind-heat upside, deter Shaoyang; bile heat Fan Wei, Kui stagnation of qi and blood; temperature drug flaming, involving heart and liver; blood loss, phlegm retention; evil back is true, Qi Yin depletion and so on. Diagnosis: 1. Epidemiology: the local epidemic, and history of contact with the patient, is more common in winter and spring. 2. Clinical manifestations: in the center before the bottom of the earlobe swelling, stiff and tenderness, and more bilateral and does not become septic. Some patients may be complicated by orchitis, myocarditis, pancreatitis, meningitis. Latency :14-24, to 17-18, the most common. Precursor of 1-2, often fever, fatigue, muscle aches, loss of appetite, vomiting, headache, conjunctivitis, pharyngitis, even meningeal irritation may first appear, most patients can no prodromal period, the lower part of the ear swelling and pain for the first symptoms. Swelling of the cheek: cheek swelling was bilateral and more generally, can be found in the side, 1 to 2 is also the other side of the future enlargement of the parotid gland swelling in earlobe as the center, spread to the surrounding, 2 ~ 3 days peak, local pain, mouth or chewing more obvious, surface hot, cheek swelling can be seen within the parotid gland orifices, submandibular and sublingual gland has also affected. Parotid gland swelling subside after 4 to 5, the whole course of about 1 to 2 weeks. 3. Laboratory tests: WBC count was mostly normal or slightly reduced, the relative increase in lymph node, concurrent orchitis, pancreatitis or meningoencephalitis, and the total number of neutrophils increased. Blood and urine amylase activity increased more than 50% of cerebrospinal fluid cells increased slightly. If necessary, special serological (neutralizing antibody, complement fixation, hemagglutination inhibition) examination, a skin test inactivation of disease and virus isolation and diagnosis. 4. Complications of meningoencephalitis and orchitis were more common. Differential Diagnosis: 1. Suppurative parotitis: (TCM as fat yi), mostly on one side, swelling and pain significantly, after the sense of volatility into pus, white blood cells in the total number of neutrophils were significantly higher, antimicrobial treatment is effective. 2. Neck, preauricular lymphadenitis: Not to earlobe as the center was clear edges of induration, tenderness significantly more inflammation in their vicinity (teeth, angina, sore ears, etc.). 3. Secondary parotid gland enlargement: seen in diabetes, malnutrition, chronic liver disease, drug-induced (iodine, hydroxy phenylbutazone, isopropyl kidney, etc.), more symmetrical, soft, no pain. 4. Other: even or still to the same allergic parotitis, parotid duct obstruction of identification, these are recurrent history BZX all speed. There adolescent men who simply swollen cheek, but not with other symptoms.