Infectious parotitis

Description:

Infectious parotitis - the acute viral disease with the aerosol mechanism of transfer which is followed by intoxication and defeat of ferruterous bodies, preferential sialadens, and also a nervous system.
Tank and source of an infection - the person with a manifest or subclinical form of parotitis. The patient becomes infectious in 1-2 days prior to emergence of clinical symptoms and allocates a virus the first 5-7 days of a disease. An important epidemiological role is played by patients not only with typical, but also with the erased and asymptomatic forms of a disease making 25-50% of all cases of an infection.
The transfer mechanism - aerosol, a way of transfer - airborne though it is impossible to exclude completely a possibility of transfer of the activator through the objects (toys, ware, etc.) polluted by the patient's saliva shortly before contact with healthy. Also transplacental transfer of the activator is possible.
Natural susceptibility of people high. Children about one year are ill infrequently owing to rare contacts with patients and existence of maternal antibodies. Postinfectious immunity long and resistant.
Main epidemiological signs. The disease is widespread everywhere. Note periodic rises in incidence with an interval of 7-8 years. During the dovaktsinalny period incidence was registered preferential among children of early age (3-6 years). In recent years it is noted, as well as at measles, shift of incidence on more senior age groups of the population (5-15 years). Males have parotitis more often than women. Epidemic flashes can be observed at all seasons of the year, but most often increase in incidence is the share of fall and winter, i.e. in the period of density of children and teenagers in the enclosed space.
Selective serological inspections showed that 33,9-42,9% of adult population are susceptible to the activator. In different age groups the specific weight of seronegative persons varies on average from 25,6% among vaccinated children of 3 years to 33,1% among 30-40-year-old people. Among adult population the increased incidence is registered in the closed and half-closed collectives (barracks, hostels, etc.). Incidence among recruits is always higher, than among old-timers. The expressed ochagovost is characteristic of epidemic parotitis: almost in a quarter of child care facilities register the centers with 15 cases and more. Child care facilities of flash proceed it is long, incidence wavy because of the big duration of an incubation interval and not identification of a part of patients with the erased clinical picture. Decrease in incidence of epidemic parotitis in the majority of territories of the country is caused in recent years by increase in coverage inoculations of children about one year.

Symptoms of Infectious parotitis:

The incubation interval varies from several days to one month, more often it proceeds 18-20 days.
At children rather seldom after it the prodromal stage which is shown chilling, a headache, muscle and joints pains, dryness in a mouth, unpleasant feelings in the field of parotid sialadens can develop short (1-3 days). More often the disease begins sharply with a fever and fervescence from subfebrile to high figures; fever remains no more than 1 week. However the cases proceeding with normal body temperature are frequent. Fever is accompanied by a headache, the general weakness, an indisposition, sleeplessness. The main display of parotitis - an inflammation parotid, and also, perhaps, submaxillary and hypoglossal sialadens. In a projection of these glands there is a swelling, painful at a palpation (it is more in the center), having a pasty consistence. At the expressed increase in a parotid sialaden the face of the patient gets a pear-shaped form, the ear lobe from the struck party rises. Skin in the field of a swelling is tense, shines, hardly gathers in folds, its color is usually not changed. More often process happens bilateral, taking in 1-2 days a parotid gland and on the opposite side, but also hemilesions are possible. The patient is disturbed by feeling of tension and pain in parotid area, especially at night; at a prelum a tumor of an Eustachian tube noise and ear pains can appear. When pressing behind a lobe of an ear there is an expressed morbidity (Filatov's symptom). This symptom - the most important and precursory symptom of parotitis. The mucous membrane around an opening of a stenonov of a channel is hyperemic and edematous (Mursu's symptom); often note a pharynx hyperemia. In certain cases the patient cannot chew food because of pain, and in even more hard cases the functional lockjaw of chewing muscles develops. Reduction of salivation and dryness in a mouth, decrease in hearing are possible. Pains proceed 3-4 days, sometimes irradiate to an ear or a neck, and by the end of the week gradually calm down. Approximately by this time or puffiness in a projection of sialadens disappears several days later. At epidemic parotitis the regional lymphadenopathy is not noted, as a rule.
At adults the prodromal stage is noted more often, more expressed clinical manifestations are characteristic of it. In addition to all-toxic during this period the catarral and dispeptic phenomena are possible. The acute phase of a disease, as a rule, happens heavier. Considerably more often than at children, observe the defeats which are (perhaps isolated) of submaxillary and hypoglossal sialadens. At a submaxillaritis the sialaden has a pasty consistence and is slightly painful, extended on the mandible course that is distinguished at a ducking back and aside. Swelled hypodermic cellulose around gland sometimes extends to a neck. Sublingvit it is shown by a swelling in mental area of the same character, pains under language, especially at its protrusion, a local hyperemia and puffiness of a mucous membrane. The swelling in a projection of sialadens at adults remains longer (2 weeks and more).

Reasons of Infectious parotitis:

The activator - a RNA-genomic virus of the family Paramyxovirus of the Paramyxoviridae family. All known strains belong to one serotype. At viruses emit V-antigen and S-antigen. A virus патогенен only for the person though there are confirmed cases of the dogs who caught from owners; also perhaps experimental infection with a virus of monkeys. It is allocated with saliva and urine, it can be found in blood, cerebrospinal liquid, a brain, breast milk, etc. The virus is unstable in external environment: it is quickly inactivated under the influence of high temperature, ultraviolet rays, disinfecting solutions, when drying. At a low temperature the virus can keep viability till 1 year.

Treatment of Infectious parotitis:

At uncomplicated forms out-patient treatment. Patients are usually hospitalized according to epidemiological indications or in cases of emergence of complications. Means of causal treatment are absent. The bed rest is recommended during the feverish period irrespective of disease severity. In the first days of a disease patients are given preferential liquid or semi-fluid food. Care of an oral cavity is of particular importance: frequent drink, rinsing by boiled water or 2% soda solution, careful toothbrushing. On area of parotid glands apply dry heat (the dry warming compresses, radiation by a lamp соллюкс), appoint local physiotherapeutic procedures in the form of ultra-violet radiation, UVCh-therapy, a diathermy. At the expressed toxicosis carry out disintoxication therapy with purpose of small doses of glucocorticoids (under medical control). In some clinics positive takes after use of interferon (leykinferon) in early terms of a disease are received.
At development of an orchitis except a bed rest recommend to apply suspenzoriya, locally in the first 3-4 days - cold, and in the next days - heat. Also carry out early treatment by average doses of glucocorticoids.