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Mumps: For health professionals

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Key information  

Mumps is caused by the mumps virus, a member of the Paramyxoviridae family. Mumps is a nationally notifiable disease.

The disease is characterized by acute parotitis that is either unilateral or bilateral. It is typically preceded by:

Complications are relatively frequent, but permanent sequelae are rare. Complications can occur in the absence of parotitis.

The virus spreads through infectious respiratory particles or secretions and, rarely, contaminated fomites.

With the introduction of routine mumps vaccination programs in Canada beginning in 1969, mumps has transitioned from being a common childhood infection to a relatively rare disease. Nonetheless, outbreaks of mumps continue to occur in Canada with an increasing proportion of cases occurring in teenagers and young adults.

The National Advisory Committee on Immunization (NACI) recommends routine immunization against mumps with a mumps-containing vaccine.

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Epidemiology

The mumps virus is an enveloped, negative-sense, single stranded RNA virus which belongs to the Rubulavirus genus in the Paramyxoviridae family.

Reservoir

Humans are the only reservoir.

Incubation period

Mumps is characterized by a relatively long incubation period of 12 to 25 days (average of 16 to 18 days).

Transmission

Mumps virus is transmitted through:

The mumps virus has been isolated from the saliva of persons who are infected with mumps from 7 days before the onset of parotitis to 9 days after. Those infected with mumps are most infectious from 2 days before to 5 days after parotitis onset.

Persons who are infected with the mumps virus and who are asymptomatic or have prodromal symptoms can still transmit the disease to others.

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Clinical manifestations

Mumps is characterized by inflammation of 1 or more salivary glands, usually the parotid. Parotitis may be unilateral or bilateral and typically lasts about 5 days.

Prodromal symptoms are usually nonspecific. They may include:

Mumps infections have been associated with cough and rhinorrhea, particularly in children younger than 5 years.

Emergence of contralateral parotitis within weeks to months after apparent recovery has been described.

Complications

Complications are relatively frequent in up to about 30% of those infected, but permanent sequelae are rare.

Complications from mumps can include:

Long-term sequelae from mumps can include:

Mumps is rarely fatal.

Complications are more common among those who are unvaccinated and in adults more so than children.

Images of clinical manifestations of mumps

Image 1: Unilateral parotitis

Source: U.S. Centers for Disease Control and Prevention.

Image 2: Bilateral parotitis

Courtesy of Dr. C.W. Leung, Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong.

Image 1 on the left shows a child with unilateral parotitis due to the mumps virus.

Image 2 on the right shows a child with bilateral parotitis due to the mumps virus.

Risk factors

Anyone is at risk of mumps if they have not had mumps or have not been fully immunized according to the recommended immunization schedule.

In Canada, adults born before 1970 are presumed to have acquired natural immunity to mumps. This is due to the high levels of mumps circulating before 1970. Vaccination for mumps may still be recommended for some population groups, even if born before 1970.

Adolescents and adults born in or after 1970 who are at the greatest risk of exposure to mumps include:

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Diagnosis and laboratory testing

When health care providers suspect mumps (including in those known to have had an epidemiologic link to a mumps case or outbreak), confirmation of the diagnosis should be done with a laboratory sample. This can include:

Viral detection specimens should be collected and, if positive, are also used to determine the mumps genotype. Only genotyping can distinguish illness due to a vaccine reaction rather than wild-type infection.

Health care providers are required to report suspected cases of mumps to their local public health unit or office as mumps is a nationally notifiable disease. 

Only cases meeting the national case definition are reported to the Canadian Notifiable Disease Surveillance System.

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Treatment

There is no specific treatment for mumps.

Medical management is supportive and aimed at symptom relief and management of complications. This can include rehydration and management of secondary complications of mumps.  

Prevention

Routine vaccination

Mumps-containing vaccines are effective at reducing the risk of mumps infection and complications. Receiving 2 doses of a mumps-containing vaccine is about 90% effective at preventing mumps. It is still possible to be infected with mumps when fully vaccinated but vaccinated people are much less likely to develop complications.

The measles-mumps-rubella (MMR) vaccine or the measles-mumps-rubella-varicella (MMRV) vaccine are routinely given in childhood.

The first dose should be given at 12 to 15 months of age and the second dose at 18 months of age or any time thereafter, but no later than school entry. The second dose must be given a minimum of 4 weeks after the first dose. Vaccination schedules may vary by province or territory.

The MMR vaccine can be given throughout the lifespan to people who have not received all their scheduled vaccinations. The MMRV vaccine is only authorized for children 12 months to less than 13 years of age.

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Catch-up and additional considerations

The following are current recommendations for those who do not meet the definition of mumps immunity.

Two doses of MMR vaccine are recommended for:

A single dose of MMR vaccine is recommended for:

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Adverse events and contraindications 

Expected reactions to mumps-containing vaccines are usually mild and resolve on their own. They can include local injection site reactions that occur soon after vaccination and others that may develop 1 to 3 weeks after vaccination, including fever and a mild rash.

Serious adverse events after vaccination are rare.

To ensure the ongoing safety of vaccines in Canada, reporting of adverse events following immunization (AEFI) by vaccine providers and other clinicians is critical. In most jurisdictions, reporting may also be mandatory under the public health legislation. Vaccine providers are asked to report AEFIs through their local public health unit or office and to check for specific AEFI reporting requirements in their province or territory.

There are circumstances where mumps vaccination may be contraindicated, such as in individuals:

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Post-exposure and outbreak management

Health care providers should contact their local public health unit or office for more direction when a mumps case is suspected. Confirmed cases are nationally notifiable.

Persons infected with mumps should be isolated for 5 days after the appearance of parotitis to prevent transmission to others. In health care settings, droplet precautions should be followed.

There are no data on the use of MMRV vaccine in post-exposure scenarios and therefore NACI recommends the use of MMR vaccine.

Post-exposure vaccination with MMR vaccine should be given to susceptible individuals because exposure may not result in infection, and MMR vaccine will induce protection against subsequent exposures.

There is no evidence of increased risk of expected side effects from immunization with MMR vaccine if an individual is:

In the event of a mumps outbreak, the size, scope and duration can be variable and difficult to predict. This can be explained by:

In a highly immunized population, circulation of the mumps virus may be under-detected.

In an outbreak scenario, implementation of an outbreak dose of MMR vaccine (up to a third dose) may be considered as a part of the broader outbreak management strategy. Early vaccination is likely to be the most effective intervention to control the outbreak.

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Surveillance and monitoring

Surveillance systems to monitor mumps in Canada

Mumps has been a nationally notifiable disease in Canada since 1924.

Cases that meet the national case definition of mumps are reportable and health care providers and laboratories report cases to their local public health unit or office. These reports are then forwarded to provincial and territorial public health officials and provide annual data to the Public Health Agency of Canada through the Canadian Notifiable Disease Surveillance System or a disease-specific surveillance system.

Genotype surveillance is conducted by the National Microbiology Laboratory. Genotyping is an important tool in mumps surveillance because it:

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Mumps epidemiology and immunization in Canada

Routine 1-dose vaccination against mumps was implemented across provinces and territories between 1969 and 1983. A second dose of MMR vaccine was implemented following large outbreaks of measles in several provinces in 1996. Since the introduction of vaccines, the number of reported mumps cases has decreased by more than 99%.

The average annual incidence rate has dropped significantly since the pre-vaccine era (Figure 1). For example, the incidence was about:

Note that between 1959 and 1985, mumps was removed from the list of nationally notifiable diseases and national surveillance data are not available.

Mumps nevertheless remains endemic in Canada, with peaks in activity occurring sporadically.

Since introducing a routine second dose of MMR vaccine in 1996 and 1997, a change in the age distribution of mumps cases has been observed. From 1991 to 1995, the highest rates of disease were among children between the ages of 1 and 14 years of age. This has shifted to older age groups, with rates being the highest in people between 20 to 24 years of age in current years.

Mumps outbreaks occurred in several provinces between 2016 and 2018, resulting in a significant increase in the number of reported cases. However, case numbers have stabilized in recent years. Between 2019 and 2023 (Figure 1), the:

Figure 1. Number and incidence rate (per 100,000 population) of reported mumps cases in Canada by year, 1924 to 1959 and 1985 to 2023

figure 1

Figure 1: Text description
Year Cases Incidence rate
1924 7,997 122.1  
1925 7,669 115.4
1926 7,607 112.7
1927 8,418 122.4
1928 23,925 245.8
1929 12,053 121.4
1930 9,464 92.8
1931 11,158 107.7
1932 12,421 118.3
1933 11,562 108.9
1934 8,460 78.9
1935 22,644 209.1
1936 29,753 272.1
1937 14,441 130.9
1938 8,401 75.4
1939 5,844 52.0
1940 13,498 118.8
1941 22,936 199.6
1942 52,344 449.8
1943 48,304 410.1
1944 19,819 166.1
1945 20,400 169.2
1946 26,056 212.4
1947 32,252 257.5
1948 24,601 192.2
1949 24,557 183.0
1950 43,671 319.1
1951 35,189 251.6
1952 38,439 266.3
1953 36,297 244.9
1954 26,908 176.3
1955 27,193 173.6
1956 28,112 195.4
1957 22,386 166.3
1958 13,360 96.5
1959 No data No data
1960 No data No data
1961 No data No data
1962 No data No data
1963 No data No data
1964 No data No data
1965 No data No data
1966 No data No data
1967 No data No data
1968 No data No data
1969 No data No data
1970 No data No data
1971 No data No data
1972 No data No data
1973 No data No data
1974 No data No data
1975 No data No data
1976 No data No data
1977 No data No data
1978 No data No data
1979 No data No data
1980 No data No data
1981 No data No data
1982 No data No data
1983 No data No data
1984 No data No data
1985 No data No data
1986 836 3.2
1987 949 3.6
1988 792 3.0
1989 1,550 5.7
1990 535 1.9
1991 390 1.4
1992 330 1.2
1993 325 1.1
1994 356 1.2
1995 397 1.4
1996 290 1.0
1997 254 0.9
1998 114 0.4
1999 92 0.3
2000 81 0.3
2001 102 0.3
2002 200 0.6
2003 28 0.1
2004 33 0.1
2005 79 0.3
2006 42 0.1
2007 1,109 3.4
2008 748 2.3
2009 187 0.6
2010 768 2.3
2011 272 0.8
2012 48 0.1
2013 96 0.3
2014 40 0.1
2015 59 0.2
2016 365 1.0
2017 2,266 6.2
2018 808 2.2
2019 174 0.5
2020 77 0.2
2021 13 0.0
2022 27 0.1
2023 47 0.1

Figure 2. Total number and average annual incidence rate (per 100,000 population) of reported mumps cases in Canada by age group, 2019 to 2023 (n=333)

figure 2

Figure 2: Text description
Age group Total number of cases Average incidence rate (per 100,000 population)
Under 1 year 2 0.1
1 to 4 years 27 0.4
5 to 9 years 30 0.3
10 to 14 years 7 0.1
15 to 19 years 28 0.3
20 to 24 years 56 0.5
25 to 29 years 50 0.4
30 to 39 years 68 0.3
40 to 49 years 51 0.1
60 years and older 14 <0.1

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2026-05-13