Mumps in children: swollen cheeks, complications and staying off school

The main symptom is painful swelling of the cheeks and neck, which may cause earache or make chewing, swallowing or speaking harder. NHS inform describes swelling of the parotid glands at the sides of the face under the ears, giving a distinctive hamster-face appearance. The NHS says the swelling usually starts on one side before appearing on both, and that sometimes only one side swells or there is no swelling at all.

Other symptoms include headache, high temperature (38C or above, says NHS inform), muscle or joint aches, tiredness, feeling sick, a dry mouth, mild stomach pain and loss of appetite. These can begin a few days before the swelling. It is also possible to have mumps without any symptoms.

The NHS says to speak to a GP if you think a child may have mumps, or if a person has been in close contact with someone with mumps and has not had 2 doses of MMR or had mumps before, and that the GP will arrange a test. Mumps spreads easily, so phone first. NHS inform notes that mumps has similar symptoms to glandular fever and tonsillitis, and that a GP who suspects it should notify the local health protection team. It says a GP can usually diagnose by seeing and feeling the swelling, looking at the position of the tonsils and checking temperature.

The NHS and NHS inform suggest the following once a GP has seen the child.

• Rest and drink plenty of water.

• Paracetamol or ibuprofen for swelling, aches and pain; no aspirin for children under 16.

• A warm towel held gently against the cheeks and neck (NHS), or a warm or cool compress on the swollen glands (NHS inform).

• Foods that need little chewing, such as soup, mashed potatoes and scrambled eggs (NHS inform).

The NHS lists swollen testicles (orchitis), swollen ovaries, meningitis, pancreatitis and temporary hearing loss in one ear, and says these are more likely when mumps occurs as a teenager or adult but usually do not cause serious long-term problems. NHS inform says about 1 in 20 cases lead to acute pancreatitis, usually mild, and about 1 in 20 people experience some temporary hearing loss, with permanent loss rare. It says mumps can lead to viral meningitis if the virus moves into the outer layer of the brain, and that swelling of the testicles or ovaries mainly affects those who have gone through puberty.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if a person with mumps has tummy or back pain, or painful or swollen testicles. It says to go to A&E or call 999 if a person with mumps has a very bad headache, is being sick, has a stiff neck, dislikes bright light, is confused or disoriented, has a fit or seizure, or passes out.

Mumps is caused by a virus that spreads when an infected person coughs or sneezes. NHS inform says a person is most contagious a few days before symptoms develop and for a few days afterwards. UKHSA says infected people should stay away from the setting until 5 days after onset of swelling, and that settings only need to contact the health protection team if there is an outbreak. The NHS gives the same 5 days and advises staying at home, washing hands often, using tissues and not sharing towels, bedding, clothes, cups or cutlery.

NHS inform says mumps used to be common in children before the MMR vaccine, which is given in 2 doses as part of the NHS childhood programme, and that most cases occur in people aged 17 to 34 who have not had 2 doses. The NHS says MMRV is offered to all young children in the UK, MMR is recommended for adults and older children who were not vaccinated, and it is very unlikely to be mumps if someone has had both doses or has had mumps before.