Materiały źródłowe

• #1 Mumps: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/966678-overview

  Mumps is an acute, self-limited, systemic viral illness characterized by the swelling of one or more of the salivary glands, typically the parotid glands. The illness is caused by the RNA virus, Rubulavirus. Rubulavirus is within the genus Paramyxovirus and is a member of the family Paramyxoviridae. This virus contains a single-stranded, negative-sense RNA surrounded by a glycoprotein envelope. Of 2 glycoproteins on the surface of the RNA viral envelope, one mediates neuraminidase and hemagglutination activity, whereas the other is responsible for fusion to the lipid membrane of the host cell. […] After the initial entry into the respiratory system, the virus replicates locally. Viremic dissemination then occurs to target tissues, such as the salivary glands (parotid glands) and extrasalivary locations (CNS). These findings are based on experimentally induced mumps infection by Henly et al in 1948.

• #1 Chapter 15: Mumps | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-15-mumps.html

  The virus is acquired by respiratory droplet transmission. It replicates in the nasopharynx and regional lymph nodes. During viremia, the virus spreads to multiple tissues, including the meninges, salivary glands, pancreas, testes, and ovaries. Inflammation in infected tissues leads to characteristic symptoms of parotitis and other complications such as orchitis and aseptic meningitis.

• #1 Unique Tropism and Entry Mechanism of Mumps Virus

  https://www.mdpi.com/1999-4915/13/9/1746

  The selective binding of MuV-HN to α2,3-linked sialic acid was confirmed by using small-scale “hand-made” glycan arrays with glycoconjugates representing major sialylated glycans found in the human respiratory tract. […] These observations demonstrated that the trisaccharide structure is responsible for the interaction between glycan receptors and the MuV-HN protein. […] The binding affinities between MuV-HN and glycan receptors, quantified by thermodynamic analysis using isothermal titration calorimetry (ITC), showed the equilibrium dissociation constant (Kd) of MuV-HN and disaccharide (Siaα2,3Gal) to be approximately 500 μM. In contrast, the Kd of MuV-HN and trisaccharide (Siaα2,3Galβ1,4Glc) was approximately 50 μM, indicating a 10-fold stronger interaction of MuV-HN with the trisaccharide compared to that with the disaccharide, hence suggesting the importance of the trisaccharide structure.

• #1

  https://step1.medbullets.com/microbiology/104101/mumps-virus

  all paramyxoviruses contain the F (fusion) protein […] can induce cell-to-cell fusion, creating multi-nucleated giant cells […] helps mediate virus and cell membrane fusion, ultimately resulting in infection of the host cell […] the virus replicates in the nasopharynx and regional lymph nodes in the glandular epithelium

• #1 Mumps virus: mode of transmission, pathogenesis, clinical disease and immunization – Online Biology Notes

  https://www.onlinebiologynotes.com/mumps-virus-mode-of-transmission-pathogenesis-clinical-disease-and-immunization/

  Mumps virus causes a lytic infection of cells and Humans are the only natural hosts. […] Once the virus enter the respiratory tract, the infection begins. […] Primary replication occurs in nasal or upper respiratory tract epithelial cells. […] Once viremia occurs, virus is then disseminated to target tissues such as the CNS and salivary glands (parotid gland). Involvement of the parotid gland is not an obligatory step in the infectious process. […] The virus replicates in the target tissues and then causes a secondary phase of viremia. […] The virus then spread throughout the body- to kidneys, testes, ovary, pancreas and other organs. […] Infection of the CNS especially meninges, causes meningitis or meningoencephalitis. […] The CNS is commonly infected and may be involved in the absence of parotitis. […] Mumps is a systematic viral disease with a propensity to replicate in epithelial cells in various visceral organs. […] Virus shed in the saliva from about 3 days before to 9 days after the onset of salivary gland swelling.

• #1 Pinkbook | Mumps | Epidemiology of Vaccine Preventable Diseases | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/vaccines/pubs/pinkbook/mumps.html

  Mumps Pathogenesis […] – Respiratory transmission of virus […] – Replication in nasopharynx and regional lymph nodes […] – Viremia 12 to 25 days after exposure with spread to tissues […] – Multiple tissues infected during viremia […] […] […] The virus is acquired by respiratory droplets. It replicates in the nasopharynx and regional lymph nodes. After 12 to 25 days a viremia occurs, which lasts from 3 to 5 days. During the viremia, the virus spreads to multiple tissues, including the meninges, and glands such as the salivary, pancreas, testes, and ovaries. Inflammation in infected tissues leads to characteristic symptoms of parotitis and aseptic meningitis.

• #1 Mumps virus pathogenesis: Insights and knowledge gaps

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5215468/

  The recent mumps outbreaks among MMR vaccinated persons have raised questions about the biological mechanisms related to mumps symptoms and complications in the background of waning immunity. […] The understanding of mumps virus pathogenesis and the immune responses required for protection against mumps virus infection is limited, whereas this knowledge is important for the development of new mumps vaccine strategies and outbreak control measures. […] Mumps virus infected cells might escape host immunosurveillance via degradation of STAT1 and STAT3 by the mumps virus V protein. […] The mechanism behind the development of mumps parotitis and orchitis is unknown. […] It has been hypothesized that these complications result from lymphocytic infiltration and destruction of periductal cells that lead to blockage of the ducts in the salivary glands and the semeniferous tubules of the testes, respectively.

• #1 Mumps Virus- An Overview

  https://microbenotes.com/mumps-virus/

  A cell-mediated immune response also develops. […] Interferon is induced early in mumps infection. […] Plasma viremia disappears coincident with the development of mumps virus-specific humoral antibody, which can be detected in serum as early as 11 days after induced apparent or inapparent infection of humans. […] Mumps virus preferentially infects activated human T lymphocytes. […] Mumps is a systemic viral disease with a propensity to replicate in epithelial cells in various visceral organs. […] Virus frequently infects the kidneys and can be detected in the urine of most patients. […] Viruria may persist for up to 14 days after the onset of clinical symptoms. […] The central nervous system is also commonly infected and may be involved in the absence of parotitis. […] Viral invasion of the CNS presumably occurs across the choroid plexus.

• #1 Mumps: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/966678-overview

  A secondary phase of viremia that occurs before the immune response is due to the replication of the virus at the target organs. Viruria is also common, via blood transmission of the virus into the kidneys, where active replication occurs. Therefore, impaired renal function (glomerulonephritis) may occur. […] Cell necrosis and inflammation with mononuclear cell infiltration is the tissue response. Salivary glands show edema and desquamation of necrotic epithelial cells lining the ducts. Focal hemorrhage and destruction of germinal epithelium may occur, leading to duct plugging.

• #1 Molecular biology, pathogenesis and pathology of mumps virus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4268314/

  Mumps is caused by the mumps virus (MuV), a member of the Paramyxoviridae family of enveloped, non-segmented, negative-sense RNA viruses. […] The virus is highly neurotropic, with laboratory evidence of central nervous system (CNS) infection in approximately half of cases. […] Despite being one of the oldest recognized diseases, with a worldwide distribution, surprisingly little attention has been given to its study. […] The disease is characterized by painful swelling of the parotid glands, but can involve numerous other tissues and organs, resulting in a wide array of inflammatory reactions, including encephalitis, meningitis, orchitis, myocarditis, pancreatitis and nephritis. […] Our current knowledge of MuV pathogenesis is therefore mostly based on animal studies, often following unnatural routes of infection.

• #1 Molecular biology, pathogenesis and pathology of mumps virus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4268314/

  Given the incidence of mumps in the pre-vaccine era, comparatively little is known about the pathogenesis of the disease. […] MuV is transmitted via the respiratory route by inhalation or oral contact with infected respiratory droplets or secretions. […] Given the array of symptoms, it is clear that MuV is able to disseminate systemically in the body, which has led to the assumption that, following infection of the upper respiratory mucosa, the virus spreads to regional lymph nodes, resulting in viraemia during the early acute phase. […] MuV is highly neurotropic, with evidence of central nervous system (CNS) involvement in up to half of all cases of infection, based on pleocytosis of the cerebrospinal fluid. […] Experimental infection in rodents suggests the virus enters the CSF through the choroid plexus, or possibly via transiting mononuclear cells during viraemia.

• #1 Mumps | PPT

  https://www.slideshare.net/slideshow/mumps-250569382/250569382

  Necrosis of acinar and epithelial duct cells is evident in the salivary glands and in the germinal epithelium of the seminiferous tubules of the testes. The virus probably enters cerebrospinal fluid (CSF) through the choroid plexus or via transiting mononuclear cells during plasma viremia. […] Documented CSF pleocytosis indicates that mumps virus invades the CNS in ~50% of cases; However, symptomatic CNS disease, typically in the form of aseptic meningitis, occurs in 10% of cases, with a male predominance. […] Mumps pancreatitis, which may present as abdominal pain, occurs in ~4% of infections. Myocarditis and endocardial fibroelastosis are rare and self-limited but may represent severe complications of mumps infection.

• #1 Mumps – Wikipedia

  https://en.wikipedia.org/wiki/Mumps

  In up to half of cases, MuV infiltrates the central nervous system (CNS), where it may cause meningitis, encephalitis, or hydrocephalus. Mumps is rarely fatal, so few post-mortem analyses have been done to analyze CNS involvement. Of these, fluid buildup, congestion, and hemorrhaging in the brain, white blood cell infiltration in the perivascular spaces in the brain, reactive changes to glial cells and damage to the myelin sheaths surrounding neurons were observed. Neurons appear to be relatively unaffected. […] In laboratory tests on rodents, MuV appears to enter the CNS first through cerebrospinal fluid (CSF), then spreading to the ventricular system. There, MuV replicates in ependymal cells that line the ventricles, which allows the virus to enter the brain parenchyma. This often leads to MuV infecting pyramidal cells in the cerebral cortex and hippocampus. Infected ependymal cells become inflamed, lose their cilia, and collapse into CSF, which may be the cause of the narrowing of the cerebral aqueduct thought to cause mumps hydrocephalus.

• #1 Opinion of the Pathogenesis of the Mumps Meningites | Uniscience Publishers

  https://unisciencepub.com/articles/opinion-of-the-pathogenesis-of-the-mumps-meningites/

  It is generally accepted that meningeal reactions in patients with mumps are due to the direct involvement of the meninges by the mumps virus. […] In present article, the author states that these reactions are not due to inflammation of the meninges, but to the choroid plexus caused by virulent and vaccine strains. […] The meningitis is considered a widespread and serious reaction to mumps infection. This type of meningitis is explained by the direct attack of the virus on the meninges. […] The author considers that meningeal reactions are not meningitis, but meningisms, based on clinical data, experiments on monkeys and the glymphatic system. […] The role of the choroid plexus is in accordance with the clinical observation of vaccinated individuals showing meningeal symptoms in contradiction with clinical symptoms and liquor findings: mild clinical sign, mainly neck stiffness and headache against clear liquor, outflow under pressure with puncture, with higher pleocytosis and increase proteins.

• #1 Mumps – Wikipedia

  https://en.wikipedia.org/wiki/Mumps

  Many aspects of the pathogenesis of mumps are poorly understood and are inferred from clinical observations and experimental infections in laboratory animals. Following exposure, the virus infects epithelial cells in the upper respiratory tract that express sialic acid receptors on their surface. After infection, the virus spreads to the parotid glands, causing the signature parotitis. […] It is thought that shortly after infection the virus spreads to lymph nodes, in particular T-cells and viruses in the blood, called viremia. Viremia lasts for 7–10 days, during which MuV spreads throughout the body. […] In mumps orchitis, infection leads to: parenchymal edema; congestion, or separation, of the seminiferous tubules; and perivascular infiltration by lymphocytes. The tunica albuginea forms a barrier against edema, causing an increase in intratesticular pressure that causes necrosis of the seminiferous tubules. The seminiferous tubules also experience hyalinization, i.e. degeneration into a translucent glass-like substance, which can cause fibrosis and atrophy of the testes.

• #1 Mumps Virus- An Overview

  https://microbenotes.com/mumps-virus/

  Natural infection is initiated by droplet spread. […] Primary replication occurs in nasal or upper respiratory tract epithelial cells. […] Viremia then disseminates the virus to the salivary glands and other major organ systems. […] The incubation period may range from 2 to 4 weeks but is typically about 14-18 days. […] Virus is shed in saliva for as long as 6 days before the onset of parotitis. […] About one-third of infected individuals does not exhibit obvious symptoms but are equally capable of transmitting infection. […] Termination of viral excretion in saliva correlates with the local appearance of virus-specific secretory IgA, as early as 5 days after disease onset. […] Virus-specific IgM antibodies are also present early in saliva. […] Thus, patients with mumps are capable of spreading virus by the respiratory route over a 7 to 10 days interval.

• #1 Mumps Virus (MuV) – Creative Diagnostics

  https://www.creative-diagnostics.com/mumps-virus-muv.htm

  Mumps virus (MuV) is a member of the family Paramyxoviridae and the organism that causes the acute infectious disease mumps. MuV is an enveloped, single-stranded negative-sense RNA virus that is highly neurotropism-causing, and can be the cause of encephalitis, meningitis, orchitis, parotitis and more. […] MuV transmission characteristics are intimately tied to the pathogenesis of mumps. The virus travels into the body via the epithelial cells of the nose and throat, where it initially invades the upper respiratory tract. This requires the viral surface fusion protein (F) to attach to receptors in the host cells. MuV’s F protein attaches to the membrane of the host cell and induces fusion, sending the viral nucleocapsid into the host cell where the virus replicates. […] MuV’s immune evasion mechanisms are mainly realized by suppressing the host immune system. Infected virus suppresses the host’s antiviral response by regulating the immune system of the host cell. Notably, MuV silences the interferon (IFN) signaling system, weakening the antiviral response and enabling the virus to slip through the host immune system’s net and avoid elimination.

• #1 Mumps pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Mumps_pathophysiology

  Humans are the only natural host for mumps virus (MuV). MuV is transmitted through respiratory droplets (saliva or mucus), direct contact, or contact with surfaces carrying MuV. MuV enters the body through inhalation or oral contact and infects the upper respiratory tract epithelium. MuV is able to attach to extracellular sialic acid via the hemagglutinin-neuraminidase (HN) glycoprotein. HN and the fusion (F) glycoprotein mediate cell membrane fusion, allowing viral material to enter respiratory epithelial cells. HN and F, in conjunction with matrix (M) protein, are also involved in localizing viral material after replication and inducing virion budding. MuV is able to inhibit an immune response to infection with the following virulence factors: […] Small hydrophobic (SH) protein is presumed to block TNF-mediated apoptosis. […] Non-structural proteins NS1 and NS2 (V proteins) inhibit IFN production and signaling. MuV disseminates through the lymphatic system to cause systemic infection. Replication in the parotid gland (or other salivary gland) causes mononuclear cell infiltration, hemorrhage, edema, and necrosis.

• #1 Mumps : Virus Characteristics, Pathology and Pathogenesis

  https://www.prepladder.com/neet-ss-pediatrics/infections/mumps-virus-characteristics-pathology-and-pathogenesis-investigations-complications-and-treatment

  In case of infections, the mumps virus replicates in epithelial cells of the oral cavity/airway tract. It will also spread to regional lymph nodes. After replication, the virus will show a phase called viremia. They reach a certain organ system, first salivary glands. […] In mumps viruses, most infected tissues have two pathologies in common. They produce cellular necrosis, Intense lymphocytic infiltrate. In addition, when the virus reaches the testes, it produces a focal infarct. CNS will show CSF pleocytosis prominent even in asymptotic cases. […] Most infected tissues have two pathologies in common. They produce cellular necrosis and Intense lymphocytic infiltrate. In addition, when the virus reaches the testes, it produces a focal infarct. CNS will show CSF pleocytosis prominent even in asymptotic cases.

• #1 Mumps – Viral Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.1.4.

  1. Etiologic agent: Mumps virus, an enveloped RNA virus in the Paramyxoviridae family. It enters the respiratory system (initially replicating in the respiratory epithelium), causes viremia, and infects multiple organs and tissues (including the salivary glands and central nervous system). […] Humans are the only reservoir for mumps virus. The virus is transmitted from a person with mumps or asymptomatic infection via droplets as well as by direct or indirect contact with contagious biological material (blood, saliva, cerebrospinal fluid, urine) or contaminated objects. […] The incubation period is from 12 to 25 days (typically 16-18 days). Patients may have viral shedding in the saliva up to 7 days before the onset of parotitis and up to 9 days afterwards (virus shedding in urine is observed for up to 2 weeks).

• #1 Mumps – Wikipedia

  https://en.wikipedia.org/wiki/Mumps

  In humans, mumps hydrocephalus may be due to obstruction of the cerebral aqueduct with dilatation of the lateral and third ventricles, obstruction of the interventricular foramina, or obstruction of the median and lateral apertures. Ependymal cells have been isolated from CSF of mumps patients, suggesting that animals and humans share hydrocephalus pathogenesis. Hydrocephalus has also been observed in the absence of canal obstruction, however, indicating that obstruction may be a result of external compression by edematous tissue and not related to hydrocephalus. […] Deafness from mumps may be caused by MuV infection in CSF, which has contact with the perilymph of the inner ear, possibly leading to infection of the cochlea, or it may occur as a result of inner ear infection via viremia that leads to inflammation in the endolymph. Hearing loss may also be caused indirectly by the immune response. In animal studies, MuV has been isolated from the vestibular ganglion, which may explain vestibular symptoms such as vertigo that often co-occur with deafness.

• #1 Factsheet about mumps

  https://www.ecdc.europa.eu/en/mumps/facts

  Central nervous system (CNS) infection is common with mumps and up to 50% of patients have been shown to have asymptomatic pleocytosis in the cerebrospinal fluid (CSF). […] Encephalitis is a rare but serious complication that affects 0.020.3% of cases and is responsible for most mumps-associated deaths. […] Orchitis is the most common complication in postpubertal males and is reported to occur in 2550% of mumps infections. […] Mumps can cause pancreatitis, which may be associated with transient hyperglycaemia. […] The mean incubation period is 19 days with a range of 1425 days. […] Mumps virus can be isolated in cell culture or detected by PCR from nasopharyngeal swabs, urine, blood and fluid from the buccal cavity, typically from seven days before up until nine days after the onset of parotitis. Genotyping of isolated strains is recommended if breakthrough infections in vaccinated individuals are identified.

• #1 Mumps Virus – Definition, Replication, Structure, Genome, Pathogenesis – Biology Notes Online

  https://biologynotesonline.com/mumps-virus-definition-replication-structure-genome-pathogenesis/

  The mumps virus replicates largely in the epithelial lining of the nose and upper respiratory tract after infection. Infection of different organs, including the salivary glands, kidney, pancreas, and central nervous system, follows lymph node penetration and temporary viremia. […] The most common symptom of parotitis virus infection is inflammation of the salivary glands. When viruses replicate, they cause tissue damage, which in turn triggers an immunological response that causes inflammation and gland enlargement. […] Infections in mice and hamsters, for example, are caused by a variety of MuV strains with various degrees of pathogenicity. […] Meningitis severity tends to be linked to certain MuV strains, although this does not appear to apply to infections that occur naturally in humans. […] The RNVT appears to be more accurate at predicting outcomes than the MNVT. In a hamster model, some mutants that are resistant to neutralizing monoclonal antibodies have altered neuropathogenicity.

• #1 Unique Tropism and Entry Mechanism of Mumps Virus

  https://www.mdpi.com/1999-4915/13/9/1746

  The amino acid residues involved in the interaction with glycan receptors were conserved in the MuV-HN of all genotypes except Phe370, which forms a stacking interaction with Tyr369 and is replaced with leucine in genotype K, suggesting that MuVs of all 12 genotypes utilize them as receptors. […] Recent studies have revealed the details of glycan structures that MuV prefers for its receptors. However, the distribution of glycan receptors in the human body alone cannot explain all the unique tropism exhibited by MuV; there may be additional unknown host factors that promote MuV infection. […] Although the distribution of these receptors and host factors may partially explain MuV tropism, many questions still need to be addressed to fully understand the pathogenesis of MuV: Why is the affinity to glandular tissues and the CNS unique to MuV, despite its similar life cycle to other paramyxoviruses? Are the tissues damaged by direct infection of the organs by MuV or by the secondary effect of immune response? Are there other receptors or host factors that restrict the MuV life cycle in specific tissues? These are just some of the questions that need further attention.

• #1 Remembering Mumps | PLOS Pathogens

  https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004791

  There is evidence that mumps antibody may be boosted in vaccinated individuals by asymptomatic wild-type infection. As endemic mumps virtually disappeared in the US, a consequent lack of natural boosting may have contributed to a reduction in population immunity to a level that is capable of sustaining transmission in some settings. Notably, recent outbreaks in the US have generally occurred in circumstances that promote a high frequency and intensity of contact, such as college dormitories, boarding schools, and youth summer camps, and spread of the virus beyond these settings into surrounding communities has been limited. […] The effectiveness of two doses of MMR vaccine is different for each virus component. In contrast to the measles and rubella vaccines, which are 95% effective, reports of mumps vaccine effectiveness vary and range from 79%95%, with a median of 88%. Although it is imperfect, the protection afforded by mumps vaccination is effective, valuable, and important. As mentioned, high vaccination coverage has nearly eliminated endemic disease in the US and has limited spread of the virus to settings of high-intensity exposure. Furthermore, as compared to the prevaccine era, there has been a reduction in the frequency of complications among vaccinated individuals, which indicates there are important measures of protection that should not be overlooked. Finally, there is no evidence of immune escape, indicating that vaccination should induce antibody that is capable of neutralizing wild-type virus.

• #1 Remembering Mumps | PLOS Pathogens

  https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004791

  Because of the lack of a well-defined correlate of immunity, it is not currently possible to predict with confidence whether or not someone who has been vaccinated is susceptible or protected. If a vaccinated individual does not have detectable mumps antibody, they may likely be susceptible, but this is not a forgone conclusion. The amount and specificity of antibody or other components of immunity that might be required for protection are simply not known. […] Limited data are available regarding the effectiveness of a third dose of mumps vaccine. During recent outbreaks when a third dose was given as a control measure, there was a reduction in disease incidence. However, it is not clear from these reports if the outcome was a direct result of third-dose vaccination or if the reduction was simply the natural decline in disease incidence due to the late timing of the intervention in the course of the outbreak. In addition, limited antibody boosting was observed following third-dose vaccination, except in individuals who had extremely low (or no) mumps antibody.

• #1 Molecular biology, pathogenesis and pathology of mumps virus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4268314/

  The finding of ependymal cell debris in the CSF of mumps patients suggests that the pathogenesis of hydrocephalus in experimentally infected animals is similar to the mechanism of hydrocephalus in humans. […] As a re-emerging pathogen, with concerns over vaccine safety and efficacy, elucidation of mechanisms of MuV pathogenesis is of paramount importance. […] This review has summarized our current understanding of MuV clinical disease, pathology, and how this relates to viral pathogenesis. […] A number of important questions remain unresolved regarding MuV pathogenesis.

• #2 Clinical Overview of Mumps | Mumps | CDC

  https://www.cdc.gov/mumps/hcp/clinical-overview/index.html

  Mumps is a viral illness caused by a paramyxovirus, a member of the Rubulavirus family. […] The mumps virus replicates in the upper respiratory tract and is transmitted person to person through direct contact with saliva or respiratory droplets of a person infected with mumps. […] Severe complications caused by the virus include cerebellar ataxia, encephalitis, viral pneumonia, and hemorrhagic conditions. […] RT-PCR and viral culture are used to confirm mumps infection. […] A negative test result does not rule out mumps infection.

• #2 Mumps – Wikipedia

  https://en.wikipedia.org/wiki/Mumps

  Many aspects of the pathogenesis of mumps are poorly understood and are inferred from clinical observations and experimental infections in laboratory animals. Following exposure, the virus infects epithelial cells in the upper respiratory tract that express sialic acid receptors on their surface. After infection, the virus spreads to the parotid glands, causing the signature parotitis. […] It is thought that shortly after infection the virus spreads to lymph nodes, in particular T-cells and viruses in the blood, called viremia. Viremia lasts for 7–10 days, during which MuV spreads throughout the body. […] In mumps orchitis, infection leads to: parenchymal edema; congestion, or separation, of the seminiferous tubules; and perivascular infiltration by lymphocytes. The tunica albuginea forms a barrier against edema, causing an increase in intratesticular pressure that causes necrosis of the seminiferous tubules. The seminiferous tubules also experience hyalinization, i.e. degeneration into a translucent glass-like substance, which can cause fibrosis and atrophy of the testes.

• #2 Structural basis for Glycan-receptor binding by mumps virus hemagglutinin-neuraminidase | Scientific Reports

  https://www.nature.com/articles/s41598-020-58559-6

  Mumps virus is one of the main cause of respiratory illnesses in humans, especially children. Among the viral surface glycoproteins, the hemagglutinin neuraminidase, MuV-HN, plays key roles in virus entry into host cells and infectivity, thus representing an ideal target for the design of novel inhibitors. […] The MuV-HN plays different functions: it recognizes and binds sialic acid containing structures, including glycosphingolipids, N- and O-glycans exposed on host cell surface; promotes the fusion activity of the F protein, leading the fusion of MuV envelope and the host cell membrane at the cell surface; finally, cleaves the sialic acid residues from glycan receptors and progeny virus particles. The neuraminidase activity of MuV-HN has important effect on the virus budding, as prevents the viral self-agglutination and facilitates the release of the virus from the host cell surface.

• #2 Mumps virus – Wikipedia

  https://en.wikipedia.org/wiki/Mumps_virus

  The mumps virus (MuV) is the virus that causes mumps. MuV replicates first by binding to the surface of cells, whereby its envelope merges with the host cell membrane to release the capsid inside of the cell. Once inside, the viral RNA-dependent RNA polymerase transcribes messenger RNA (mRNA) from the genome and later replicates the genome. […] The SH protein is thought to be involved in blocking NF()-mediated apoptosis of the host cell, which is done as an antiviral response to suppress the spread of viruses, though SH is not necessary for replication since MuVs engineered without SH are still able to replicate. The V protein is also involved in evading host antiviral responses by means of inhibiting production and signalling of interferons. […] MuV first interacts with a host cell by binding to its surface via the HN protein’s receptor, sialic acid, which binds to sialic acid receptors on the surface of host cells. Following attachment, the F protein is triggered and begins fusing the viral envelope with the host cell’s membrane.

• #2 Chapter 15: Mumps | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-15-mumps.html

  The virus is acquired by respiratory droplet transmission. It replicates in the nasopharynx and regional lymph nodes. During viremia, the virus spreads to multiple tissues, including the meninges, salivary glands, pancreas, testes, and ovaries. Inflammation in infected tissues leads to characteristic symptoms of parotitis and other complications such as orchitis and aseptic meningitis.

• #2 Current Status of Mumps Virus Infection: Epidemiology, Pathogenesis, and Vaccine

  https://www.mdpi.com/1660-4601/17/5/1686

  MuV can spread systemically in human body resulting in viremia during the early phase of infection. […] Classic mumps infection is characterized by parotitis, but inflammation of salivary gland is not a main or necessary clinical manifestation of mumps infection. […] Other organs, including the central nervous system (CNS), heart, kidney, and genital organs can also be affected via viremia dissemination. […] It has been assumed that mumps virus invades T cells and efficiently grows in these cells. […] Migrating mumps virus-infected T cells could enhance the mumps virus to disseminate to the various organs and might therefore play a key role in the development of mumps disease.

• #2 Mumps Virus/Mumps | Concise Medical Knowledge

  https://www.lecturio.com/concepts/mumps-virus-mumps/

  The primary site of viral replication is the upper respiratory epithelium. […] The virus spreads to the local lymphoid tissue. […] Moment of highest transmissibility occurs just before the development of parotitis. […] Usually involves the parotid gland. […] May also spread to the CNS, testis/epididymis, thyroid gland, pancreas, and ovaries, leading to the inflammation of these structures. […] The virus is excreted in the urine in its infectious form during the 2 weeks following the onset of clinical illness.

• #2 Factsheet about mumps

  https://www.ecdc.europa.eu/en/mumps/facts

  Central nervous system (CNS) infection is common with mumps and up to 50% of patients have been shown to have asymptomatic pleocytosis in the cerebrospinal fluid (CSF). […] Encephalitis is a rare but serious complication that affects 0.020.3% of cases and is responsible for most mumps-associated deaths. […] Orchitis is the most common complication in postpubertal males and is reported to occur in 2550% of mumps infections. […] Mumps can cause pancreatitis, which may be associated with transient hyperglycaemia. […] The mean incubation period is 19 days with a range of 1425 days. […] Mumps virus can be isolated in cell culture or detected by PCR from nasopharyngeal swabs, urine, blood and fluid from the buccal cavity, typically from seven days before up until nine days after the onset of parotitis. Genotyping of isolated strains is recommended if breakthrough infections in vaccinated individuals are identified.

• #2 Molecular biology, pathogenesis and pathology of mumps virus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4268314/

  The finding of ependymal cell debris in the CSF of mumps patients suggests that the pathogenesis of hydrocephalus in experimentally infected animals is similar to the mechanism of hydrocephalus in humans. […] As a re-emerging pathogen, with concerns over vaccine safety and efficacy, elucidation of mechanisms of MuV pathogenesis is of paramount importance. […] This review has summarized our current understanding of MuV clinical disease, pathology, and how this relates to viral pathogenesis. […] A number of important questions remain unresolved regarding MuV pathogenesis.

• #2 Opinion of the Pathogenesis of the Mumps Meningites | Uniscience Publishers

  https://unisciencepub.com/articles/opinion-of-the-pathogenesis-of-the-mumps-meningites/

  In meninges there is no condition for reproduction of the mumps virus. […] This gives the author reason to formulate the opinion: In natural infection and vaccination, meningitis is not due to direct involvement of the meninges, but to the choroid plexus from the mumps virus. Inflammation of the choroid plexus leads to increase secretion of the cerebrospinal fluid. Abundant cerebrospinal fluid increases intracranial pressure, which is clinically manifested by meningisms. […] The absence of receptors on the surface of the neural and glial cells for corresponding to mumps antigens was confirmed in experiments conducted in collaboration with the Institute for Production Viral Vaccines, Moscow, and the Institute of Virology in East Berlin. […] If they have receptors corresponding to mumps virus antigens, during the stay of infected with the virus cerebral fluid in the brain parenchyma of patient or vaccinated, the neurological symptoms would have a completely different form.

• #2 Mumps virus: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/mumps-virus.html

  Rare manifestations include meningitis (1-10%), epididymo-orchitis (25% to 38% of post-pubertal males), encephalitis (0.1%) with a mortality rate of 1.4%, oophoritis (5% of post-pubertal females), transient high-frequency deafness (4%), permanent deafness (0.01%), and pancreatitis (4%). […] Neurologic syndromes infrequently associated with mumps include cerebellar ataxia, facial palsy, transverse myelitis, Guillain-Barr syndrome, and poliomyelitis-like syndrome. […] The estimated basic reproductive number (R0) of MuV, which represents the number of secondary cases generated by a primary case in an otherwise susceptible population, is 10-12. […] No antivirals are currently available to treat MuV infection. Ribavirin has shown virostatic activity in vitro. […] MuV is sensitive to 1% sodium hypochlorite (NaOCl), chlorine dioxide (ClO2) at a concentration of 1.0 mg/L for 30 minutes, 70% ethanol, and glutaraldehyde. […] MuV tends to remain infective for several hours in the external environment but can persist for days depending on environmental conditions such as temperature and humidity.

• #2 Mumps virus pathogenesis: Insights and knowledge gaps

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5215468/

  Mumps virus shedding in urine is caused by dissemination of mumps virus to the kidneys and is associated with abnormal renal function. […] The hypothesis that orchitis is caused by an immune mediated reaction is strengthened by the relatively rapid development of orchitis after MMR vaccination as was reported for 2 persons who had been exposed to mumps in the past. […] Arguing against immune-mediated pathogenesis is the clear protection provided through vaccination. […] Thus, once the virus has entered the body via the upper respiratory tract, vaccine-induced adaptive immune responses seem to prevent mumps virus spread, although it is not clear which immune responses are essential for protection against systemic mumps virus infection. […] In summary, clinical and laboratory data obtained from recent mumps outbreak investigations have improved our understanding of mumps virus pathogenesis and the role of immunological factors, but important gaps in knowledge remain.

• #2 Causes of Orchitis, Differential Diagnosis, and Treatment of Mumps Orchitis

  https://www.urology-textbook.com/mumps-orchitis.html

  Mumps orchitis is an acute viral orchitis and a complication of epidemic parotitis. […] The mumps virus is a neurotropic paramyxovirus with single-stranded RNA. Orchitis leads to infiltration of lymphocytes, damage to the blood-testis barrier, and edema with the rise of intratesticular pressure with pressure atrophy (caused by the inelastic tunica albuginea). Infertility, subfertility, and hypogonadism may develop depending on the extent of the (bilateral) disease. […] Bilateral orchitis may cause testicular atrophy with infertility, in severe cases with hypergonadotropic hypogonadism.

• #2 Mumps Virus (MuV) – Creative Diagnostics

  https://www.creative-diagnostics.com/mumps-virus-muv.htm

  Moreover, MuV’s neurotropism enables it to escape across the blood-brain barrier into the central nervous system, causing meningitis or encephalitis. The virus binds to receptors on the neurons and envelops the brain, setting off an athletic immune response when it proliferates. […] MuV infection leads to parotid enlargement because the virus has local immune responses within the parotid glands, where it infects via epithelial cells. A large accumulation of immune cells (such as T cells and B cells) in the parotid tissue further promotes the inflammatory response. […] Although most infected individuals recover completely, some may experience chronic inflammation or permanent damage, particularly in organs like the testes and ears.

• #2 Mumps Virus- An Overview

  https://microbenotes.com/mumps-virus/

  A cell-mediated immune response also develops. […] Interferon is induced early in mumps infection. […] Plasma viremia disappears coincident with the development of mumps virus-specific humoral antibody, which can be detected in serum as early as 11 days after induced apparent or inapparent infection of humans. […] Mumps virus preferentially infects activated human T lymphocytes. […] Mumps is a systemic viral disease with a propensity to replicate in epithelial cells in various visceral organs. […] Virus frequently infects the kidneys and can be detected in the urine of most patients. […] Viruria may persist for up to 14 days after the onset of clinical symptoms. […] The central nervous system is also commonly infected and may be involved in the absence of parotitis. […] Viral invasion of the CNS presumably occurs across the choroid plexus.

• #2 Mumps | PPT

  https://www.slideshare.net/slideshow/mumps-250569382/250569382

  Mumps is caused by a paramyxovirus that typically presents as swelling of the parotid or other salivary glands. It spreads through respiratory droplets and saliva. […] Humans are the only natural hosts for mumps virus infection. The incubation period of mumps is ~19 days (range, 7-23 days). The virus is transmitted by the respiratory route via droplets, saliva, and fomites. Mumps virus is typically shed from 1 week before to 1 week after symptom onset, although this window appears to be narrower in vaccinated individuals. […] Classic sites of mumps virus replication include the salivary glands, testes, pancreas, ovaries, mammary glands, and central nervous system (CNS). The virus replicates well in glandular epithelium, but classic parotitis is not a necessary component of mumps infection. Affected glands contain perivascular and interstitial mononuclear cell infiltrates and exhibit hemorrhage with prominent edema.

• #2 Mumps virus: mode of transmission, pathogenesis, clinical disease and immunization – Online Biology Notes

  https://www.onlinebiologynotes.com/mumps-virus-mode-of-transmission-pathogenesis-clinical-disease-and-immunization/

  Mumps virus causes a lytic infection of cells and Humans are the only natural hosts. […] Once the virus enter the respiratory tract, the infection begins. […] Primary replication occurs in nasal or upper respiratory tract epithelial cells. […] Once viremia occurs, virus is then disseminated to target tissues such as the CNS and salivary glands (parotid gland). Involvement of the parotid gland is not an obligatory step in the infectious process. […] The virus replicates in the target tissues and then causes a secondary phase of viremia. […] The virus then spread throughout the body- to kidneys, testes, ovary, pancreas and other organs. […] Infection of the CNS especially meninges, causes meningitis or meningoencephalitis. […] The CNS is commonly infected and may be involved in the absence of parotitis. […] Mumps is a systematic viral disease with a propensity to replicate in epithelial cells in various visceral organs. […] Virus shed in the saliva from about 3 days before to 9 days after the onset of salivary gland swelling.

• #2 Mumps | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/mumps

  Mumps is an acute viral illness with an incubation period of 12–25 days. […] Mumps is transmitted by respiratory secretions, including aerosol transmission, and direct contact with saliva or possibly urine. […] People may be infectious from 7 days before parotid swelling until 9 days after. Maximum infectiousness is between 2 days before onset of illness and 5 days afterwards.

• #2 Mumps | PPT

  https://www.slideshare.net/slideshow/mumps-250569382/250569382

  Necrosis of acinar and epithelial duct cells is evident in the salivary glands and in the germinal epithelium of the seminiferous tubules of the testes. The virus probably enters cerebrospinal fluid (CSF) through the choroid plexus or via transiting mononuclear cells during plasma viremia. […] Documented CSF pleocytosis indicates that mumps virus invades the CNS in ~50% of cases; However, symptomatic CNS disease, typically in the form of aseptic meningitis, occurs in 10% of cases, with a male predominance. […] Mumps pancreatitis, which may present as abdominal pain, occurs in ~4% of infections. Myocarditis and endocardial fibroelastosis are rare and self-limited but may represent severe complications of mumps infection.

• #2 Unique Tropism and Entry Mechanism of Mumps Virus

  https://www.mdpi.com/1999-4915/13/9/1746

  The amino acid residues involved in the interaction with glycan receptors were conserved in the MuV-HN of all genotypes except Phe370, which forms a stacking interaction with Tyr369 and is replaced with leucine in genotype K, suggesting that MuVs of all 12 genotypes utilize them as receptors. […] Recent studies have revealed the details of glycan structures that MuV prefers for its receptors. However, the distribution of glycan receptors in the human body alone cannot explain all the unique tropism exhibited by MuV; there may be additional unknown host factors that promote MuV infection. […] Although the distribution of these receptors and host factors may partially explain MuV tropism, many questions still need to be addressed to fully understand the pathogenesis of MuV: Why is the affinity to glandular tissues and the CNS unique to MuV, despite its similar life cycle to other paramyxoviruses? Are the tissues damaged by direct infection of the organs by MuV or by the secondary effect of immune response? Are there other receptors or host factors that restrict the MuV life cycle in specific tissues? These are just some of the questions that need further attention.

• #3 Chapter 15: Mumps | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-15-mumps.html

  The virus is acquired by respiratory droplet transmission. It replicates in the nasopharynx and regional lymph nodes. During viremia, the virus spreads to multiple tissues, including the meninges, salivary glands, pancreas, testes, and ovaries. Inflammation in infected tissues leads to characteristic symptoms of parotitis and other complications such as orchitis and aseptic meningitis.

• #3 Pinkbook | Mumps | Epidemiology of Vaccine Preventable Diseases | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/vaccines/pubs/pinkbook/mumps.html

  Mumps Pathogenesis […] – Respiratory transmission of virus […] – Replication in nasopharynx and regional lymph nodes […] – Viremia 12 to 25 days after exposure with spread to tissues […] – Multiple tissues infected during viremia […] […] […] The virus is acquired by respiratory droplets. It replicates in the nasopharynx and regional lymph nodes. After 12 to 25 days a viremia occurs, which lasts from 3 to 5 days. During the viremia, the virus spreads to multiple tissues, including the meninges, and glands such as the salivary, pancreas, testes, and ovaries. Inflammation in infected tissues leads to characteristic symptoms of parotitis and aseptic meningitis.

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