section name header

Introduction ⬇

The mumps virus (single-stranded RNA) is a member of the paramyxovirus group (genus Rubulavirus) and the etiologic agent of mumps in humans. Mumps is a generalized illness, usually accompanied by parotid (salivary gland) swelling and mild symptoms lasting 2 or more days. Parotitis as a presenting symptom in mumps is usually sufficient to preclude confirmation by serology. However, one third of mumps infections are subclinical and may require viral isolation to confirm mumps infection. Infection with mumps virus, whether symptomatic or subclinical, is generally thought to offer lifelong immunity.

ELISA testing can be both specific and sensitive for the detection and measurement of serum proteins. Current methods for serodiagnosis of mumps include in vitro serum neutralization, hemagglutination inhibition (HAI), IFA, and complement fixation (CF). These test methods, however, lack specificity, which limits their usefulness in establishing immune status.

Normal Findings ⬆ ⬇

Procedure ⬆ ⬇

  1. Collect a 7-mL blood serum sample in a red-topped tube. The optimal time to collect serum in unvaccinated persons is 3–5 days after they become symptomatic. This is necessary because, in unvaccinated patients, IgM may not be present until 5 days after onset of symptoms, typically peaks in 7 days, and may be present for up to 6 weeks or more.

  2. Observe standard and droplet precautions. Label the specimen with the patient’s name, date, and tests ordered and place in a biohazard bag for transport to the laboratory.

  3. The CDC recommends that a blood specimen, buccal/oral swab, and urine be collected from individuals with clinical suspicion of mumps. Buccal/oral and urine specimens should be collected 3–5 days after the onset of symptoms. To collect the buccal/oral specimen, massage the parotid gland for 30 seconds and then swab the area between the cheek and gum by sweeping the swab near the upper to lower molar area.

  4. Follow-up testing may be required.

Clinical Implications ⬆ ⬇

  1. When testing for IgG antibody, seroconversion between acute and convalescent sera is considered strong evidence of a current or recent infection.

  2. The recommended interval between an acute and convalescent sample is 10–14 days.

  3. The clinical case definition of mumps is an acute onset of unilateral or bilateral tender, self-limiting swelling of the parotid gland (or other salivary glands) with or without other apparent cause lasting 2 or more days. A probable case is one that meets the clinical case definition without serologic or virologic testing, whereas a confirmed case meets the clinical definition and is laboratory confirmed.

Interventions ⬆

Pretest Patient Care

  1. Assess patient’s test knowledge. Explain test purpose and procedure.

  2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Clinical Alert

False-positive results by IFA for IgM have been reported

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient regarding abnormal findings; explain the need for possible follow-up testing and treatment.

  2. Institute or maintain droplet precautions.

  3. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.