What is the relevancy of a surveillance of mumps without a systematic laboratory confirmation in highly immunized populations? Epidemiology of suspected and biologically confirmed mumps cases seen in general practice in France between 2014 and 2020.

BACKGROUND: In France, mumps surveillance is conducted in primary care by the Sentinelles network, the National Reference Centre for Measles, Mumps and Rubella and Santé publique France. AIM: The objective of this study was to estimate the incidence of suspected mumps in general practice, the proportion of laboratory confirmed cases and the factors associated with a virological confirmation. METHODS: General practitioners (GPs) participating in the Sentinelles network should report all patients with suspected mumps according to a clinical definition in case of parotitis and a serological definition in case of clinical expression without parotitis. All suspected mumps cases reported between January 2014 and December 2020 were included. A sample of these cases were tested by real time reverse transcriptase polymerase chain reaction (RT-PCR) for mumps biological confirmation. RESULTS: A total of 252 individuals with suspected mumps were included in the study. The average annual incidence rate of suspected mumps in general practice in France between 2014 and 2020 was estimated at 11 cases per 100,000 population [CI95%: 6-17]. A mumps confirmation RT-PCR test was performed on 146 cases amongst which 17 (11.5 %) were positive. Age (between 20 and 29 years old), the presence of a clinical complication and an exposure to a suspected mumps case within the 21 days prior the current episode were associated with a mumps biological confirmation. CONCLUSION: If these results confirm the circulation of mumps virus in France, they highlight the limits of a surveillance without a systematic laboratory confirmation in highly immunized populations.

Brotes epidémicos de parotiditis, revisión de la literatura / Mumps outbreaks, literature review

La parotiditis es un infección viral producida por el virus parotídeo. Clínicamente se caracteriza por aumento de volumen de la glándula parótida generalmente bilateral. La estrategia que ha mostrado ser más eficaz para la prevención de esta infección ha sido la implementación de la vacuna tres vírica en los programas de inmunización. En países con población altamente inmunizada como Chile, se logró una importante disminución de la incidencia de esta enfermedad. Sin embargo, a pesar de la efectividad de la vacuna se siguen reportando brotes en todo el mundo, evidenciándose un cambio epidemiológico, trasladándose la edad de presentación clínica desde la niñez y adolescencia hacia los adultos jóvenes. Este aumento en el número de casos ha sido estudiado, determinando que el efecto protector inmunitario de la vacuna decaería con el transcurso del tiempo, contribuyendo a la propagación de los brotes. Con respecto a posibles estrategias para el manejo de los brotes la aplicación de una dosis adicional de la vacunas tres vírica en población expuesta sería una medida que mejoraría el control de los brotes.

Mumps is a viral infection caused by mumps virus. Clinically, it is characterized by increased parotid volume. The most effective strategy for preventing this infection, has been the implementation of measles-mumps-rubella (MMR) vaccine in the national immunization program. Among countries with a highly immunized population, like Chile, there has been an important reduction in the incidence of this disease. Nevertheless, despite the effectivity of the MMR, there are reports of outbreaks worldwide, with an epidemiological change, from clinical presentation in childhood, to adolescents and adults. This outbreaks have been studied, and it has been determined that they are due to the waning of vaccine-derived immunity. Regarding strategies for the management of new outbreaks, the administration of an additional dose of MMR, would be an alternative.

Salivary Gland Disorders in Children and Adolescents: A 15-year Experience

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.

[Parotitis and influenza: unusual association during 2017, in Santa Fe, Argentina]. / Parotiditis e influenza: inusual asociación durante 2017, en Santa Fe, Argentina.

BACKGROUND: Parotitis is an acute viral disease characterized by swelling and pain in one or both salivary glands, submaxillary or submental, fever, headache, muscle ache and/or fatigue. AIM: To investigate the occurrence of influenza virus infection in parotitis cases in a population of Santa Fe during 2017 and analyze clinical and epidemiological characteristics of the cases. METHODS: We studied patients with diagnosis of mumps without age restriction, who came for examination from week 26 to the network of clinicians forming the Sentinel Influenza Unit in Santa Fe. RESULTS: Between epidemiological weeks 26 and 44, 22 clinical parotitis cases we enrolled. The influenza virus was detected in 68.2%, influenza A (H3N2) 93%, and influenza B, 7%. The clinical signs of cases were mild, with an average swelling development of 5 days and no complications. 74% presented with influenza-like illness in tandem with parotitis. CONCLUSIONS: This study provides evidence that a proportion of children presenting with parotitis had influenza A(H3N2) virus infection. It is necessary to implement systematic surveillance of parotitis associated with influenza and differential diagnosis even in the absence of respiratory symptoms.

Parotiditis e influenza: inusual asociación durante 2017, en Santa Fe, Argentina / Parotitis and influenza: unusual association during 2017, in Santa Fe, Argentina

Resumen Introducción: La parotiditis es una enfermedad vírica aguda caracterizada por tumefacción y dolor en una o ambas glándulas salivales, submaxilar o submentoniana, fiebre, dolor de cabeza, dolor muscular y/o fatiga. Objetivos Investigar la ocurrencia de infección por el virus influenza en casos de parotiditis en una población de Santa Fe, durante 2017 y analizar las características clínicas y epidemiológicas de los casos. Materiales y Métodos: Se estudiaron pacientes con diagnóstico de parotiditis, que acudieron a la consulta desde la semana 26 en la red de médicos que forman la Unidad Centinela de Influenza en Santa Fe. Resultados: Entre las semanas epidemiológicas 26 y 44, se incluyeron 22 casos de parotiditis clínica. El virus influenza se detectó en 68,2%, influenza A (H3N2) 93% e influenza B 7%. Los síntomas clínicos de los casos fueron leves, con una tumefacción de cinco días y sin complicaciones. El 74% presentó una enfermedad tipo influenza en conjunto con la parotiditis. Conclusiones: Este estudio evidencia que niños que presentaban parotiditis tenían una infección por el virus de la influenza A (H3N2). Es necesario implementar una vigilancia sistemática de las parotiditis asociadas con influenza y el diagnóstico diferencial, incluso en ausencia de síntomas respiratorios.

Background: Parotitis is an acute viral disease characterized by swelling and pain in one or both salivary glands, submaxillary or submental, fever, headache, muscle ache and/or fatigue. Aim: To investigate the occurrence of influenza virus infection in parotitis cases in a population of Santa Fe during 2017 and analyze clinical and epidemiological characteristics of the cases. Methods: We studied patients with diagnosis of mumps without age restriction, who came for examination from week 26 to the network of clinicians forming the Sentinel Influenza Unit in Santa Fe. Results: Between epidemiological weeks 26 and 44, 22 clinical parotitis cases we enrolled. The influenza virus was detected in 68.2%, influenza A (H3N2) 93%, and influenza B, 7%. The clinical signs of cases were mild, with an average swelling development of 5 days and no complications. 74% presented with influenza-like illness in tandem with parotitis. Conclusions: This study provides evidence that a proportion of children presenting with parotitis had influenza A(H3N2) virus infection. It is necessary to implement systematic surveillance of parotitis associated with influenza and differential diagnosis even in the absence of respiratory symptoms.

Non-mumps Viral Parotitis During the 2014-2015 Influenza Season in the United States.

Background: During the 2014-2015 US influenza season, 320 cases of non-mumps parotitis (NMP) among residents of 21 states were reported to the Centers for Disease Control and Prevention (CDC). We conducted an epidemiologic and laboratory investigation to determine viral etiologies and clinical features of NMP during this unusually large occurrence. Methods: NMP was defined as acute parotitis or other salivary gland swelling of >2 days duration in a person with a mumps- negative laboratory result. Using a standardized questionnaire, we collected demographic and clinical information. Buccal samples were tested at the CDC for selected viruses, including mumps, influenza, human parainfluenza viruses (HPIVs) 1-4, adenoviruses, cytomegalovirus, Epstein-Barr virus (EBV), herpes simplex viruses (HSVs) 1 and 2, and human herpes viruses (HHVs) 6A and 6B. Results: Among the 320 patients, 65% were male, median age was 14.5 years (range, 0-90), and 67% reported unilateral parotitis. Commonly reported symptoms included sore throat (55%) and fever (48%). Viruses were detected in 210 (71%) of 294 NMP patients with adequate samples for testing, ≥2 viruses were detected in 37 samples, and 248 total virus detections were made among all samples. These included 156 influenza A(H3N2), 42 HHV6B, 32 EBV, 8 HPIV2, 2 HPIV3, 3 adenovirus, 4 HSV-1, and 1 HSV-2. Influenza A(H3N2), HHV6B, and EBV were the most frequently codetected viruses. Conclusions: Our findings suggest that, in addition to mumps, clinicians should consider respiratory viral (influenza) and herpes viral etiologies for parotitis, particularly among patients without epidemiologic links to mumps cases or outbreaks.

Influenza-Associated Parotitis During the 2014-2015 Influenza Season in the United States.

Background: During the 2014-2015 influenza season in the United States, 256 cases of influenza-associated parotitis were reported from 27 states. We conducted a case-control study and laboratory investigation to further describe this rare clinical manifestation of influenza. Methods: During February 2015-April 2015, we interviewed 50 cases (with parotitis) and 124 ill controls (without parotitis) with laboratory-confirmed influenza; participants resided in 11 states and were matched by age, state, hospital admission status, and specimen collection date. Influenza viruses were characterized using real-time polymerase chain reaction and next-generation sequencing. We compared cases and controls using conditional logistic regression. Specimens from additional reported cases were also analyzed. Results: Cases, 73% of whom were aged <20 years, experienced painful (86%), unilateral (68%) parotitis a median of 4 (range, 0-16) days after onset of systemic or respiratory symptoms. Cases were more likely than controls to be male (76% vs 51%; P = .005). We detected influenza A(H3N2) viruses, genetic group 3C.2a, in 100% (32/32) of case and 92% (105/108) of control specimens sequenced (P = .22). Influenza B and A(H3N2) 3C.3 and 3C.3b genetic group virus infections were detected in specimens from additional cases. Conclusions: Influenza-associated parotitis, as reported here and in prior sporadic case reports, seems to occur primarily with influenza A(H3N2) virus infection. Because of the different clinical and infection control considerations for mumps and influenza virus infections, we recommend clinicians consider influenza in the differential diagnoses among patients with acute parotitis during the influenza season.

Viral etiology of sporadic cases of parotitis among children in Korea during 2013-2014.

Recent years have seen a high incidence of mumps, which is generally diagnosed based on clinical features, especially parotitis, without laboratory confirmation in Korea. To better understand the epidemiology of mumps in Korean children, we investigated sporadic suspected mumps cases with parotitis. In total, 237 buccal swabs or throat swabs collected from children with parotitis who had been clinically diagnosed with mumps were tested using real-time PCR for the detection of six viruses (Epstein-Barr virus, Human herpesvirus 6, Mumps virus, Human parainfluenza virus-1, -2, -3, Human adenovirus, Human bocavirus). Among 237 parotitis cases, 87 (36.7%) were positive for at least one virus; a single infection was observed in 73 (83.9%) cases, and co-infections were detected in 14 (16.1%) cases. Epstein-Barr virus was most frequent (20.7%), followed by human herpesvirus 6 (8.0%), mumps virus (5.5%), human parainfluenza virus-3 (4.6%), human adenovirus (4.2%), and human bocavirus (0.4%). These data suggested that the sporadic suspected mumps in the children might be related to other respiratory viruses rather than to the mumps virus. Our findings also indicate the limitation of clinical diagnosis without laboratory confirmation for mumps and thus highlight the importance of laboratory testing in suspected mumps cases.

Parotiditis en el Hospital General de Agudos Parmenio Piñero y su Área Programática / Parotitis in the Acute General Hospital Parmenio Piñero and its programmatic area

La parotiditis epidémica (fiebre urliana) es una infección viral cuyo único huésped natural es el ser humano. La enfermedad es en general, benigna y autolimitada y un tercio de las personas afectadas tiene una infección subclínica. Puede producir una infección más grave en individuos que han pasado la pubertad que en los niños. Debido a que el diagnóstico de parotiditis es clínico en un 99%, algunos de los casos podrían corresponder a una etiología diferente a la urliana (enterovirus, Epstein Barr, virus Parainfluenza y Adenovirus). Se estima que el esquema de 2 dosis de vacuna triple viral tiene una efectividad de 88% (rango: 66-95%) en la prevención de enfermedad.Se analizaron casos de parotiditis, confirmados o sospechosos, notificados por el Hospital Piñero de la Ciudad de Buenos Aires y/o CeSAC del Área Programática. La fuente de información utilizada fue el SNVS (Módulo C2). Para los estudios etiológicos, se analizó el registro del laboratorio central del Hospital. (AU) .

Situación epidemiológica de las parotiditis / Epidemiological situation of parotiditis

La parotiditis epidémica (fiebre urliana) es una infección vírica aguda, sistémica, endémica en todo el mundo y los seres humanos son los únicos huéspedes naturales del virus. La enfermedad es en general, benigna y autolimitada y un tercio de las personas afectadas tiene una infección subclínica. Puede producir una infección más grave en individuos que han pasado la pubertad que en los niños. En este informe se describe esta enfermedad y sus agentes etiologicos, incubación y transmisibilidad, cuadros clínicos y complicaciones, diagnóstico, medidas de prevención y control, vigilancia, notificación del caso y toma de muestra, situación histórica en Argentina, y situación actual en la Ciudad de Buenos Aires

Inflammation following invasive procedures for Warthin's tumour: A retrospective case series.

OBJECTIVE: To determine the risk of inflammation associated with fine-needle aspiration during evaluation of Warthin's tumour. DESIGN: Retrospective case series. SETTING: Tertiary medical centre. PARTICIPANTS: All patients who underwent fine-needle aspiration followed by parotidectomy between 1992 and 2009 for the diagnosis/evaluation of a parotid gland tumour. MAIN OUTCOME MEASURE: Rate of fine-needle-aspiration-related parotitis in patients with Warthin's tumour or other parotid pathologies. RESULTS: A total of 593 parotidectomies were performed in 553 patients during the study period, 96 (16.2%) for Warthin's tumour (study group) and 497 for other parotid-related pathologies (control group). Parotid gland inflammation following fine-needle aspiration was observed in 16 cases in the study group (16.7%) and eight (1.6%) in the control group (P<.001). On multivariate regression analysis, parotitis following fine-needle aspiration was more common in patients with Warthin's tumour than other parotid-related pathologies even after adjustment for possible confounders (P<.007). Signs of inflammation were noted during surgery in six cases in the study group (6.3%) and none in the control group (P<.001); respective rates of postoperative inflammation (wound infection) were 1.04% and 3.3% (P=NS). Management of parotitis consisted of hospitalisation and systemic antibiotic therapy. CONCLUSIONS: Warthin's tumour is associated with a tenfold higher risk of inflammation compared to other parotid tumours following invasive procedures. Clinicians should be alert to this complication in order to initiate proper treatment and patients must be properly counselled.

Severity of mumps disease is related to MMR vaccination status and viral shedding.

BACKGROUND: During recent years, various mumps outbreaks have occurred among measles, mumps, and rubella (MMR) vaccinated persons in various countries worldwide, including the Netherlands. We studied mumps virus shedding in MMR vaccinated and unvaccinated mumps patients and related these findings to clinical data. METHODS: In this study, we included 1112 mumps patients of whom diagnostic samples were tested positive in our laboratory between 1 January 2007 and 31 December 2014. We compared mumps virus shedding and severity of disease between patients who had received 2 doses of MMR (n=592) and unvaccinated mumps patients (n=195). Mumps virus shedding in saliva and urine specimens was measured by qPCR. Severity of disease was studied in a subset of patients with clinical data available. RESULTS: Mumps patients who had received 2 MMR doses shed less often mumps virus in their urine than unvaccinated patients. Salivary viral loads were higher at day of onset of disease in twice MMR vaccinated patients with viruria than in twice MMR vaccinated patients without viruria. However, salivary viral loads did not significantly differ between patients who had received 2 MMR doses and unvaccinated patients. Bilateral parotitis and orchitis were less often reported in patients who had received 2 MMR doses than in unvaccinated patients. Furthermore, the prevalence of bilateral parotitis and orchitis was higher among twice MMR vaccinated patients with viruria than among twice MMR vaccinated patients without viruria. CONCLUSIONS: MMR vaccination was associated with less severe disease among mumps patients. Systemic spread of virus was associated with more severe disease. The elevated salivary viral loads in patients with systemic mumps disease suggest that these patients pose a higher risk for mumps virus transmission. Our study contributes to the understanding of mumps virus pathogenesis and shows the protective effect of MMR vaccination on severity of disease.

Tuberculous Lymphadenitis and Parotitis.

Tuberculous lymphadenitis is the most common extrapulmonary manifestation of disseminated tuberculosis (TB). It is considered to be the local manifestation of the systemic disease that has disseminated to local lymph nodes, but a high index of suspicion is needed for the diagnosis, because there are several infectious and noninfectious diseases that can mimic the same clinical picture. In recent years, different diagnostic methods have been introduced, including fine-needle aspiration cytology, which has emerged as a simple outpatient diagnostic procedure that replaced the complete excisional node biopsy, and a number of molecular methods which have greatly improved diagnostic accuracy. This chapter covers the most actual knowledge in terms of epidemiology, clinical manifestations, pathogenesis, and treatment and emphasizes current trends in diagnosis of tuberculous lymphadenitis. TB parotid gland involvement is extremely rare, even in countries in which TB is endemic. Because of the clinical similarity, parotid malignancy and other forms of parotid inflammatory disease always take priority over the rarely encountered TB parotitis when it comes to differential diagnosis. As a result, clinicians often fail to make a timely diagnosis of TB parotitis when facing a patient with a slowly growing parotid lump. This chapter highlights the most important features of this uncommon disease.

Aspectos clínicos y evolución de la parotiditis recurrente infantil / Clinical aspects and progression of recurrent parotitis of childhood

INTRODUCCIÓN: la parotiditis recurrente infantil es una enfermedad inflamatoria de las glándulas parótidas que se presenta con frecuencia en la práctica pediátrica. OBJETIVO: describir algunos aspectos clínicos y la evolución de la parotiditis recurrente infantil en un grupo de niños atendidos en el Hospital "Hermanos Cordové" de Manzanillo, Granma, Cuba. MÉTODOS: estudio descriptivo y longitudinal. La población quedó constituida por 86 pacientes afectados por la enfermedad que fueron vistos de primera instancia entre los años 1990 y 2005. La información se obtuvo mediante la observación y la entrevista; se consideraron las variables siguientes: sexo, edad en la primera consulta, localización, edad al momento de remisión de la enfermedad, número de crisis, y estado funcional glandular al final del seguimiento. Se utilizaron métodos estadísticos descriptivos que incluyeron medidas de tendencia central y de dispersión. Se determinaron diferencias de medias y sus intervalos de confianza del 95 %. RESULTADOS: predominaron el sexo masculino (66,3 %), las edades entre 5 y 9 años (53,5 %) y la localización derecha (47,6 %). El tiempo promedio general entre la primera consulta y la remisión de las crisis fue de 3 años y medio, mientras que el promedio de crisis fue de 6,36. CONCLUSIONES: la evolución fue buena; al final del seguimiento todos los pacientes tuvieron una función glandular salival adecuada.

INTRODUCTION: recurrent parotitis of childhood is an inflammatory disease of the parotid glands that frequently occurs in pediatric patients. OBJECTIVE: to describe some clinical aspects and the progression of recurrent parotitis of childhood in a group of children seen at ¨Hermanos Cordové¨ hospital, Manzanillo, Gramma province, Cuba. METHODS: longitudinal and descriptive study was conducted. The population was made up of 86 patients with the disease, who were seen from 1990 to 2005. The information was collected through observation and interview and the study variables were sex, age at the first medical appointment, location, age at the time of remission, number of crises and functional status of the glands at the end of the follow-up period. Summary statistic methods included central tendency and dispersion measures. Mean differences and their 95% confidence intervals were then determined. RESULTS: males (66.3 %), five to nine years of age patients (53.5 %) and right location (47.6 %). The average time elapsed from the first medical appointment to remission of crises was 3 and a half years whereas the average number of crises was 6.36 CONCLUSIONS: recovery was good. At the end of the follow-up period, all the patients showed adequate salivary gland function.

Serie de 8 casos de parotiditis supurada aguda neonatal / Eight cases of acute neonatal suppurative parotitis

La parotiditis supurada aguda es una infección poco frecuente en la práctica del pediatra y neonatólogo. El objetivo es mostrar nuestra experiencia en la atención de serie de casos con parotiditis supurada aguda en el período neonatal, y describir sus características de presentación. Se presentan los hallazgos clínicos en 8 pacientes con parotiditis supurativa neonatal, quienes estuvieron ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario "Juan Manuel Márquez", durante el período de 22 años (desde el año 1992 hasta el año 2013), y se contrasta con los reportes publicados en la literatura internacional. Las características de presentación de la parotiditis aguda supurada de nuestros casos concuerdan con la literatura revisada en muchos aspectos, y se demuestra que es, además, una infección poco frecuente en el período neonatal. Es la primera publicación sobre esta entidad en neonatos en Cuba, y la mayor serie de casos en el ámbito latinoamericano.

Acute suppurative parotitis is a rare infection in the pediatric and neonatological practice. This case presentation showed our experience in the care of a case series affected by acute suppurative parotitis in their neonatal period and described the characteristics of their presentation. The clinical findings obtained in 8 patients with neonatal suppurative parotitis, who had been admitted to the neonatology service of ¨Juan Manuel Marquez¨university pediatric hospital in the period of 1992 to 2013, were presented and compared with the reports from the international literature. The presentation characteristics of the disease in our cases agreed with those of the reviewed literature in many aspects, and it was proved that this illness is rate in the neonatal period. This is the first report published about this disease in neonates in Cuba and the highest number of cases in the Latin American context.

Viral etiology of mumps-like illnesses in suspected mumps cases reported in Catalonia, Spain.

We investigated the etiology of reported sporadic suspected mumps cases with a negative RT-PCR result for the mumps virus in the Barcelona-South region in 2007-2011. Samples from mumps virus-negative patients presenting unilateral or bilateral parotitis or other salivary gland swelling were tested for Epstein-Barr virus (EBV) by real-time PCR and for respiratory viruses by two multiplex-PCR-based assays to detect parainfluenza virus (PIV) 1-4, influenza virus (InV) A, B and C, respiratory syncytial virus (RSV), enterovirus, coronavirus 229E, coronavirus OC43, and rhinovirus. 101 samples were analyzed in persons aged 8 months to 50 years. Oral samples were collected on the first day of glandular swelling in 53 patients (52.5%), and on the first two days in 74 patients (73.3%). Viruses were detected in 52 (51.5%) of samples: one virus (25 EBV, 8 PIV3, 4 adenovirus, 4 PIV2, 1 PIV1, 1 InVA, and 1 enterovirus) was detected in 44 patients (84.6%), two viruses in 7 patients, and three viruses in one patient. In 58 patients (57.5%) whose sample was collected in the first 2 days after onset of parotitis and had received two doses of MMR vaccine and in 15 patients (14.8%) whose sample was collected on the first day, it is very likely that the cause was not the mumps virus. This would mean that 72.3% (73/101) of the reported sporadic suspected mumps cases were not mumps cases. The timing of oral-sample collection is crucial to correctly interpret the negative results for mumps virus RNA, especially when suspected cases occur in vaccinated persons.

Sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis.

PURPOSE: The aim of the current study was to analyze the use of sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis (JRP), note possible complications, and the rate of disease recurrence. We believe that this cutting edge procedure may be very effective both for the diagnosis and treatment of JRP, with few complications and low rates of recurrence. PATIENTS AND METHODS: A retrospective descriptive case study was conducted on a sample of patients presenting with JRP. Data was collected from the patient's medical records. Diagnostic sialendoscopy was performed to identify and classify the ductal pathology, treated by interventional therapeutic sialendoscopy. We carefully noted all complications and the disease recurrence rates. RESULTS: The patient sample included 50 children presenting with JRP (33 M, 17 F; age range: 2 to 16 years). Seven children presented with bilateral parotitis, the remaining 43 with unilateral parotitis. The study was conducted from 2003 to 2012. There was a statistically significant association between sialendoscopic data and the actual outcome. Seven children underwent additional sialendoscopy because of recurrence. They were all in the group of children presenting with unilateral parotitis. DISCUSSION: Our results validate the expected outcome. Sialendoscopy is an accurate technique for the diagnosis of JPR, and an effective tool for the treatment of JRP, with a low rate of complications and recurrence.

Viruses detected among sporadic cases of parotitis, United States, 2009-2011.

BACKGROUND: Sporadic cases of parotitis are generally assumed to be mumps, which often requires a resource-intensive public health response. This project surveyed the frequency of viruses detected among such cases. METHODS: During 2009-2011, 8 jurisdictions throughout the United States investigated sporadic cases of parotitis. Epidemiologic information, serum, and buccal and oropharyngeal swabs were collected. Polymerase chain reaction methods were used to detect a panel of viruses. Anti-mumps virus immunoglobulin M (IgM) antibodies were detected using a variety of methods. RESULTS: Of 101 specimens, 38 were positive for a single virus: Epstein-Barr virus (23), human herpesvirus (HHV)-6B (10), human parainfluenza virus (HPIV)-2 (3), HPIV-3 (1), and human bocavirus (1). Mumps virus, enteroviruses (including human parechovirus), HHV-6A, HPIV-1, and adenoviruses were not detected. Early specimen collection did not improve viral detection rate. Mumps IgM was detected in 17% of available specimens. Patients in whom a virus was detected were younger, but no difference was seen by sex or vaccination profile. No seasonal patterns were identified. CONCLUSIONS: Considering the timing of specimen collection, serology results, patient vaccination status, and time of year may be helpful in assessing the likelihood that a sporadic case of parotitis without laboratory confirmation is mumps.

Genotyping and subtyping of mumps virus isolates from the Indian subcontinent.

Mumps is a vaccine-preventable disease that usually occurs as a self-limiting parotitis, but it can also lead to several life-threatening complications, including pancreatitis, meningitis, and encephalitis. The molecular epidemiology of the virus is poorly understood. The present study describes an outbreak of mumps virus infection in Punjab, India. The etiology was confirmed by serology and RNA detection to be mumps virus in 72 % of the cases and 50 % of contacts. This study, for the first time, revealed the mumps virus genotypes circulating in the Indian subcontinent as subtype G2 of genotype G.