"Chipmunk Cheeks" Caused by a Virus

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Mumps, a viral disease characterized by “chipmunk cheeks,” was first described by Hippocrates over 2,000 years ago. Prior to the introduction of the mumps vaccine (part of the MMR vaccine) in 1967, mumps was a common cause of childhood disease. Although the number of cases has dropped dramatically due to the widespread use of this highly effective vaccine, cases of mumps still occur, such as those in the 2006 outbreak in the Midwest.

Name: Paramyxovirus

Type of Microbe: RNA virus

How it causes disease: The mumps virus enters through the upper respiratory tract and spreads throughout the body via the lymphatic system (which circulates cells and fluids of the immune system). The virus moves to the salivary and other glands and induces an inflammatory response and edema (accumulation of fluid), leading to painful, swollen salivary glands.

How it spreads: Mumps spreads from person-to-person through airborne droplets and saliva. The virus can also be transmitted through contaminated surfaces. The infection is very contagious, especially to people who lack immunity, and can be spread from 3 days before to 6 days after symptoms appear. The CDC recommends isolating people with mumps for 5 days after symptoms appear.

Who’s at risk? Anyone can get mumps, but kids between 5 to 14 years of age are more likely to get it.

Symptoms: Symptoms usually appear around 16 to 18 days after exposure to an infected person.

Early signs of mumps include fever, headache, tiredness and lack of appetite for 1 to 2 days. The classic sign of mumps is the presence of painful, tender, and swollen salivary glands (located in the cheeks, below the jawline), but it only appears in about 30% to 40% of cases. These “chipmunk cheeks” usually resolve in about a week, and recovery takes about 10 to 12 days.

But the virus can spread to other tissues, leading to more serious complications (see ‘Complications’ below).

Diagnosis: Mumps is usually diagnosed based on classic features, including parotitis, or inflammation of the salivary glands and nonspecific symptoms, such as fever, body aches, and poor appetite. Analysis of blood samples may show abnormal findings that include low white blood cell counts and high levels of the serum protein amylase. If additional lab diagnosis is required, these methods may include detection of the virus from saliva or urine (by viral culture or PCR) or detection of antibodies made against the virus.

Prognosis: Most people will recover within 10 to 12 days and develop lifelong immunity against the mumps virus.

Treatment: There are no specific treatments for mumps. Fevers can be treated with acetaminophen or ibuprofen, and swollen glands can be soothed with warm or cold packs. Avoid sour or acidic foods that may aggravate pain in the salivary glands.

Prevention: The MMR vaccine contains a live attenuated mumps virus.

Immunization is recommended at 12 to 15 months of age and just before entry into kindergarten. Adults born after 1956 who have not been vaccinated or have not had mumps should also get vaccinated.

Complications: Complications of mumps increase with age and can arise from infection of different body tissues leading to inflammation. These complications can include inflammation of the brain (encephalitis or meningitis), testis (orchitis), pancreas (pancreatitis), mammary glands (mastitis), ovaries (oophoritis), thyroid (thyroiditis), heart (myocarditis), and joints (arthritis). Complications may also lead to spontaneous abortions, permanent deafness, and even death.


Mumps Vaccination. Centers for Disease Control and Prevention. Accessed: February 24, 2009.

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