History and Geography

In the fifth century B.C., Hippocrates is believed to have first recognized mumps as a distinct clinical entity in his work Epidemics I. He described an outbreak of an illness on the island of Thasus, noting that "swelling appeared about the ears, in many on either side, and in the greatest number on both sides ... in some instances earlier, and in others later, inflammations with pain seized sometimes one of the testicles, and sometimes both." Greek and Roman medical writers of antiquity as well as medieval practitioners at various times recorded cases of mumps-like illnesses, but there was relatively little study of the disease. Outbreaks of mumps in Paris in the sixteenth century were recorded by Guillaume de Baillou. In 1755 Richard Russell described mumps and expressed his opinion that the disease was communicable.

Mumps is called Ziegenpeter or Bauerwetzel in German and oreillons in French. The origin of the term "mumps" is unclear although it may come from the English noun mump, meaning a "lump," or the English verb mump, meaning "to be sulky," or even perhaps from the pattern of mumbling speech in individuals with significant salivary gland swelling.

In 1790, Robert Hamilton presented a very full description of mumps to the Royal Society of Edinburgh. He emphasized that orchitis was a manifestation of mumps and suggested that some mumps patients had symptoms of central nervous system involvement. In the beginning of the eighteenth century, interest in the study of epidemics helped to establish the communicability and wide geographic distribution of the disease.

August Hirsch collected references to some 150 epidemics occurring between 1714 and 1859 in temperate latitudes in both hemispheres as well as in cold, subtropical, and equatorial regions. He specifically mentioned accounts of outbreaks that had occurred in diverse countries and places: "Iceland, the Faroe Islands, Lapland, Alaska, Egypt, Arabia, India, Malay Archipelago, Polynesia, the West Coast of Africa, Mexico, the West Indies, Peru, Italy, Sweden, Prussian Saxony, Schleswig and Holstein, the departments of Dusseldorf and Treves, the Cologne department, Martinique, Canton Zurich, Denmark, Lower Bavaria, Central Franconia, the quondam Duchy of Nassau, New York, Halle, Moscow, Bombay, and Berlin." He also stated that during the American Civil War, 11,216 cases among Confederate troops were reported during the first year of the war and 13,429 cases during the second year. He concluded that mumps "occurs in widest diffusion over the globe, no part of the world being exempt from this strange malady."

Data have also demonstrated the occurrence of epidemic mumps in the closely associated populations of prisons, orphanages, boarding schools, garrisons, and ships. Indeed, Haven Emerson noted that mumps was the most important disease in terms of days lost from active duty in the American Expeditionary Force in France during World War I; and Surgeon General T. Parran of the U.S. Public Health Service stated in 1940 that mumps was one of the most disabling of the acute infections among armed forces recruits, exceeded only by the venereal diseases.

Despite earlier animal experiments suggesting that the fluid of the salivary glands was infective, C. D. Johnson and E. W. Goodpasture were not able to prove conclusively the viral etiology of mumps until 1934. They demonstrated that mumps was caused by a filtrable virus in saliva by transmitting mumps from patients to rhesus monkeys. In 1945 K. Habel successfully cultivated mumps virus in chick embryos. In 1948 G. Henle and associates experimentally confirmed the significant percentage of clinically inapparent infections by deliberately exposing 15 susceptible subjects to mumps, then following their clinical condition, isolating the virus, and performing serologic studies. In 1951, an experimental killed-virus vaccine was used in humans. A live mumps virus vaccine has been used in the former U.S.S.R. since the early 1960s. In 1966 E. B. Buynak and M. R. Hilleman reported on the development of a live attenuated mumps virus vaccine, and they, R. E. Weibel, and others conducted a successful trial of the vaccine, which led to its licensure in 1967 in the United States.

The worldwide geographic distribution of mumps is well documented, even in Hirsch's collection of some 150 epidemics noted earlier. In populous countries without any sustained, large-scale immunization programs, mumps is widespread. In island or remote communities, large numbers of susceptible persons may exist. In countries with sustained, large-scale immunization programs, the impact of control efforts has been documented through decreasing numbers of cases of reported mumps.

Robert J. Kim-Farley

This chapter was written in the author's private capacity. No official support or endorsement by the Centers for Disease Control is intended or should be inferred.

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