Lab Testing for Mumps at the MDH Public Health Laboratory

Though mumps is no longer common in the United States, outbreaks continue to occur as a result of internationally imported or import-linked cases. Continued success in disease reduction is dependent on maintaining awareness of the disease along with improving vaccination rates.  

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On this page:
Clinical features and differential diagnoses
Report suspect case
Lab tests offered at MDH-PHL
Preferred specimens: PCR
Specimen collection: PCR
Approved swabs and media
Transporting specimens to MDH

Clinical features and differential diagnoses

Mumps is characterized by:

  • Non-specific prodrome including myalgia, anorexia, malaise, headache, and low-grade fever
  • Acute onset of unilateral or bilateral tender swelling of the parotid or salivary gland lasting 2 or more days without other apparent cause

Mumps should be considered in the differential diagnosis of patients presenting with parotitis or swelling of the salivary glands, regardless of vaccination history.                                                                                

MDH also encourages health care providers to consider other infectious and non-infectious causes of parotitis. Other etiologies include:

  • Influenza A, Parainfluenza virus types 1 and 3, Coxsackie A virus, Cytomegalovirus, Epstein Barr virus, Lymphocytic choriomeningitis virus, HIV
  • Acute bacterial suppurative parotitis (Staphylococcus aureus and Streptococcus spp.)
  • Recurrent parotitis
  • Drug reactions, allergies, tumors, immunologic diseases

Report suspect case

Suspect cases of mumps must be reported within one (1) working day to the Minnesota Department of Health (MDH).

All suspect cases of mumps and specimens submitted for testing must be coordinated with an MDH epidemiologist at 651-201-5414 or toll-free at 1-877-676-5414. Failure to contact MDH prior to submitting a specimen to the Minnesota Department of Health’s Public Health Laboratory (MDH-PHL) will result in a delay in testing.

Lab tests offered at MDH-PHL

Mumps Real-Time Polymerase Chain Reaction (RT-PCR, or PCR) is available for mumps case confirmation at MDH-PHL. Providers are encouraged to collect and send a PCR specimen to MDH-PHL when mumps is suspected. Contact an MDH mumps epidemiologist (see Report suspect case) to coordinate specimen submission.

Serologic testing (mumps-specific IgM) can still be used in conjunction with clinical and epidemiologic data to presumptively confirm a case in outbreak situations; however, mumps serologic testing is not definitive due to sensitivity and specificity issues.

Serum specimens for serologic testing should be sent to your facility’s normal reference laboratory, and a specimen for PCR should be sent to MDH-PHL.

Preferred specimens: PCR

A clinical specimen for PCR should be taken as soon as mumps is suspected. Viral RNA is more likely to be detected when the specimen is collected as soon as possible after parotitis (or other symptom) onset. Ideally, a specimen for mumps PCR should be obtained within 0-3 days of parotitis onset (0-9 days at most). Consider the parotitis (or other symptom) onset date as day ‘0.’

Please send one (1) of the following specimens to the MDH-PHL, in order of preference:

  1. Buccal swab
  2. Throat swab
  3. Urine specimenǂ

ǂIf date of specimen collection is on day 5-9 after parotitis/symptom onset (day 0), urine is preferred over other specimens. If date of specimen collection is already more than 9 days past parotitis/symptom onset, PCR is less likely to detect viral presence and may give false negative results.

Specimen collection: PCR

Buccal swab:Massage the buccal cavity (the space near the upper rear molars between the cheek and the teeth) for 30 seconds and swab the area; obtain a generous amount of saliva. Place swab in a sterile tube containing 2-3 ml of viral transport medium (VTM) (see Approved swabs and media).

Throat swab:Vigorously swab tonsillar areas and posterior nasopharynx with a viral culturette. Use tongue blade to depress tongue to prevent contamination of swab with saliva. Place swab into VTM.

Urine specimen: Collect 10 ml of urine in a STERILE urine specimen container. First-morning voided specimens are ideal, but any urine collection is adequate. Have patient void directly into container, collecting from the first part of the urine stream if possible.

Approved swabs and media

Appropriate

  • VTM
  • M5
  • M4
  • MEM
  • Saline
  • Balanced salt solutions (BSS)
  • Sterile isotonic solutions
  • Phosphate buffered salines (PBS)
  • Stuart’s Liquid Media
  • BBL Culture Swab
  • Culturettes

Not Appropriate

  • Wood-tipped applicators
  • Calcium-alginate tipped swabs
  • Charcoal swabs
  • Gel swabs
  • Anaerobic media

Transporting specimens to MDH

  • Label all tubes/containers with the following information:
    • Patient name
    • Patient date of birth
    • Date specimen collected
    • Specimen type
  • Include an Infectious Disease Testing and Submission Form for each specimen.
  • Fill out the form as completely as possible and be sure to indicate which test is requested. Please include project #955 on the request form.
  • Specimens should be kept and transported at refrigeration temperature (2-8° C).
  • Before shipping, always consult with an MDH epidemiologist at 651-201-5414 or toll-free at 877-676-5414.
  • Send to MDH Public Health Laboratory via overnight shipping.
  • For help with packaging and shipping, call MDH-PHL Biological Accessioning at 651-201-4953.

Send specimens to arrive Monday-Friday before 4:30 p.m. to:
MDH Public Health Laboratory
Attn: Biological Accessioning
601 Robert St. N.
St. Paul, MN 55155-2531

Updated Tuesday, 08-Apr-2014 16:31:57 CDT