Gondongan (Mumps)

Masa inkubasi: 12–25 hari (rata-rata 16–18 hari)

Gejala utama:

• Pembengkakan kelenjar parotis yang nyeri — awalnya unilateral (satu sisi), menjadi bilateral (kedua sisi) pada 70–80% kasus dalam beberapa hari

• Nyeri saat mengunyah dan menelan, terutama saat makan makanan asam

• Demam ringan hingga sedang (38–39°C)

• Malaise, sakit kepala, mialgia

Komplikasi sistemik:

• Orkitis (15–30% pria pascapubertas): Nyeri dan pembengkakan testis yang hebat, biasanya unilateral. Onset 4–8 hari setelah parotitis.

• Ooforitis (5% wanita pascapubertas): Nyeri perut bawah

• Meningitis aseptik (1–10%): Sakit kepala, kaku kuduk, fotofobia — biasanya ringan dan self-limiting

• Pankreatitis (2–5%): Nyeri epigastrium, mual, muntah

• Ketulian sensorineural (1/20.000): Biasanya unilateral, dapat permanen

Risk factors for mumps infection:

• Vaccination status: Unvaccinated or incompletely vaccinated individuals have the highest risk. However, waning immunity means that even two-dose MMR recipients become increasingly susceptible over time (particularly >10 years after the second dose).

• Close-contact settings: University dormitories, military barracks, boarding schools, prisons, and sports teams create ideal conditions for transmission. Most contemporary outbreaks in vaccinated populations occur in these settings.

• Age: In the prevaccine era, peak incidence was in children aged 5–9 years. In the vaccine era, outbreaks have shifted to young adults (18–25 years), reflecting waning immunity from childhood vaccination.

• Travel: Exposure to regions with endemic mumps or ongoing outbreaks, particularly areas with low MMR coverage.

• Crowding and shared living spaces: Household secondary attack rate in susceptible contacts is 40–50%.

Risk factors for complications:

• Post-pubertal age: Orchitis occurs almost exclusively in post-pubertal males (15–30% of post-pubertal male mumps cases vs. <1% in prepubertal boys). Oophoritis occurs in 5% of post-pubertal females.

• Age >15 years: Meningitis and encephalitis are more common in adolescents and adults than in young children.

• Male sex: Males are 3–5 times more likely to develop mumps encephalitis than females.

• Immunosuppression: Limited data, but immunocompromised individuals may have atypical presentations and prolonged viral shedding.

• Genotype: Some evidence suggests that genotype G (currently dominant globally) may be associated with higher rates of complications in vaccinated populations, possibly due to antigenic differences from the Jeryl Lynn vaccine strain (genotype A), though this remains debated.

Orkitis (15–30% pria pascapubertas): Atrofi testis pada ~50% kasus orkitis, namun infertilitas total jarang terjadi (karena biasanya unilateral). Oligospermia sementara sering terjadi. Ooforitis (5% wanita pascapubertas): Biasanya ringan, tidak menyebabkan infertilitas. Meningitis aseptik (1–10%): Prognosis baik, pemulihan lengkap dalam mayoritas kasus. Ensefalitis (1/6.000): Lebih serius, dapat menyebabkan sekuele neurologis. Ketulian sensorineural (1/20.000): Dapat permanen, biasanya unilateral. Penyebab penting ketulian didapat pada anak. Pankreatitis (2–5%): Biasanya ringan dan self-limiting. Mortalitas: 1,6–3,8/10.000 kasus — sangat rendah di era modern.