Measles and mumps are infections caused by similar viruses. They are both very contagious, meaning they easily spread from person to person. Measles and mumps mostly affect children.

• Measles can make you feel like you have a bad cold or the flu. It will also cause a flat, red rash. This rash usually starts on your face and spreads all over your body.
• Mumps can also make you feel like you have the flu. It causes painful swelling of the salivary glands. These glands are located in your cheek and jaw area.

Most people with measles or mumps infections will get better in about two weeks or less. But sometimes these infections can cause serious complications, including meningitis (swelling of the brain and spinal cord) and encephalitis (a type of infection in the brain). Measles and mumps testing can help your health care provider find out if you or your child has been infected with one of the viruses. It may also help prevent the spread of these diseases in your community.

Measles testing and mumps testing can be used to:

• Find out whether you have an active infection of measles or mumps. An active infection means you have symptoms of the illness.
• Find out whether you are immune to measles or mumps because you've been vaccinated or have had either virus before.
• Help public health officials track and monitor outbreaks of measles or mumps.

Your health care provider may order tests if you or your child has symptoms of measles or mumps.

Symptoms of measles include:

• Rash that starts on the face and spreads to the chest and legs
• High fever
• Cough
• Runny nose
• Sore throat
• Itchy, red eyes
• Tiny white spots in the mouth

Symptoms of mumps include:

• Swollen, painful jaw
• Puffy cheeks
• Headache
• Earache
• Fever
• Muscle aches
• Loss of appetite
• Painful swallowing

• A blood test. During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
• Swab test. Your health care provider will use a special swab to take a sample from your nose or throat.
• Nasal aspirate. Your health care provider will inject a saline solution into your nose, then remove the sample with gentle suction.
• Spinal tap, if meningitis or encephalitis is suspected. For a spinal tap, your health care provider will insert a thin, hollow needle into your spine and withdraw a small amount of fluid for testing.

You don't need any special preparations for measles testing or mumps testing.

There is very little risk to measles or mumps testing.

• For a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
• For a swab test, you may feel a gagging sensation or even a tickle when your throat or nose is swabbed.
• The nasal aspirate may feel uncomfortable. These effects are temporary.
• For a spinal tap, you may feel a little pinch or pressure when the needle is inserted. Some people may get a headache after the procedure.

If your test results are negative, it likely means you do not have and have never been exposed to measles or mumps. If your test results are positive, it can mean one of the following:

• A measles diagnosis
• A mumps diagnosis
• You have been vaccinated for the measles and/or mumps
• You have had a previous infection of measles and/or mumps

If you (or your child) tests positive for measles and/or mumps and have symptoms of illness, you should stay at home for several days to recover. This will also help make sure you don't spread the disease. Your health care provider will let you know how long you will be contagious and when it will be okay to return to your regular activities.

If you've been vaccinated or have had a previous infection, your results will show that you have been exposed to the measles virus and/or mumps virus at one time in your life. But you will not be sick or have any symptoms. It also means you should be protected from getting sick in the future. Vaccination is the best protection against measles and mumps and their complications.

The Centers for Disease Control and Prevention (CDC) recommends that children get two doses of the MMR (measles, mumps, and rubella) vaccine; one in infancy, the other before starting school. Talk to your child's pediatrician for more information. If you are an adult, and don't know if you have been vaccinated or were ever sick with the viruses, talk to your health care provider. Measles and mumps tend to make adults sicker than children.

If you have questions about your test results or your vaccination status, talk to your health care provider.

Instead of separate measles and mumps tests, your health care provider may order a combination blood test called an MMR antibody screening. MMR stands for measles, mumps, and rubella. Rubella, also known as German measles, is another type of viral infection.

Measles, also called rubeola, is an infectious disease caused by a virus. The virus stays in the environment for up to two hours after an infected person has coughed or sneezed, and you can get infected by direct contact or by touching a contaminated surface and then putting your hands in your mouth or nose.

About 1 to 2 weeks after getting infected, flu-like symptoms and a high fever appear; then, after 2 to 4 days, a rash appears on the face and then begins to spread to the rest of the body.

Measles can result in serious complications, especially in pregnant women and in people with weakened immune systems.

When you get infected by the measles virus, your body’s immune system recognizes a harmful substance called antigens in your blood, so, proteins called antibodies are released to fight those antigens.

This test detects the presence of either immunoglobulin G (IgG) or immunoglobulin M (IgM) antibodies to the measles virus in a sample of your blood.

Your doctor may want to order this test if you have signs or symptoms of measles, which include:

• A high fever
• Sore throat
• Cough
• Runny nose
• Red, watery eyes
• Tiny white spots inside the mouth (Koplik spots)
• Face rash, which can spread to the rest of the body

This test can also be ordered to determine whether a person has been immunized against measles and to track the spread of the disease in cases of outbreaks to prevent further people from getting infected.

A small amount of blood will be drawn of a vein in your arm by using a needle.

No fasting or any special preparations are needed for this test.

The risks are related only to the blood extraction procedure, including a little bleeding, temporary pain or discomfort, bruising, or local infection.

Measles IgM

• Negative: <0.80 AU. This means that you don’t have a current infection.
• Equivocal: 0.80 to 1.20 AU. An equivocal result may occur during acute infection; nevertheless, in some cases, the test must be repeated to help define the infection status.
• Positive: > 1.20 AU. This means that you are currently infected with the measles virus or that you had the infection recently. Low levels of IgM can persist for 1 year or longer.

Measles IgG

• Negative: less than 25 AU/mL. This indicates that you don’t have immunity against the virus. Therefore, you could get infected in the future if a vaccine is not provided.
• Equivocal: 25 to 29.99 AU/mL. This result does not give a definitive diagnosis. Repeat testing may be necessary.
• Positive: above 29.99 AU/mL. This means that you have immunity against the measles virus, either because you were immunized (vaccinated) or because you had measles in the past. In this case, you are protected against further infections.

In people who have never had the disease, measles can be prevented with the MMR (measles, mumps, and rubella) vaccine.

Mumps is an infectious disease caused by a virus. The virus gets in the environment after an infected person has coughed or sneezed, and you can get infected by direct contact, sharing utensils, or by touching a contaminated surface and then putting your hands in your mouth or nose.

About 2 weeks after getting infected, flu-like symptoms, a low-grade fever, and sometimes swelling of the jaw (parotiditis) may appear; however, in most people, the disease passes unnoticed without producing any symptoms.

Out of those infected, a few can develop serious complications, including deafness, or inflammation of the ovaries, testicles, pancreas, or brain.

When you get infected by the mumps virus, your body’s immune system recognizes a harmful substance called antigens in your blood, so, proteins called antibodies are released to fight those antigens.

This test detects the presence of either immunoglobulin G (IgG) or immunoglobulin M (IgM) antibodies to the mumps virus in a sample of your blood.

Your doctor may want to order this test if you have signs or symptoms of mumps or a complication of mumps, which include:

• Mild fever
• Muscle pain
• Headache
• Diminished appetite (hyporexia)
• Painful swelling of the parotid glands below one or both ears (parotiditis)
• Meningitis (inflammation of the lining of the brain)
• Encephalitis (inflammation of the brain)
• Oophoritis (inflammation of the ovaries)
• Orchitis (inflammation of the testicles)
• Pancreatitis (inflammation of the pancreas)
• Deafness in one or both ears

This test can also be ordered to determine whether a person has been immunized against mumps and to track the spread of the disease in cases of outbreaks to prevent further people from getting infected.

A small amount of blood will be drawn of a vein in your arm by using a needle.

No fasting or any special preparations are needed for this test.

The risks are related only to the blood extraction procedure, including a little bleeding, temporary pain or discomfort, bruising, or local infection.

Mumps IgM

• Negative: 0.80 AU. This means that you don’t have a current infection, or that the infection is too recent for the test to detect it.
• Equivocal: 0.80 to 1.20 AU. An equivocal result may occur during acute infection; nevertheless, in some cases, the test must be repeated to help define the infection status.
• Positive: > 1.20 AU. This means that you are currently infected with the mumps virus or that you had the infection recently.

Mumps IgG

• Negative: less than 9 AU/mL. This indicates that you don’t have immunity against the virus. Therefore, you could get infected in the future if a vaccine is not provided.
• Equivocal: 9 to 10.9 AU/mL. This result does not give a definitive diagnosis. Repeat testing may be necessary.
• Positive: above 10.9 AU/mL. This means that you have immunity against the mumps virus, either because you were immunized (vaccinated) or because you had mumps in the past. In this case, you are protected against further infections.

In people who have never had the disease, mumps can be prevented with the MMR (measles, mumps, and rubella) vaccine.

Exposure to other viruses, such as Epstein-Barr, parainfluenza, adenovirus, and human herpes virus 6, may affect your results.

Hearing tests measure how well you are able to hear. Normal hearing happens when sound waves travel into your ear, causing your eardrum to vibrate. The vibration moves the waves farther into the ear, where it triggers nerve cells to send sound information to your brain. This information is translated into the sounds you hear.

Hearing loss happens when there is a problem with one or more parts of the ear, the nerves inside the ear, or the part of the brain that controls hearing. There are three main types of hearing loss:

• Sensorineurual (also called nerve deafness). This type of hearing loss is caused by a problem with the structure of the ear and/or with the nerves that control hearing. It may be present at birth or show up late in life. Sensorineural hearing loss is usually permanent. This type of hearing loss ranges from mild (the inability to hear certain sounds) to profound (the inability to hear any sounds).
• Conductive. This type of hearing loss is caused by a blockage of sound transmission into the ear. It can occur at any age, but it's most common in infants and young children and is often caused by ear infections or fluid in the ears. Conductive hearing loss is usually mild, temporary, and treatable.
• Mixed, a combination of both sensorineural and conductive hearing loss.

Hearing loss is common in older adults. About one-third of adults over the age of 65 have some hearing loss, most often the sensorineural type. If you are diagnosed with hearing loss, there are steps you can take that may help treat or manage the condition.

Hearing tests are used to find out whether or not you have a hearing problem and, if so, how serious it is.

You may need a hearing test if you have symptoms of hearing loss. These include:

• Trouble understanding what other people are saying, especially in a noisy environment
• Needing to ask people to repeat themselves
• Trouble hearing high-pitched sounds
• Needing to turn up the volume on the TV or music player
• A ringing sound in your ears

Your hearing test may be done by a primary health care provider or one of the following types of providers:

• An audiologist, a health care provider who specializes in diagnosing, treating, and managing hearing loss
• An otolaryngologist (ENT), a doctor specializing in treating diseases and conditions of the ears, nose, and throat.

There are several types of hearing tests. Most tests check for your response to tones or words delivered at different pitches, volumes, and/or noise environments. These are called sound tests. Common sound tests include:

Acoustic Reflex Measures, also called middle ear muscle reflex (MEMR), test how well the ear responds to loud sounds. In normal hearing, a tiny muscle inside the ear tightens when you hear loud noises. This is called the acoustic reflex. It happens without you knowing it. During the test:

• The audiologist or other provider will place a soft rubber tip inside the ear.
• A series of loud sounds will be sent through the tips and recorded onto a machine.
• The machine will show when or if the sound has triggered a reflex.
• If hearing loss is bad, the sound may have to be very loud to trigger a reflex, or it may not trigger the reflex at all.

Pure-tone test, also known as audiometry. During this test:

• You will put on headphones.
• A series of tones will be sent to your headphones.
• The audiologist or other provider will change the pitch and loudness of the tones at different points during the test. At some points, the tones may be barely audible.
• The provider will ask you to respond whenever you hear the tones. Your response may be to raise your hand or press a button.
• The test helps find the quietest sounds you can hear at different pitches.

Tuning fork tests. A tuning fork is a two-pronged metal device that makes a tone when it vibrates. During the test:

• The audiologist or other provider will place the tuning fork behind your ear or on top of your head.
• The provider will hit the fork so that it makes a tone.
• You'll be asked to tell the provider whenever you hear the tone at different volumes, or if you heard the sound in your left ear, right ear, or both equally.
• Depending on where the fork is placed and how you respond, the test can show if there is hearing loss in one or both ears. It can also show which type of hearing loss you have (conductive or sensorineural).

Speech and word recognition tests can show how well you can hear spoken language. During the test:

• You will put on headphones.
• The audiologist will talk to you through your headphones, and ask you to repeat a series of simple words, spoken at different volumes.
• The provider will record the softest speech you are able to hear.
• Some of the testing may be done in a noisy environment, because many people with hearing loss have trouble understanding speech in loud places.

Another type test, called tympanometry, checks for how well your eardrum moves.

During a tympanometry test:

• The audiologist or other provider will place a small device inside the ear canal.
• The device will push air into the ear, making the eardrum move back and forth.
• A machine records the movement on graphs called tympanograms.
• The test helps find out if there is an ear infection or other problems such as fluid or wax buildup, or a hole or tear in the eardrum.

You don't need any special preparations for a hearing test.

There is no risk to having a hearing test.

Your results may show if you have a hearing loss, and whether the hearing loss is sensorineural or conductive.

If you are diagnosed with sensorineural hearing loss, your results may show that the hearing loss is:

• Mild: you can't hear certain sounds, such as tones that are too high or too low.
• Moderate: you can't hear many sounds, such as speech in a noisy environment.
• Severe: you can't hear most sounds.
• Profound: you can't hear any sounds.

Treatment and management of sensorineural hearing loss will depend on serious it is.

If you are diagnosed with conductive hearing loss, your provider may recommend medicine or surgery, depending on the cause of the loss.

If you have questions about the results, talk to your health care provider.

Even mild hearing loss can make it difficult to understand normal speech. Because of this, many older adults will avoid social situations, leading to isolation and depression. Treating hearing loss can help prevent these problems. While hearing loss in older adults is usually permanent, there are ways to manage the condition. Treatment options include:

• Hearing aids. A hearing aid is a device that's worn either behind or inside the ear. A hearing aid amplifies (makes louder) sound. Some hearing aids have more advanced functions. Your audiologist can recommend the best option for you.
• Cochlear implants. This is a device that's implanted surgically in the ear. It's usually used in people with more severe hearing loss and who don't get much benefit from using a hearing aid. Cochlear implants send sound directly to the hearing nerve.
• Surgery. Some types of hearing loss can be treated with surgery. These include problems with the eardrum or in the tiny bones inside the ear.

Hearing tests measure how well your baby or child can hear different sounds. Some babies are born with hearing problems. Other children are born with normal hearing and begin to have hearing problems later in childhood.

Hearing loss in infancy and early childhood can delay a child's ability to talk, understand spoken language, and develop social skills. Hearing tests can find problems early so that children with hearing loss can be treated and get help learning language skills as soon as possible.

Hearing depends on a series of steps that change sound waves into electrical signals that the brain understands as sounds. Hearing loss happens when there's a problem with any of these steps:

• Sound waves enter the outer ear and travel to the eardrum in the middle ear.
• The soundwaves vibrate the eardrum, which sends the vibrations to tiny bones that make the vibrations stronger.
• The vibrating bones make tiny waves in the fluid that's inside the cochlea. The cochlea is a snail-shaped structure in the inner ear. It is lined with sensory cells that have hair-like structures. When the hair cells move with the fluid waves, they create electrical signals.
• The auditory (hearing) nerve carries the electrical signals from the inner ear to the brain, which turns them into sounds you can recognize and understand.

There are three main types of hearing loss:

• Conductive hearing loss happens when sound waves can't reach the inner ear. Earwax or abnormal fluid in the ear may be blocking the path, or a hole in the eardrum may prevent it from vibrating. Ear infections are a common cause of this type of hearing loss in infants and young children. Medical treatment or surgery can often improve hearing.
• Sensorineural hearing loss (also called nerve deafness) happens when there's damage to the cochlea in the inner ear or the auditory nerve. This type of hearing loss ranges from mild (difficulty hearing certain sounds) to profound (not hearing any sound). The hearing loss is usually permanent, but it can improve with hearing aids or other devices.
• Mixed hearing loss is a combination of both sensorineural and conductive hearing loss.

One type of sensorineural hearing loss is called auditory neuropathy spectrum disorder (ANSD). With ANSD, there's problem with how the inner ear or the hearing nerve sends sound to the brain. This type of hearing disorder may happen if your child has health problems before or during birth or as a newborn. These problems include premature birth (being born too soon), low birth weight, and jaundice. ANSD may also be caused by a genetic disorder.

Other names: audiometry; audiography, audiogram, sound test

Hearing screening tests are used to find out if a newborn, baby, or child may have hearing loss. These quick pass/fail tests show whether your child needs more testing. They can't diagnose hearing loss.

More complete hearing tests are used to diagnose hearing loss if your child doesn't pass a screening test, or if you have concerns about your child's hearing. These tests can show which type of hearing loss your child has and how severe it is.

Routine hearing screening tests are recommended for all babies and children:

• Newborns should have a screening test for hearing problems by 1 month of age.
  • If you give birth in a hospital, the screening test is usually done before your baby goes home.
  • If you give birth at home, make sure to get your baby tested during the first month after birth.
• Children should have their hearing checked before they enter school. School-aged children may have hearing screening tests as part of their regular health checkups. The tests are often done in school, too.

More complete hearing tests are needed any time there is a concern about your child's hearing:

• If your baby doesn't pass the newborn hearing screening test, your baby will need complete hearing tests as soon as possible, but no later than 3 months of age.
• If your baby passes the newborn hearing screening test, but has a high risk for developing hearing loss, your baby will need complete hearing tests between 24 to 30 months of age. Your baby's risk may be higher if childhood hearing loss runs in your family or if your baby had certain infections. Ask your baby's provider about your baby's risk level.
• If your baby or child shows signs of hearing loss, contact your child's provider as soon as possible.

Signs of hearing loss in a baby include:

• Not jumping or being startled at loud noises
• After 6 months of age, not turning toward a sound
• By 12 months of age, not saying a few simple words, such as "dada" or "mama"

Signs of hearing loss in children include:

• Unclear speech
• Not following directions
• Often saying, "Huh?"
• Turning the TV volume up too high
• Learning problems

Hearing tests depend on your child's age and ability to follow instructions:

Hearing screening tests for newborns, infants, and very young children can measure hearing without needing your child to cooperate. These tests can even be done while your child sleeps:

• Auditory brainstorm (ABR) tests check the inner ear, the hearing nerve, and parts of the brain that are involved with hearing. During an ABR test:
  • The provider will place electrodes (small sensors that stick to the skin) on the scalp. The electrodes are connected to a computer.
  • Tiny, soft earphones will be placed inside the ears.
  • The earphones will play sounds.
  • The electrodes measure how the brain responses to the sounds. The results are shown on the computer.
• Otoacoustic emissions (OAE) tests check for damage in the hair cells in the cochlea. During an OAE test:
  • A small device will be placed in the ear. It can make sound and measure sound.
  • Sound from the device makes the fluid in the cochlea ripple, which moves the hair cells. When the hairs move, they make vibrations that have their own sound called OAEs.
  • The device measures OAEs to see how well the hair cells are working. If the test shows little or no OAEs, your child may have sensorineural hearing loss.

Hearing screening tests for older children are usually audiometry tests. These tests check the quietest sounds or words that your child can hear. For these tests:

• Your child will wear headphones. If your child won't wear headphones, sounds may be played through speakers in a sound booth.
• For a pure-tone test, each time your child hears a tone they will raise their hand, push a button, or say that they heard the sound.
• For a speech test (also called speech discrimination testing), your child will hear simple words at different levels of loudness. Some words will be spoken over noise. Your child will repeat the words they hear.

Audiometry tests can be adapted for very young children and infants. For young children, the tests may include a game to help them pay attention to the sounds. For example, a child may put a block in a box each time they hear a sound.

For infants and toddlers, the provider will watch for behavior changes that show the child heard a sound. For example, an infant may start sucking a pacifier or look to see where the sound came from. When the child responds to a sound, they get to see a moving toy as a reward.

More complete hearing tests will be done if your child doesn't pass a hearing screening test. Your child's provider will usually refer you to a hearing specialist, such as:

• A pediatric audiologist, a health care professional who is trained to test hearing, diagnose hearing loss, and provide hearing devices and services to improve hearing in children.
• A pediatric otolaryngologist (ENT), a doctor who specializes in diagnosing and treating ear conditions in children. This type of provider may also be called a pediatric otologist.

During a complete hearing exam, your child may have several types of hearing tests that examine different parts hearing. These tests may include an ABR and/or an OAE test for children who were screened with audiometry tests. Other common tests include:

• Tympanometry. This test checks how well the eardrum and bones in the middle ear are working. Your child will need to sit very still, so this test usually isn't used for infants or young children. During the test:
  • A small device will be placed in your child's ear.
  • The device will send air and sound into the ear, which makes the eardrum move. Your child will feel the air pressure.
  • A machine records the movements of the eardrum on graphs called tympanograms.
  • If the eardrum doesn't move normally, your child may have fluid or wax buildup in the ear, a hole in the eardrum, a tumor in the ear, middle ear bones that don't vibrate well, or another problem in the middle ear.
• Acoustic Reflex Measures, also called middle ear muscle reflex (MEMR) test. This test shows how the ear responds to loud sounds. Normally, a tiny muscle inside the ear tightens to protect your ear when you hear loud noises. If unusually loud noises are needed to trigger the muscle to tighten, or if it doesn't tighten at all, your child may have hearing loss. To do the test:
  • A small device will be placed in your child's ear.
  • The device will make loud sounds.
  • A machine will show if the sound triggered the ear muscle to tighten.

There are no special preparations for a hearing test. But it's helpful to tell you child what to expect. Let your child know they will hear sounds. If you have a pair of headphones, you might let your child try them on to see what they feel like.

There is no risk to having hearing tests.

If your child's hearing screening test shows normal hearing, your child usually won't need more hearing tests until their next routine screening. But if you have concerns about your child's hearing or if your child has risks for hearing loss, talk with your child's provider about getting more complete hearing tests.

If the results of complete hearing tests show that your child has hearing loss, the results will also show how severe it is, which ear is affected more, and whether they have conductive sensorineural, or both types of hearing loss.

• With conductive hearing loss, treatment may be able to restore your child's hearing. The treatment will depend on what's blocking sound from reaching the inner ear. It may include removing wax, draining fluid, or doing surgery to fix problems with the eardrum or ear bones.
• With sensorineural hearing loss, the loss of hearing is permanent. But your child's hearing may improve with hearing aids or surgery to implant a device called a cochlear implant.

Other treatment and support options for hearing loss in children include:

• Working with professionals who can help children and their families learn to communicate. This may include learning sign language, lip reading, or other ways to communicate.
• Education to help your child learn communication skills.
• Assistive devices, such as devices for using the telephone and alerting your child to alarms, doorbells, and other sounds.
• Support groups.

If you have questions about your child's hearing and treatment, talk with your child's primary care provider or hearing specialist.