What is the treatment for mumps?

Treatment for Mumps

Mumps treatment is primarily supportive care, as there is no specific antiviral therapy available for this self-limiting viral infection. 1

Clinical Presentation and Diagnosis

Mumps presents with these characteristic features:

• Bilateral or unilateral parotid gland swelling (parotitis) in 30-40% of cases
• Prodromal symptoms including fever, headache, malaise, myalgia, and anorexia
• Incubation period of 16-18 days after exposure
• 15-20% of infections are asymptomatic, and up to 50% present with nonspecific respiratory symptoms 1

Diagnosis is typically clinical based on parotid swelling, but can be confirmed by:

• Serological testing for mumps IgM antibodies
• Viral isolation or detection of viral nucleic acid via PCR
• Suitable specimens include serum, saliva, urine, and CSF 2

Supportive Treatment Approach

1. Pain and fever management:

   • Acetaminophen or NSAIDs for pain relief and fever reduction
   • Avoid aspirin in children due to risk of Reye syndrome

2. Hydration:

   • Maintain adequate fluid intake
   • Consider IV fluids if oral intake is significantly compromised

3. Rest:

   • Adequate rest until symptoms resolve

4. Symptomatic measures for parotitis:

   • Warm or cold compresses to the parotid area for comfort
   • Soft diet to minimize chewing discomfort
   • Avoid acidic foods and beverages that may stimulate salivary flow and worsen pain

Management of Complications

Mumps can cause several complications requiring specific management:

1. Orchitis (affects up to 38% of postpubertal males):

   • Bed rest
   • Scrotal support and ice packs
   • Pain management
   • Interferon alpha-2b may be considered specifically for mumps epididymo-orchitis 2

2. Aseptic meningitis (4-6% of clinical cases):

   • Usually mild and self-limiting
   • Supportive care with pain management and hydration
   • Neurological monitoring 1

3. Pancreatitis:

   • Bowel rest
   • Pain management
   • IV hydration if needed

4. Mumps-associated hepatitis (rare):

   • Conservative management with hydration, pain relief, and rest
   • Monitor liver function tests until normalization 3

Isolation and Prevention

• Isolation: Patients should be isolated for 5 days after onset of parotid swelling
• Vaccination: The most effective preventive measure is MMR vaccination
  • Administered at ages 1 and 4 years in Australia 2
  • One dose is approximately 80% effective 4
  • Two doses provide better protection 1

Special Considerations

• Pregnant women: Mumps during first trimester pregnancy carries increased risk of fetal death, though not associated with congenital malformations 1
• Immunocompromised patients: May require closer monitoring for complications
• Healthcare workers: Should be vaccinated and follow strict isolation protocols when caring for mumps patients 5

Important Caveats

• No antiviral medications have proven efficacy against mumps
• Antibiotics are not effective as mumps is a viral infection
• Intravenous immunoglobulin therapy may have a future role in mumps management, but is not currently standard practice 2
• Mumps is a reportable disease in most states/countries 5
• The disease is generally self-limiting with symptoms resolving within 7-10 days