What is the treatment for mumps?

Treatment for Mumps

The treatment for mumps 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 characteristic bilateral or unilateral parotid gland swelling
• Prodromal symptoms occur with an incubation period of 16-18 days after exposure
• 15-20% of infections may be asymptomatic 1
• Parotitis is absent in 10%-30% of symptomatic cases, making diagnosis challenging 2
• Diagnosis is primarily clinical but can be confirmed by:
  • Antibody testing
  • Reverse transcriptase-polymerase chain reaction (RT-PCR)
  • Suitable specimens include serum, saliva, urine, and cerebrospinal fluid 2

Treatment Approach

Primary Treatment

• Supportive care is the mainstay of treatment 1, 3:
  • Adequate hydration
  • Rest
  • Analgesics for pain and fever (acetaminophen or ibuprofen)
  • Cold or warm compresses to the parotid area for comfort

Management of Complications

1. Aseptic Meningitis (occurs in up to 15% of cases 4):

   • Supportive care with pain management
   • Hydration
   • Neurological monitoring 1

2. Orchitis (occurs in 20-30% of postpubertal males 4):

   • Pain management
   • Scrotal support and ice packs
   • Interferon alpha-2b may be considered specifically for mumps epididymo-orchitis 2
   • Note: Sterility is a rare sequela of mumps orchitis 4

3. Other complications requiring specific management:

   • Pancreatitis: Supportive care, pain management
   • Mumps-associated hepatitis: Supportive care, monitoring of liver function 1
   • Sensorineural deafness: Occurs at a rate of 1 per 20,000 cases 4

Prevention and Isolation

• Proper isolation is crucial to prevent widespread outbreaks 3
• MMR vaccination is the most effective preventive measure 1
• Two doses of MMR provide better protection against mumps 1
• Most adults born before 1957 are likely naturally immune 4

Emerging Treatments

• Intravenous immunoglobulin therapy may have a future role in mumps management, though this is not yet standard practice 2
• Research continues on potential antiviral therapies, but none are currently approved for routine use

Important Considerations

• Mumps is a reportable disease in most states 3
• The epidemiology has changed, with more cases now affecting adolescents and adults 2
• Complications occur more frequently in adults than in children 5
• Pregnant women with mumps in the first trimester have an increased risk of fetal death, though mumps is not associated with congenital malformations 1

Pitfalls to Avoid

• Failing to recognize mumps in the absence of parotitis
• Overlooking potential complications, especially in adult patients
• Not implementing proper isolation measures, which can lead to outbreaks
• Neglecting to report cases to appropriate public health authorities