What is the treatment and prevention for mumps (measles, mumps, and rubella)?

Treatment and Prevention of Mumps

The most effective way to prevent mumps is through vaccination with the measles, mumps, and rubella (MMR) vaccine, while treatment is primarily supportive as there is no specific antiviral therapy for mumps. 1, 2

Prevention of Mumps

Vaccination

• MMR vaccine is the cornerstone of mumps prevention, with one dose being approximately 80% effective and two doses providing 86% effectiveness against mumps disease 2, 3
• The recommended schedule for MMR vaccination is:
  • First dose at 12-15 months of age 4
  • Second dose at 4-6 years of age 4
• For international travelers, children ≥12 months should receive two doses of MMR separated by at least 28 days before departure 4
• Children aged 6-11 months traveling internationally should receive a dose of monovalent measles vaccine or MMR before departure, but will need to be revaccinated with two doses of MMR starting at 12-15 months 4

Post-Exposure Prophylaxis

• Unlike measles, post-exposure MMR vaccination does not prevent or alter the clinical severity of mumps after exposure 4
• However, widespread vaccination during a mumps outbreak may help terminate the outbreak 4
• The effectiveness of immune globulin (IG) or intravenous immune globulin (IGIV) for preventing mumps is unknown, and these products should not be used for prophylaxis among immunocompromised persons exposed to mumps 4

Special Populations

• Healthcare workers: All healthcare workers should have evidence of mumps immunity, with adequate vaccination consisting of one dose of live mumps-containing vaccine for those born during or after 1957 4
• HIV-infected individuals: MMR vaccination is recommended for asymptomatic HIV-infected persons without severe immunosuppression and should be considered for symptomatic HIV-infected persons without severe immunosuppression 4
• Immunocompromised patients: Persons with leukemia in remission who were not immune to mumps when diagnosed may receive MMR vaccine at least 3 months after termination of chemotherapy 4

Treatment of Mumps

Supportive Care

• Treatment for mumps infection is symptomatic, as there is no specific antiviral therapy available 1, 5
• Supportive measures include:
  • Pain management for parotitis
  • Adequate hydration
  • Rest
  • Fever control with antipyretics 6

Management of Complications

• For orchitis (inflammation of the testicles), which occurs commonly in post-pubertal males:
  • Pain management
  • Scrotal support
  • Ice packs to reduce swelling 5
• For aseptic meningitis, which occurs in approximately 10% of patients:
  • Supportive care
  • Pain management
  • Monitoring for neurological complications 4

Isolation Precautions

• Patients with mumps should be isolated to prevent transmission 6
• The virus can be isolated from saliva from 7 days before through 8 days after onset of salivary gland swelling 4
• Any suspected or known cases of mumps should be reported immediately to local or state health departments 4

Outbreak Control

• Surveillance and reporting are essential components of mumps control 4
• During outbreaks, identification and vaccination of susceptible individuals is crucial 4
• All suspected cases should be reported immediately, with laboratory confirmation through serologic testing or detection of virus from clinical specimens 4

Common Pitfalls and Caveats

• Mumps can occur in highly vaccinated populations; outbreaks have been reported among persons who previously received a single dose of mumps-containing vaccine 4
• Diagnosis can be challenging as parotitis (the hallmark of infection) is absent in 10-30% of symptomatic cases 5
• The clinical presentation of mumps can vary, with manifestations including respiratory tract infection, orchitis, meningitis, and other systemic complications 4, 2
• Serious reactions to the mumps component of the MMR vaccine are rare, but there is evidence supporting an association between MMR vaccination and febrile seizures and idiopathic thrombocytopenic purpura (ITP), though the risk is smaller than after natural infection 3

By implementing proper vaccination strategies and managing cases appropriately, mumps can be effectively controlled, reducing morbidity and preventing outbreaks.