What is the recommended treatment for a 10-year-old child with mumps?

Treatment of Mumps in a 10-Year-Old Child

Mumps treatment is entirely supportive, as there is no specific antiviral therapy available for this viral infection. 1, 2

Primary Management Approach

Provide symptomatic relief with the following measures:

• Pain and fever control: Administer acetaminophen or NSAIDs (ibuprofen) for fever, headache, and parotid gland pain 3
• Adequate hydration: Ensure the child maintains good fluid intake, as parotitis can make swallowing uncomfortable 3
• Soft diet: Recommend bland, soft foods that don't require extensive chewing and avoid acidic foods/beverages that stimulate salivary flow and worsen pain 4
• Rest: Encourage bed rest during the acute febrile phase 2

Isolation and Infection Control

Implement strict isolation measures to prevent transmission:

• Droplet precautions: Isolate the child for 5 days after onset of parotid swelling, as patients are contagious from 7 days before through 8 days after parotitis onset 1, 3
• Exclude from school: Keep the child home from school during the contagious period 2
• Household precautions: Educate family members about transmission through respiratory droplets and direct contact with saliva 1

Monitoring for Complications

Watch carefully for complications, which are less common in children than adults but can still occur:

• Aseptic meningitis: Monitor for severe headache, neck stiffness, photophobia, or altered mental status (occurs in 4-6% of clinical cases) 5, 1
• Orchitis: In postpubertal males, assess for testicular pain and swelling 5, 1
• Pancreatitis: Watch for severe abdominal pain, nausea, and vomiting 1
• Hearing loss: Be aware that sudden sensorineural deafness can occur, though rare 5, 1
• Neurological sequelae: Monitor for signs of encephalitis including seizures, paralysis, or cranial nerve palsies 5

When Corticosteroids May Be Considered

Corticosteroids are NOT routinely recommended for uncomplicated mumps parotitis. However, if facial nerve involvement (facial droop) develops, prednisone 1-2 mg/kg/day for 5-7 days followed by a taper may be initiated 3

Important Clinical Pitfalls

• No antibiotics needed: Mumps is viral; antibiotics are not indicated unless secondary bacterial infection develops 2
• Avoid aspirin: Do not use aspirin in children due to risk of Reye's syndrome 2
• Laboratory confirmation: While treatment is supportive regardless, confirm diagnosis through PCR testing or mumps IgM serology to guide public health reporting and contact tracing 1, 3

Public Health Reporting

Mumps is a reportable disease in most states. Notify local health authorities promptly to facilitate contact tracing and outbreak control measures 2

Vaccination Status Review

Review the child's vaccination history: A 10-year-old should have received two doses of MMR vaccine (first at 12-15 months, second at 4-6 years) 5. Even with two doses, breakthrough infections can occur, as vaccine effectiveness is approximately 88% 1, 3