Treatment of Mumps in Children
There is no specific antiviral drug of choice for mumps in children; treatment is entirely supportive with acetaminophen or NSAIDs for symptom control. 1
Primary Symptomatic Management
Mumps is a self-limiting viral infection that requires only supportive care, as no specific antiviral therapy has been proven effective or is recommended for routine use. 1, 2
The cornerstone of treatment involves:
- Acetaminophen or NSAIDs for fever control, headache, and parotid gland pain 1
- Adequate hydration, as parotitis makes swallowing uncomfortable and painful 1
- Rest until symptoms resolve
Why No Antiviral Therapy?
While favipiravir (T-705) has shown in vitro activity against mumps virus at low micro-molar concentrations, this remains experimental with no clinical trials in humans, and it is not approved or recommended for mumps treatment. 3 No other antiviral agents have demonstrated efficacy against mumps virus in clinical practice. 2, 4
Isolation Requirements
Implement strict droplet precautions for 5 days after onset of parotitis, as patients are contagious from 7 days before through 8 days after parotid swelling begins. 1 This prevents transmission through respiratory droplets and direct contact with saliva. 1
Monitoring for Complications
The absence of specific antiviral therapy makes vigilant monitoring for complications essential:
- Aseptic meningitis (4-6% of cases): Watch for severe headache, neck stiffness, photophobia, or altered mental status 1
- Orchitis in postpubertal males (3.8% of males >12 years): Assess for testicular pain and swelling 1, 5
- Pancreatitis: Monitor for severe abdominal pain, nausea, and vomiting 1
- Sensorineural hearing loss: Be aware of sudden deafness, though rare 1
- Neurological sequelae: Watch for seizures, paralysis, or cranial nerve palsies suggesting encephalitis 1
Common Pitfall
Do not prescribe antibiotics for uncomplicated mumps, as it is a viral infection. Antibiotics are only indicated if secondary bacterial complications develop, which is uncommon. 2
Vaccination Context
Even with two doses of MMR vaccine (approximately 88% effective), breakthrough infections can occur, particularly during outbreaks in densely populated settings like schools. 1, 5 However, vaccinated individuals typically experience milder disease with fewer complications compared to unvaccinated children. 5