Treatment of Mumps
Mumps treatment is entirely supportive and symptomatic, as there is no specific antiviral therapy available for this viral infection. 1, 2
Primary Symptomatic Management
The cornerstone of mumps treatment focuses on alleviating symptoms while the infection runs its natural course:
- Provide pain and fever control with acetaminophen or NSAIDs to manage fever, headache, and parotid gland pain 1
- Ensure adequate hydration and fluid intake, as parotitis can make swallowing uncomfortable and painful 3, 1
- Recommend soft foods and avoidance of acidic foods that may stimulate salivary flow and worsen parotid pain 1
Isolation and Infection Control Measures
Given that mumps is highly contagious, strict isolation is critical to prevent transmission:
- Implement droplet precautions immediately, as patients are contagious from 7 days before through 8 days after parotitis onset 1, 4
- Isolate patients for 5 days after onset of parotitis to limit spread to susceptible contacts 3
- Educate patients and family members about transmission through respiratory droplets and direct contact with saliva 1
Monitoring for Complications
While most mumps cases are self-limiting, serious complications can occur and require vigilant monitoring:
Neurological Complications
- Monitor for aseptic meningitis (occurs in 4-6% of cases), characterized by severe headache, neck stiffness, photophobia, or altered mental status 5, 1
- Watch for signs of encephalitis, including seizures, paralysis, or cranial nerve palsies, which can cause permanent sequelae 5, 1
- Assess for hearing loss, including sudden sensorineural deafness, which was a major cause of childhood deafness in the pre-vaccine era 5, 4
Reproductive System Complications
- In postpubertal males, assess for orchitis (occurs in up to 38% of cases), characterized by testicular pain and swelling, though sterility is rare 5, 1
- In postpubertal females, monitor for oophoritis (ovarian inflammation) 4
Other Systemic Complications
Special Consideration: Facial Nerve Involvement
If facial droop develops due to facial nerve inflammation:
- Initiate corticosteroid therapy promptly with prednisone 1-2 mg/kg/day for 5-7 days followed by a taper over 5-7 days to reduce inflammation and improve nerve function 3
- Provide eye protection if facial weakness prevents complete eye closure to prevent corneal damage 3
- Reassure patients that complete recovery occurs in approximately 70-80% of cases within 3-6 months 3
Important Clinical Caveats
Mumps disease is generally self-limiting, with most patients recovering without intervention beyond supportive care 5. However, the absence of specific antiviral therapy underscores the critical importance of prevention through vaccination 2, 6.
Parotitis is not present in all cases—only 30-40% of mumps infections produce typical acute parotitis, while 15-20% are asymptomatic and up to 50% present with nonspecific or respiratory symptoms 5, 4. This makes clinical diagnosis challenging and emphasizes the need for laboratory confirmation when mumps is suspected 7, 8.
Complications are more common and severe in adults than children, making age an important consideration in monitoring intensity 5. The virus demonstrates tropism for salivary glands, gonads, pancreas, and meninges, explaining the diverse manifestations 4.