What is the treatment for mumps?

Treatment for Mumps

Mumps treatment is entirely supportive and symptomatic, as there is no specific antiviral therapy available—focus on pain control, hydration, isolation, and vigilant monitoring for complications. 1, 2

Primary Symptomatic Management

The cornerstone of mumps treatment involves symptomatic relief with acetaminophen or NSAIDs to control fever, headache, and parotid gland pain. 1, 3

• Ensure adequate hydration and fluid intake, as parotitis makes swallowing uncomfortable and painful 1
• Recommend soft foods and avoid acidic foods that stimulate salivary flow and worsen parotid pain 1
• Treatment remains supportive regardless of patient age, as no specific antiviral therapy exists 2, 4

Isolation and Infection Control

Implement droplet precautions immediately and isolate patients for 5 days after parotitis onset, as patients are contagious from 7 days before through 8 days after symptom onset. 1, 3

• Educate patients and family members about transmission through respiratory droplets and direct contact with saliva 1, 3
• Strict isolation measures are critical to prevent spread to susceptible contacts 1

Monitoring for Complications

Neurological Complications

• Monitor for aseptic meningitis (occurs in 4-6% of cases), characterized by severe headache, neck stiffness, photophobia, or altered mental status 1, 3
• Watch for signs of encephalitis including seizures, paralysis, or cranial nerve palsies, which can cause permanent sequelae 1, 3
• Assess for hearing loss, including sudden sensorineural deafness, which was a major cause of childhood deafness in the pre-vaccine era 1, 3

Reproductive System Complications

In postpubertal males, assess for orchitis (occurs in up to 38% of cases), characterized by testicular pain and swelling, typically developing 10 days after parotitis onset. 1, 5, 6

• Orchitis treatment includes bed rest with local cooling, scrotal support, and systemic nonsteroidal anti-inflammatory drugs 6
• Consider antibiotics initially if bacterial orchitis cannot be excluded at presentation 6
• Reassure patients that sterility is rare despite the high incidence of orchitis 1
• In postpubertal females, monitor for oophoritis (ovarian inflammation) 1

Other Systemic Complications

• Watch for pancreatitis, characterized by severe abdominal pain, nausea, and vomiting 1, 3

Special Consideration: Facial Nerve Involvement

If facial nerve inflammation with weakness develops, 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. 1

• Provide eye protection to prevent corneal damage in patients with facial weakness 1
• Reassure patients that complete recovery occurs in approximately 70-80% of cases within 3-6 months 1

Important Clinical Caveats

• Mumps disease is generally self-limiting, with most patients recovering without intervention beyond supportive care 1
• 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. 1, 5
• Complications are more common and severe in adults than children, making age an important consideration in monitoring intensity 1
• Despite two-dose MMR vaccine effectiveness of approximately 88%, breakthrough infections can still occur 5, 3