Mumps Treatment
Mumps treatment is entirely supportive and symptomatic, as there is no specific antiviral therapy available—focus on pain control, hydration, isolation to prevent transmission, and vigilant monitoring for potentially serious complications. 1, 2
Primary Symptomatic Management
The cornerstone of mumps management involves addressing symptoms as they arise:
- Provide acetaminophen or NSAIDs for fever and pain control, targeting fever, headache, and parotid gland pain that characterizes the infection. 1
- Ensure adequate hydration and fluid intake, as parotitis makes swallowing uncomfortable and painful, potentially leading to dehydration. 1
- Recommend soft foods and avoidance of acidic foods (citrus, vinegar-based items) that stimulate salivary flow and worsen parotid pain. 1
Mandatory Isolation and Infection Control
Preventing transmission is critical given mumps' high contagiousness:
- Implement droplet precautions immediately, as patients are contagious from 7 days before through 8 days after parotitis onset. 1
- Isolate patients for 5 days after onset of parotitis to limit spread to susceptible contacts. 1
- Educate patients and family members about transmission through respiratory droplets and direct contact with saliva. 1
Vigilant Monitoring for Complications
Complications are more common and severe in adults than children, requiring age-appropriate monitoring intensity. 1
Neurological Complications
- Monitor for aseptic meningitis (occurs in 4-6% of cases), characterized by severe headache, neck stiffness, photophobia, or altered mental status. 1
- Watch for signs of encephalitis, including seizures, paralysis, or cranial nerve palsies, which can cause permanent neurological sequelae. 1
- Assess for hearing loss, including sudden sensorineural deafness, which was historically a major cause of childhood deafness in the pre-vaccine era. 1
Reproductive System Complications
- Assess for orchitis in postpubertal males (occurs in up to 38% of cases), characterized by testicular pain and swelling—though reassure patients that sterility is rare despite the high incidence. 1
- Monitor for oophoritis (ovarian inflammation) in postpubertal females, which can present with pelvic pain. 1
Other Systemic Complications
- Watch for pancreatitis, characterized by severe abdominal pain, nausea, and vomiting. 1
Special Consideration: Facial Nerve Involvement
When facial droop or weakness occurs 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. 1, 3
- Provide eye protection (artificial tears, eye patches at night) to prevent corneal damage if facial weakness prevents complete eye closure. 1, 3
- Reassure patients that complete recovery occurs in approximately 70-80% of cases within 3-6 months, though some residual weakness may persist. 1, 3
Critical Clinical Caveats
- Mumps disease is generally self-limiting, with most patients recovering without intervention beyond supportive care—avoid overtreatment. 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, making diagnosis challenging. 1
- No specific antiviral therapy exists for mumps—any claims of antiviral efficacy lack robust evidence, though interferon alpha-2b has been suggested specifically for mumps epididymo-orchitis in limited reports. 4
- Complications are significantly more common and severe in adults than children, making age a critical factor in determining monitoring intensity and patient counseling. 1