What is the treatment for a typical child or young adult with no significant medical history diagnosed with mumps?

Treatment of Mumps

Primary Management: Supportive Care Only

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

Immediate Symptomatic Management

• Provide acetaminophen or NSAIDs for pain and fever control to manage fever, headache, and parotid gland pain 1, 2
• Ensure adequate hydration and fluid intake, as parotitis makes swallowing uncomfortable and painful 1, 2
• Recommend soft foods and avoidance of acidic foods that may stimulate salivary flow and worsen parotid pain 1, 2

Critical Isolation Requirements

Implement droplet precautions immediately and isolate the patient for 5 days after onset of parotitis, as patients are contagious from 7 days before through 8 days after parotitis onset 1, 2

• Educate patients and family members about transmission through respiratory droplets and direct contact with saliva 1, 2
• Report probable or confirmed cases immediately to state and local health departments 2

Monitoring for Complications

Complications are significantly more common and severe in adults than children, requiring heightened surveillance in young adults. 3, 1, 2

Neurological Complications (Monitor Closely)

• Watch for aseptic meningitis (occurs in 4-6% of cases), characterized by severe headache, neck stiffness, photophobia, or altered mental status 3, 1, 2
• Assess for encephalitis signs, including seizures, paralysis, or cranial nerve palsies, which can cause permanent sequelae 1, 2
• Monitor for hearing loss, as sudden sensorineural deafness can be bilateral and permanent—mumps was a major cause of childhood deafness in the pre-vaccine era 3, 1, 2

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 3, 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, 2

Special Management: Facial Nerve Involvement

If facial droop or 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, 2

• Provide eye protection to prevent corneal damage if facial weakness prevents complete eye closure 1, 2
• Reassure patients that complete recovery occurs in approximately 70-80% of cases within 3-6 months 1

Important Clinical Caveats

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 3, 1, 2

• Mumps disease is generally self-limiting, with most patients recovering without intervention beyond supportive care 3, 1, 2
• Laboratory confirmation is preferred over clinical diagnosis alone, as parotitis has multiple infectious and noninfectious causes 2
• Laboratory criteria include isolation of mumps virus from clinical specimens, significant rise in serum mumps IgG antibody, or positive serologic test for mumps IgM antibody 2

Common Pitfalls to Avoid

• Do not administer mumps vaccine to pregnant women due to theoretical risk of fetal harm from live-virus vaccine 3, 2
• Do not assume immunity based on vaccination alone—recent outbreaks have occurred in highly vaccinated populations, particularly among young adults in college settings 3, 4
• Do not overlook complications in patients without parotitis—serious complications can occur without evidence of parotid swelling 3