eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease

Mumps: Treatment & Medication

Author: Cem S Demirci, MD, Fellow in Endocrinology, Children's Hospital of Pittsburgh
Coauthor(s): Walid Abuhammour, MD, FAAP, Associate Professor of Pediatrics, Michigan State University; Director of Pediatric Infectious Disease, Department of Pediatrics, Hurley Medical Center
Contributor Information and Disclosures

Updated: Nov 20, 2009

Treatment

Medical Care

  • Conservative therapy is indicated in patients with mumps.
  • Generous offering of fluids is essential because adequate hydration and alimentation of patients is important.
  • Foods and liquids that contain acid may cause swallowing difficulty as well as gastric irritation.
  • Prescribe analgesics for severe headaches or discomfort due to parotitis. In orchitis, stronger analgesics may be needed.
  • No antiviral agent is indicated for mumps, which is a self-limited disease.

Consultations

  • Consultation may be considered in complicated cases with multiple organ system involvement.

Diet

  • A light diet with generous fluid intake is recommended.
  • Avoiding acid-containing foods (eg, tomato, vinegar-containing food additives) and liquids (eg, orange juice) are beneficial to reduce pain.

Activity

  • Bed rest is recommended for a faster recovery and is needed for patients with complicated cases.

Medication

Analgesics

These agents may be prescribed for severe headaches or discomfort due to parotitis. In orchitis, stronger analgesics may be needed.


Ibuprofen (Advil, Motrin)

DOC for patients with mild-to-moderate pain and fever. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Adult

200-400 mg PO q4-6h while symptoms persist; not to exceed 3.2 g/d

Pediatric

10 mg/kg/dose q8h prn for relief of pain/fever; not to exceed 2.4 g/d

Coadministration with aspirin increases risk of inducing serious NSAID-related side effects; probenecid may increase concentrations and, possibly, toxicity of NSAIDs; may decrease effect of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; monitor PT closely (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently

Documented hypersensitivity; peptic ulcer disease; recent GI bleeding or perforation; renal insufficiency; high risk of bleeding

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions

Category D in third trimester of pregnancy; caution in congestive heart failure, hypertension, and decreased renal and hepatic function; caution in anticoagulation abnormalities or during anticoagulant therapy


Acetaminophen (Tylenol, Tempra)

DOC for pain in patients with documented hypersensitivity to NSAIDs, with upper GI disease, or who are taking PO anticoagulants. Reduces fever by acting directly on hypothalamic heat-regulating centers, which increases dissipation of body heat via vasodilation and sweating.

Adult

325-650 mg PO q4-6h or 1000 mg tid/qid; not to exceed 4 g/d

Pediatric

15 mg/kg/dose q4-6h prn for relief of pain/fever; not to exceed 2.6 g/d

Rifampin can reduce analgesic effects of acetaminophen; coadministration with barbiturates, carbamazepine, hydantoins, and isoniazid may increase hepatotoxicity

Documented hypersensitivity; known G-6-P deficiency

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions

Hepatotoxicity possible in people with long-term alcoholism following various dose levels; severe or recurrent pain or high or continued fever may indicate a serious illness; APAP is contained in many OTC products, and combined use with these products may result in cumulative APAP doses exceeding recommended maximum dose

Vaccines (measles, mumps, rubella)

Prevention of mumps through immunization cannot be overemphasized. All children younger than 7 years should receive the mumps vaccine. In the United States, mumps vaccine is recommended and is usually combined with MMR.


Measles, mumps, and rubella vaccine (M-M-R)

Live virus vaccine. Combined MMR vaccine is recommended for the prevention of mumps, measles, and rubella. For children, the typical recommended 2 dose schedule is administered at age 12-15 mo for the 1st dose and the second dose at 4-6 y of age.

Adult

0.5 mL SC in outer aspect of upper arm
Adults in 1957 or after should receive one dose of MMR unless they have a medical contraindication, history of mumps, laboratory evidence of immunity
A second dose is recommended for adults in an age group affected during a mumps outbreak, students in postsecondary educational institutions, work in a health care facility, or for international travel

Pediatric

0.5 mL SC in outer aspect of upper arm
Administer 1st dose between age 12-15 mo; administer the 2nd dose between age 4-6 y

Patients receiving immunosuppressants, including corticosteroids or radiation therapy, may remain susceptible despite immunization because of poor immune response

Pregnancy

X - Contraindicated; benefit does not outweigh risk

Precautions

Fever, rash, lymphadenopathy, parotitis, allergic reactions, thrombocytopenia, arthralgia, arthritis, and persistent or recurrent arthropathy; interference with tuberculin skin tests; contraception in females is advised for 3 mo following immunization; not indicated for immunocompromised patients

More on Mumps

Overview: Mumps
Differential Diagnoses & Workup: Mumps
Treatment & Medication: Mumps
Follow-up: Mumps
Multimedia: Mumps
References
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References

  1. CDC. Mumps--United States, 1985-1988. MMWR Morb Mortal Wkly Rep. Feb 24 1989;38(7):101-5. [Medline].

  2. [Guideline] Watson JC, Hadler SC, Dykewicz CA, et al. Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR - Morbidity & Mortality Weekly Report. May 22 1998;47(RR-8):1-57. [Medline].

  3. Hopkins RS, Jajosky RA, Hall PA, et al. Summary of notifiable diseases--United States, 2003. MMWR Morb Mortal Wkly Rep. Apr 22 2005;52(54):1-85. [Medline].

  4. CDC. Mumps outbreak at a summer camp--New York, 2005. MMWR Morb Mortal Wkly Rep. Feb 24 2006;55(7):175-7. [Medline]. [Full Text].

  5. WHO. Global status of mumps immunization and surveillance. Wkly Epidemiol Rec. Dec 2 2005;80(48):418-24. [Medline].

  6. CDC. Mumps epidemic--United kingdom, 2004-2005. MMWR Morb Mortal Wkly Rep. Feb 24 2006;55(7):173-5. [Medline]. [Full Text].

  7. Shanley JD. The resurgence of mumps in young adults and adolescents. Cleve Clin J Med. Jan 2007;74(1):42-4, 47-8. [Medline].

  8. Hatchette TF, Mahony JB, Chong S, LeBlanc JJ. Difficulty with mumps diagnosis: what is the contribution of mumps mimickers?. J Clin Virol. Dec 2009;46(4):381-3. [Medline].

  9. [Guideline] Update: recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding administration of combination MMRV vaccine. MMWR Morb Mortal Wkly Rep. Mar 14 2008;57(10):258-60. [Medline].

  10. AAP. Mumps. In: Red Book: Report of the Committee on Infectious Diseases. 26th ed. Elk Grove, IL: American Academy of Pediatrics; 2003:439-43.

  11. CDC. Brief report: update: mumps activity--United States, January 1-October 7, 2006. MMWR Morb Mortal Wkly Rep. Oct 27 2006;55(42):1152-3. [Medline]. [Full Text].

  12. [Guideline] CDC. Mumps prevention. MMWR Morb Mortal Wkly Rep. Jun 9 1989;38(22):388-92, 397-400. [Medline].

  13. CDC. Status report on the Childhood Immunization Initiative: reported cases of selected vaccine-preventable diseases--United States, 1996. MMWR Morb Mortal Wkly Rep. Jul 25 1997;46(29):665-71. [Medline].

  14. CDC. Update: childhood vaccine-preventable diseases--United States, 1994. MMWR Morb Mortal Wkly Rep. Oct 7 1994;43(39):718-20. [Medline].

  15. Chaiken BP, Williams NM, Preblud SR, et al. The effect of a school entry law on mumps activity in a school district. JAMA. May 8 1987;257(18):2455-8. [Medline].

  16. Cherry JD. Mumps Virus. In: Feigin RD, Cherry JD, eds. Textbook of Pediatric Infectious Disease. 2nd ed. Philadelphia, PA: WB Saunders; 1998:2075-83.

  17. Maldonado Y, Phillips C. Mumps. In: Behrman RE, ed. Nelson Textbook of Pediatrics. Philadelphia, PA: WB Saunders; 1996:873-75.

  18. McQuone SJ. Acute viral and bacterial infections of the salivary glands. Otolaryngologic Clinics of North America. Oct. 1999;32(5):793-811. [Medline].

  19. Ornoy A, Tenenbaum A. Pregnancy outcome following infections by coxsackie, echo, measles, mumps, hepatitis, polio and encephalitis viruses. Reprod Toxicol. May 2006;21(4):446-57. [Medline].

  20. Sosin DM, Cochi SL, Gunn RA, et al. Changing epidemiology of mumps and its impact on university campuses. Pediatrics. Nov 1989;84(5):779-84. [Medline].

  21. Taber LH, Demmler GJ. Mumps. In: McMillan JA, DeAngelis CD, Feigin R, Warshaw JB, eds. Oski's Pediatrics. Philadelphia, PA: Lippincott Williams & Wilkins; 1999:1141-2.

  22. van Loon FP, Holmes SJ, Sirotkin BI, Williams WW, Cochi SL, Hadler SC. Mumps surveillance--United States, 1988-1993. MMWR CDC Surveill Summ. Aug 11 1995;44(3):1-14. [Medline].

  23. Wharton M, Cochi SL, Williams WW. Measles, mumps, and rubella vaccines. Infect Dis Clin North Am. Mar 1990;4(1):47-73. [Medline].

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Further Reading

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Keywords

mumps, parotitis, epidemic parotiditis, measles-mumps-rubella vaccine, MMR vaccine, mumps virus, mumps encephalitis, meningitis, transient myelitis, polyneuritis, oophoritis, myocarditis, nephritis, arthritis, thyroiditis, pancreatitis, thrombocytopenia purpura, mastitis, pneumonia, parotitis, orchitis, meningoencephalitis

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Contributor Information and Disclosures

Author

Cem S Demirci, MD, Fellow in Endocrinology, Children's Hospital of Pittsburgh
Disclosure: Nothing to disclose.

Coauthor(s)

Walid Abuhammour, MD, FAAP, Associate Professor of Pediatrics, Michigan State University; Director of Pediatric Infectious Disease, Department of Pediatrics, Hurley Medical Center
Walid Abuhammour, MD, FAAP is a member of the following medical societies: American Medical Association and Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Medical Editor

Gary J Noel, MD, Department of Pediatrics, Clinical Associate Professor, Weill Medical College of Cornell University
Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Mark R Schleiss, MD, American Legion Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School
Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

CME Editor

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; sanofi pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association
Disclosure: None None None

 
 
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