Acute Mumps Treatment & Management

Updated: Nov 06, 2015
  • Author: Yonatan Yohannes, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Treatment

Medical Care

Prehospital Care

Supportive care is usually all that is needed for patients with mumps.

Persons exposed to the virus should be counseled on vaccination and risks.

Emergency Department Care

Supportive care with analgesics and antipyretics as needed. Symptomatic treatment with warm and/or cold compresses over the parotid gland may also be comforting. and outpatient follow up is indicated for straightforward infections.

Complications due to mumps should be treated based on presentation, as follows:

  • Testicular ultrasonography for orchitis
  • Ice packs applied to scrotal area for swelling
  • Discharge with scrotal support and anti-inflammatory agents
  • Intravenous hydration for severe pancreatitis
  • Lumbar puncture for symptomatic meningitis or encephalitis
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Consultations

Consultations should be requested as needed for specific complications.

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Prevention

Vaccination remains the best protection. The Centers for Disease Control and Prevention posts the latest immunization schedules on their Web site.

All children older than 1 year and all adults should receive the full two-dose mumps vaccine unless contraindicated. The vaccine is live and is prepared within a chicken embryo and usually given as the mumps, measles, and rubella (MMR) vaccine. Groups who are of concern include those with severe egg allergies, pregnant women, and people who have high fevers or other severe illness or in the immunocompromised host.

If the history of being infected with the mumps virus or vaccination status is questioned, blood tests may be performed to check antibody levels or the vaccine should simply be administered. A third dose of MMR vaccine in the setting of an outbreak may be considered, as evidence has shown that it can help control mumps outbreaks among populations with high two-dose vaccine coverage. [19]

The main reported adverse reactions to the vaccine have been pain, redness, and swelling at the injection site; joint or muscle aches; fevers; and, rarely, parotitis. Other more serious reported complications include CNS effects, such as deafness, febrile seizures, [20] and encephalitis, which are extremely rare and should not deter vaccination.

Acute mumps in an individual and/or community may result from a combination of factors, including incomplete vaccination, waning immunity over time (≥10 years since vaccination), and/or antigenic variation of mumps viruses. [21]

Current evidence suggests that patients diagnosed with mumps should be isolated with standard and droplet precautions in a hospital setting for 5 days from the onset of parotitis, including the exclusion of healthcare personnel from work during this period. Transmissibility is greatest immediately after onset of parotitis and decreases rapidly over the subsequent 5 days. Transmission may also occur from patients prior to development of parotitis or with subclinical mumps. [22]

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Further Inpatient Care

Patients with specific complications may require further inpatient care.

Persons with encephalitis, meningitis, nephritis, myocarditis, or severe pancreatitis require inpatient management and monitoring.

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Further Outpatient Care

Classic mumps with no major complications can be managed on an outpatient basis with supportive care and good follow up.

Current evidence suggests that patients diagnosed with mumps should be isolated for 5 days from the onset of symptoms. [22]

Scrotal support, ice, and analgesia are indicated.

Hearing testing is performed upon resolution of symptoms.

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Transfer

Transfer is rarely needed. Indication to transfer would be if major complications are present and current hospital does not have appropriate services to treat the patient appropriately.

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