So how do we manage mumps?
Well, unfortunately there's no specific antiviral treatment for mumps.
Antibiotics are not effective because remember, this is a viral illness.
You're gonna provide your patient with supportive care.
This means proper nutrition and adequate fluid intake.
You wanna treat their dehydration if this is present and you wanna encourage warm saltwater gargles.
I have patients just mix up a warm cup of saltwater and gargle it in the back of their throat
and swishing their their mouth and this can feel a little bit better.
Patients can have tylenol or ibuprofen.
Ibuprofen, remember, is only safe in older than 6 month-olds.
And remember, no aspirin in children under 18 because this can cause Reye syndrome
which is a rare but serious condition that causes swelling in the liver and brain.
And after a patient had mumps, the administration of post-exposure vaccine
or immunoglobulin is unfortunately not effective.
So we need to prevent the spread. There are two ways. The first is isolation.
Remember, your patient is most contagious in the 5 days after the onset of their symptoms
so you wanna keep all unvaccinated people away.
And then the second is through vaccination.
This happens at the 12 month vaccines and then again around kindergarten.
Here we can see the effect of the mumps vaccine.
When it was first developed, there was a dramatic drop
and then it was combined into the MMR vaccine and there was a further drop which has been holding steady
but lately, we've seen a little bit of bumps as it's not providing total protection
and we know that the protection wanes.
So in developed countries, we give this at 12 months. This is the MMR vaccine.
And then again at 4-5 years with a booster.
And this sort of reminds the body that it does have that antibody protection.
Adverse reactions are rare and the patient may get pain at the injection site and fever.
Vaccination rates have been high enough to make mumps a relatively uncommon infection.
We also look for herd immunity and this is promoting and preserving widespread immunity.
Since the introduction of the mumps vaccine, infectious causes of mumps
have been virtually eliminated in the United States
even though not everyone has been vaccinated.
This effect is what we call herd immunity.
But herd immunity might be weakening a bit likely due to the drop in vaccination rates.
The incidents of mumps in the United States has increased significantly.
Here we see an example. On the left, two patients have mumps
and if no one in the community is immunized,
this contagious disease is gonna spread through the population.
In the middle, we have a different scenario.
Some people are immunized and most aren't.
This contagious disease is gonna spread through some of the population.
And then on the right, we see the best case scenario. This is herd immunity.
This is where most of the population is immunized.
There's containment of the infectious spread.
There are a lot of complications from mumps and one is orchitis.
This is painful testicular inflammation.
This is going to occur in 15-40% of men who have completed puberty and contract mumps.
It's generally unilateral and it's typically 10 days after the parotid swelling.
Fortunately, there's decrease fertility is uncommon and this is why you want to do a full exam
on your male patients that you're suspecting may have mumps.
They may have a decrease in their parotitis by the time they come in
but this is when they may have maximum orchitis symptoms.
Other complications include spontaneous abortion, aseptic meningitis, encephalitis, oophoritis
which is ovarian inflammation and this happens in about 5% of adolescent and adult females.
Acute pancreatitis will occur in about 4% of cases and brain inflammation,
this is very rare but it is fatal.
Patients can also experience profound hearing loss. It can be unilateral or bilateral.