Mumps, orchitis and male fertility problems

Mumps, also known by the term “mumps”, is a contagious and widespread viral infection before the introduction of the trivalent vaccine (MMR vaccine = measles, mumps, rubella ).

It is generally a childhood disease, affecting children between the ages of five and nine. However, the mumps virus can also infect adults and when this occurs, even serious complications such as meningitis (up to 15% of cases), orchitis and deafness can occur . Very rarely, mumps can cause encephalitis and permanent neurological damage.

How does mumps manifest itself?

The disease manifests itself with a very pronounced and painful swelling of the parotid glands located on the sides of the face under the ears.

Other symptoms of mumps include headache, joint pain, and high fever, all of which can develop a few days before the parotid glands become swollen.

The diagnosis must always be made by the attending physician also to exclude pathologies with similar symptoms but also with serious courses.

How is it transmitted?

It is transmitted in the same way as colds and flu, through droplets of infected saliva that can be inhaled or picked up from surfaces and transferred to the mouth or nose. A person is contagious for 6 days before symptoms appear and for 9 days after.
During this period, it is important to prevent the spread of the infection to others, especially adolescents and young adults who have not been vaccinated.

Precautions to be taken to reduce the risk of contagion

• wash your hands regularly with soap
• use disposable handkerchiefs
• avoid going to public places during illness

The best prevention remains vaccination . The first injection of the MMR vaccine is given around 13-15 months of age, and the booster is given at 6 years of age.

Once both doses are given, the vaccine provides 95% protection against mumps.

How is mumps treated?

There is no specific cure, except for the containment of fever and pain. The infection should clear up within a week or two.
To alleviate the symptoms, rest, antipyretic drugs and possibly painkillers are prescribed according to the indications of the attending physician.

Applying a warm or cool compress to the swollen glands can help ease the pain. Once infected with the mumps virus, lifelong immunity usually develops.

Complications

Mumps in most cases passes without causing serious harm to a person’s health. Serious complications are fortunately rare and are mainly the following:

• inflammation of the testicles (orchitis) in boys who have reached puberty this rarely leads to fertility problems
• encephalitis (0.02-0.3%)
• meningitis (0.5-15%): inflammation of the tissue covering the brain and spinal cord
• inflammation of the ovaries (oophoritis) and/or breast tissue (mastitis). It affects 5% of post-puberty women and can lead to infertility in half of the cases.
• deafness (5 cases per 100,000)
• pancreatitis (4%)

Mumps in pregnancy

Contagion during the first 12 weeks of pregnancy is associated with a high percentage of spontaneous abortions (25%), but does not involve the risk of malformations of the fetus. (ISS source)

Orchitis and male fertility

It is a painful inflammation that can affect one or both testicles.

Orchitis is the most common complication of mumps in postpubertal men, affecting about 20%-30% of male patients and in 10%-30% both testicles. Orchitis usually occurs 1-2 weeks after the onset of mumps.

In the first days of infection, the virus attacks the testicular glands, causing parenchymal inflammation, separation of the seminiferous tubules, and perivascular interstitial lymphocyte infiltration. The tunica albugenia forms a barrier against edema and the resulting increase in intratesticular pressure leads to pressure-induced testicular atrophy.

Of the affected testicles, 30%-50% show some degree of testicular atrophy.

Mumps-derived orchitis rarely leads to infertility but can contribute to subfertility. It can also cause oligospermia, azoospermia and asthenospermia (defects in the ability to move sperm). Unilateral disease can significantly, but only transiently, decrease sperm count, mobility, and morphology. Impaired fertility is estimated to occur in about 13% of patients, while 30%-87% of patients with bilateral orchitis caused by mumps have infertility.