Complications and Symptoms of Mumps in Men Complications and Symptoms of Mumps in Men Search the site Complications and Symptoms of Mumps in Men In Men, Mumps Can Cause Orchitis or Testicular Swelling By Jerry Kennard Updated September 05, 2016 Mumps is an acute viral infection that is most common in the winter and spring. Mumps is more common in children but riskier in older children and can, in rare cases, cause long term and life-threatening complications in men. How Mumps Spreads Mumps is spread through contact with infected saliva or discharges from the nose or throat of infected people, usually through sneezing and coughing. Incubation Period for Mumps The usual incubation period for mumps is between 16 to 18 days although this period may vary between 12 to 25 days. When a Person With Mumps is Contagious A person who has mumps is contagious (can pass on the virus) for the 3 days before signs and symptoms become evident and for 4 days after the onset of them. Mumps is less contagious than measles or chickenpox but as contagious as flu and rubella.

Signs and Symptoms of Mumps Symptoms of mumps include the following: Fever Headache Tenderness of one or more of the salivary glands close to the jaw. The parotid gland located in front of the ear is the most commonly affected gland. Complications of mumps Complications of mumps, although potentially very serious, are quite rare. In men these complications include: Orchitis : is an inflammatory condition that causes swelling of one or both testicles. Orchitis although painful rarely leads to sterility. Meningitis: is infection and inflammation of the membranes and fluid surrounding the brain and spinal cord. Meningitis is a rare complication of mumps but can be life threatening. Encephalitis: is inflammation of the brain caused by a viral infection , in this case, mumps. Encephalitis is a serious but rare complication of mumps but can be life threatening. Pancreatitis : is a complication of mumps that causes swelling of the pancreas. Hearing loss : is a rare complication of mumps. Mumps can cause temporary or permanent hearing loss in one or both ears. Immunity From Mumps Once you have had mumps you acquire immunity.

This means people who have had mumps rarely get it again. If they do it is usually a much milder case of the illness. Adult Male Vaccination for Mumps There is a vaccine for mumps . This is usually administered in childhood. The vaccine is usually offered in combination with the vaccine for measles and mumps. High immunization rates in your local community provide good protection for adults and children. Unfortunately the rates of mumps are increasing because the MMR (measles mumps and rubella) vaccine has been linked with autism. This link is far from proven. Not all adults will need to consider having a vaccination against mumps (MMR). This includes you if: A blood test shows you already have immunity to mumps If you have already have had 2 doses of the MMR vaccine If you have already had 1 dose of MMR and a second dose of measles vaccine You have had one dose of MMR vaccine and are not at high risk of becoming exposed to the disease If you are a man who was born before 1957 you do not requires the vaccine.

It is advisable for adults to have the MMR vaccine if you are a health worker, a college student, in the military or are traveling abroad where you are more likely to come into contact with mumps. The vaccine is not recommended for people who have had a life-threatening allergic reaction to gelatin or the antibiotic neomycin, if you have had cancer, a blood disorder, or another disease that affects your immune system. If this profile fits you then you must consult your doctor before making the decision to have an MMR vaccine. MMR Vaccine Adverse Effects The great majority of people who have the MMR vaccine or the mumps vaccine experience no side effects at all. In 1 out of 1,000,000 doses, the recipient experiences a serious allergic reaction. Ten percent experience fever that occurs within between 5 to 12 days following the vaccination. Five percent of people develop a mild rash. Treatment for mumps Self-care, unless you get complications, is best. There is not much the doctor can do. Take yourself to bed if you have a fever and take things easy. You can take aspirin or ibuprofen to help bring down the fever and ease any muscle discomfort.

Eat what you fancy and drink plenty of fluids. Have someone nice look after you! Continue Reading Mumps | Complications | CDC Complications Mumps can occasionally cause complications, especially in adults. Complications include: inflammation of the testicles (orchitis) in males who have reached puberty; rarely does this lead to fertility problems inflammation of the brain (encephalitis) inflammation of the tissue covering the brain and spinal cord (meningitis) inflammation of the ovaries (oophoritis) and/or breast tissue (mastitis) deafness Eastern Illinois University :: Health Service - Mumps Information CDC, "Outbreak-Related Questions and Answers for Patients" Overview Mumps is an infection caused by the mumps virus. Anyone who is not immune from either previous mumps infection or from vaccination can get mumps. Before the routine vaccination program was introduced in the United States, mumps was a common illness in infants, children and young adults. Because most people have now been vaccinated, mumps is now a rare disease in the United States. Of those people who do get mumps, up to half have very mild, or no symptoms, and therefore do not know they were infected with mumps.

Symptoms The most common symptoms are fever, headache, muscle aches, tiredness and loss of appetite followed by onset of parotitis (swollen and tender salivary glands under the ears - on one or both sides). Mumps can lead to hearing loss, aseptic meningitis (infection of the covering of the brain and spinal cord) in about 10% of cases, painful, swollen testicles in 20% to 30% of males who have reached puberty (orchitis) but rarely does this lead to fertility problems, and painful swollen breasts in about 30% of women who have reached puberty (mastitis), and in a very few cases, inflammation of the ovaries. Inflammation of the brain and/or tissue covering the brain and spinal cord (encephalitis/meningitis) Inflammation of the testicles (orchitis) Inflammation of the ovaries and/or breasts (oophoritis and mastitis) Spontaneous abortion particularly in early pregnancy (miscarriage) Deafness, usually permanent (usually in children) Symptoms typically appear 16-18 days after infection, but this period can range from 12-25 after infection.

How mumps is spread Mumps is spread by mucus or droplets from the nose or throat of an infected person, usually when a person coughs or sneezes. Surfaces of items (e.g. desks) can also spread the virus if someone who is sick touches them without washing their hands, and someone else then touches the same surface and then rubs their eyes, mouth, nose etc. (this is called fomite transmission). Mumps virus has been isolated from respiratory secretions 3 days before the start of symptoms until 9 days after onset. Treatment and Protection There is no specific treatment. Supportive care should be given as needed. If someone becomes very ill, they should seek medical attention. If someone seeks medical attention, please contact the EIU Medical Clinic in advance by calling 217.581.2727. Please call in advance and do not walk in unannounced so that you don't have to sit in the waiting room for a long time and possibly infect other patients. Mumps vaccine (usually MMR), is the best way to prevent mumps. Other things people can do to prevent mumps and other infections is to wash hands well and often with soap,.

Eating utensils should not be shared, and surfaces that are frequently touched (toys, doorknobs, tables, counters, etc) should also be regularly cleaned with soap and water, or with cleaning wipes. Mumps Vaccine Two doses of mumps-containing vaccine, given as combination measles, mumps, rubella (MMR) vaccine, separated by at least 28 days, are routinely recommended for all children. The first dose is given on or after the first birthday; the second is given at 4 - 6 years of age. MMR is a live, weakened (attenuated) vaccine. Most adults who have not been vaccinated should also receive 1 dose of MMR vaccine, but adults who work in healthcare, a school/university setting, and persons at high risk of exposure to mumps should get 2 doses. Pregnant women and persons with an impaired immune system should not receive live attenuated vaccines (MMR vaccine). One dose of mumps vaccine will ‘take' (be effective) in approximately 80% of people vaccinated, but two doses of mumps vaccine will ‘take' in approximately 90% of people. Therefore, two doses are better at preventing mumps than one dose.

Where to get vaccinated Most family and pediatric doctors keep vaccine in their clinics; and local health departments usually have vaccine. If someone isn't sure where to get vaccine, they can call the local or state health department. For more information, please call EIU Health Service at 217.581.2727. EIU Health Service does have the MMR vaccine. Please, keep in mind that all EIU students taking 6 or more credit hours on campus must have shown proof of two doses of MMR prior to re-enrollment. The MMR vaccine is safe and there is no increased risk of side effects if a person gets another vaccination. Exposure Not everyone who is exposed to someone with mumps will get sick. If a person has been vaccinated with two doses of mumps vaccine, it is very unlikely they will get mumps. However, if a person hasn't been vaccinated, it is possible they could get sick and they should watch for symptoms of mumps. Additionally, if a person hasn't been vaccinated, this is a good time to get another dose of mumps vaccine, and to make sure that everyone else in the house where they live is also vaccinated.

Mumps vaccine has not been shown to be effective in preventing disease after exposure, but vaccination of exposed susceptible persons will reduce the risk of disease from possible future exposures. If symptoms develop (generally 16-18 days after exposure), the person should not go to school or work for at least 9 days and should contact their medical provider. Information on the Midwest Outbreak Q: How many cases usually occur in the US each year? A: In the United States , since 2001, an average of 265 mumps cases (range: 231-293) have been reported each year. March 30, 2006 [55(13);366-368] ) Q: When did the outbreak in the Midwest start? A: The first cases of mumps-like illness were reported from Iowa in December 2005. More cases have been occurring since then in Iowa, and in several other states. (See CDC's Report on Recent Mumps Outbreak.) Q: Where did the outbreak in the Midwest start? A: The current information indicates that the outbreak may have begun on a college campus.

Colleges that have group living, dining, studying, and sports are areas that make disease transmission more likely, and increase the chance of outbreaks. Once started, such outbreaks sometime spread to the community, causing illness in persons who do not attend college. For this reason, CDC recommends that all college students have two doses of measles-mumps-rubella (MMR) vaccine. Currently, it has spread to several states including Illinois. Additionally, some universities have had confirmed cases within Illinois. Q: Why are people who have been vaccinated getting sick? A: One dose of mumps vaccine prevents approximately about 80% of mumps and two doses approximately about 90% of cases. Even though the vaccine is effective, if most persons in a population are vaccinated, most cases in an outbreak would also be expected to be vaccinated. However, if the vaccine hadn't been used, the outbreak would have affected everyone, rather than a small percent of the population. Q: Does the current vaccine work against the mumps virus that is causing the outbreak? A: Yes.

The strain of mumps virus in the Midwest is the same as the one that is found in other countries, and that caused a large ongoing outbreak in the United Kingdom (UK) with more than 60,000 cases. In 2005 a small mumps outbreak occurred in the US after a person visited from the UK and mumps vaccine was effective in preventing this outbreak. Q: What can be done to stop the spread of mumps? A: Anyone with mumps should not go back to child care, school or work for 9 days after symptoms begin. People who come in contact with a mumps case should have their immunization status evaluated. Anyone who has not received mumps-containing vaccine (preferably MMR vaccine) should be vaccinated. Persons who may have been in contact with a mumps case should be educated on the signs and symptoms of mumps disease and should seek medical attention if any of these symptoms begin.

Charleston, IL 61920 | (217) 581-5000 | webmaster@eiu.edu Mumps: Causes, Diagnosis, and Treatment - Medical News Today Mumps: Causes, Diagnosis, and Treatment Written by Mike PaddockReviewed by Deborah Weatherspoon, PhD, MSN, CRNA, COI 4 3 Mumps is an extremely contagious viral infection of the salivary glands that most commonly affects children. The most obvious symptom is swelling of one or both of the salivary glands on the sides of the face. These glands are called the parotid glands, when they swell, the patient develops a "hamster-like" face. Sometimes the mumps virus can also cause inflammation of the testis, ovary, pancreas, or meninges. Once someone has had mumps, they usually become immune to future infections. To reduce the spread of mumps, the MMR ( measles , mumps, and rubella) vaccine is often given at an early age to help the body become immune to the virus. Since the MMR vaccination was brought in, there has been a 99 percent decrease in mumps cases in the United States.

Fast facts on mumps Here are some key points about mumps. More detail and supporting information is in the main article. Mumps is extremely contagious Pain in joints Reduced appetite Rarely, adults can contract mumps. In these cases, the symptoms are generally the same, but sometimes slightly worse. Causes of mumps Mumps is due to an infection by the mumps virus. It can be transmitted by respiratory secretions (e.g. saliva) from a person already affected with the condition. When contracting mumps, the virus travels from the respiratory tract to the salivary glands and reproduces, causing the glands to swell. Examples of how mumps can be spread include: Sneezing or coughing Using the same cutlery and plates as an infected person Sharing food and drink with someone who is infected Kissing Someone infected touching their nose or mouth and then passing it onto a surface that someone else may touch Individuals infected with the mumps virus are contagious for approximately 15 days (6 days before the symptoms start to show, and up to 9 days after they start). The mumps virus is part of the paramyxovirus family, a common cause of infection, especially in children.

Tests and diagnosis of mumps Normally, mumps can be diagnosed by its symptoms alone, especially by examining the facial swelling. In addition to examining this area and taking a note of the symptoms, a doctor might: Check inside the mouth to see the position of the tonsils - when infected with mumps, a person's tonsils can get pushed to the side Take the patient's temperature Take a sample of blood, urine, or saliva for testing Take a sample of CSF (cerebrospinal fluid) from the spine for testing - this is usually only in severe cases Treatment for mumps Because mumps is viral, antibiotics cannot be used to treat it, and at present, there are no anti-viral medications that can treat mumps. Current treatment can only help relieve the symptoms until the infection has run its course and the body has built up an immunity, much like a cold. In most cases, people recover from mumps within 2 weeks. Steps that can be taken to help relieve the symptoms of mumps include: Consuming plenty of fluids, ideally water - avoid fruit juices as they stimulate the production of saliva, which is painful for someone with mumps. Putting something cold on the swollen area to alleviate the pain.

Eating mushy or liquid food as chewing will also be painful. Getting sufficient rest and sleep. Gargling warm salt water. Taking painkillers such as acetaminophen or ibuprofen. Prevention of mumps The MMR vaccine prevents mumps, measles, and rubella. The mumps vaccine is the best method for preventing mumps; it can come on its own or as part of the MMR vaccine. The MMR vaccine also defends the body from rubella and measles. The MMR vaccine is given to an infant when they are just over 1 year old and again, as a booster, just before they start school. Anyone born after the 1990s would most probably have been given the MMR vaccine but if unsure it is always advised to check with a doctor. The mumps vaccine is routinely given to children in 82 countries. In many of these countries, encephalitis and deafness related to mumps have nearly disappeared. An adult can be given the MMR at any age; a doctor may advise someone to take the vaccine before traveling abroad to certain areas of the globe.

These areas include: India Japan Pakistan Other reasons someone may be advised to have the MMR vaccine in adulthood is if they are: Working in healthcare e.g. hospital or medical facility Working or attending somewhere with lots of young people, such as a college Working in a school or around lots of children If suffering from cancer or a disease that lowers the immune system, a doctor would need to be consulted before the MMR vaccine is considered. Individuals are not advised to have the MMR vaccine if: The patient's immune system is seriously compromised The patient has had an allergic reaction to neomycin (a type of antibiotic ) or gelatin The patient is pregnant or soon to be pregnant (in the next four weeks) MMR vaccine side effects Most people given the MMR vaccine do not suffer side effects, and the disease itself cannot be contracted from the vaccine. A small percentage might develop a rash or fever and possibly aches in their joints. Less than one in a million will suffer a severe allergic reaction from the MMR vaccine.

Preventing the spread of mumps There are a number of precautions that will help prevent the spread of infection; these are as follows: Washing hands with water and soap frequently Not going into work/school until 5 days after the symptoms start Covering the nose and mouth with a tissue when sneezing or coughing Complications of mumps Complications are more frequent in adults than children, the most common are: Orchitis - testicles swell and become painful, this happens to 1 in 5 adult males with mumps. The swelling normally diminishes within 1 week; tenderness can last longer than that. This condition rarely results in infertility. Oophoritis - ovaries swell and are painful, this is even less frequent than orchitis and occurs in 1 in 20 adult females. The swelling will subside as the immune system fights off the virus. This rarely results in infertility. Viral meningitis - this is one of the rarest of the common complications. It happens when the virus spreads through the bloodstream and infects the body's central nervous system (brain and spinal cord).

Inflamed pancreas - pain will be experienced in the upper abdomen; this occurs in 1 out of 20 cases and is usually mild. If a pregnant woman contracts mumps within the first 12-16 weeks of her pregnancy, she will have a slightly increased risk of miscarriage. Rarer complications of mumps include: Encephalitis - the brain swells causing neurological issues. In some cases, this can be fatal. This is a very rare risk factor and affects just 1 in 6,000 cases. Hearing loss - this is the rarest of all the complications affecting just 1 in 15,000. As rare as some of these complications are, it is important to seek medical advice or help if an individual suspects they, or their child, are developing any of them. Written by Mike Paddock Click the stars to rate this article Mumps: Causes, Diagnosis, and Treatment Public / Patient Mumps - Complications - NHS Choices Mumps - Complications Mumps Complications Complications of mumps There are several problems that often occur with mumps. These can be worrying, but they're rarely serious and usually improve as the infection passes.

Common complications Swollen testicle Pain and swelling of the testicle (orchitis) affects one in four males who get mumps after puberty. The swelling is usually sudden and affects only one testicle. The testicle may also feel warm and tender. In affected boys and men, swelling of the testicle normally begins four to eight days after the swelling of the parotid gland. Occasionally, swelling can occur up to six weeks after the swelling of the glands. Any testicle pain can be eased using over-the-counter painkillers such as paracetamol or ibuprofen . If the pain is particularly severe, contact your GP, who may prescribe a stronger painkiller for you. Applying cold or warm compresses to your testicle and wearing supportive underwear may also reduce any pain. Just under half of all males who get mumps-related orchitis notice some shrinkage of their testicles and an estimated 1 in 10 men experience a drop in their sperm count (the amount of healthy sperm their body can produce). However, this is very rarely large enough to cause infertility .

Swollen ovaries One in 20 females who get mumps after puberty experience swelling of the ovaries (oophoritis), which can cause: lower abdominal pain high temperature being sick Mumps | For Healthcare Providers | CDC For Healthcare Providers From the Merck Manual Consumer Version, edited by Robert Porter. Copyright 2015 by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co, Inc, Kenilworth, NJ. Available at merckmanuals.com . Accessed June 2015. The Virus Mumps is a viral illness caused by a paramyxovirus, a member of the Rubulavirus family. The average incubation period for mumps is 16 to 18 days, with a range of 12 to 25 days. Clinical Features Mumps usually involves pain, tenderness, and swelling in one or both parotid salivary glands (cheek and jaw area). Swelling is first visible in front of the lower part of the ear. It then extends downward and forward as fluid builds up in the skin and soft tissue of the face and neck. Swelling usually peaks in 1 to 3 days and then subsides during the next week.

The swollen tissue pushes the angle of the ear up and out. As swelling worsens, the angle of the jawbone below the ear is no longer visible. Often, the jawbone cannot be felt because of swelling of the parotid. One parotid may swell before the other, and in 25% of patients, only one side swells. Other salivary glands (submandibular and sublingual) under the floor of the mouth also may swell but do so less frequently (10%). Nonspecific prodromal symptoms may precede parotitis by several days, including low-grade fever which may last three to four days, myalgia, anorexia, malaise, and headache. Fever may persist for 3 to 4 days. Parotitis, lasts at least 2 days, but may persist longer than 10 days. However, mumps infection may present only with nonspecific or primarily respiratory symptoms, or may be asymptomatic. Mumps infection is most often confused with swelling of the lymph nodes of the neck.

Lymph node swelling can be differentiated by the well-defined borders of the lymph nodes, their location behind the angle of the jawbone, and lack of the ear protrusion or obscuring of the angle of the jaw, which are characteristics of mumps. People with mumps are usually considered most infectious for several days before and after onset of parotitis. Parotitis and Flu While not a common symptom of flu, swelling of their salivary glands (parotitis) has been reported in persons with laboratory-confirmed influenza infections. To learn more, see 2016-2017 Influenza Update for Health Care Providers: Parotitis and Influenza . Top of Page Background Before there was a vaccine against mumps, the disease was common in the United States and caused complications, such as permanent deafness in children, and occasionally, encephalitis, which could result in death, although very rarely. Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year, and many more unreported cases occurred.

Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases in the United States. From year to year, the number of mumps cases can range from roughly a couple hundred to a couple thousand. However, outbreaks still occasionally occur. In 2006, there was an outbreak affecting more than 6,584 people in the United States, with many cases occurring on college campuses. In 2009, an outbreak started in close-knit religious communities and schools in the Northeast, resulting in more than 3,000 cases. These outbreaks have shown that when people who are sick with mumps have close contact with a lot of other people (such as among students living in dormitories and students and families in close-knit communities) mumps can spread even among vaccinated people. However, outbreaks are much larger in areas where vaccine coverage rates are lower. Transmission The mumps virus replicates in the upper respiratory tract and spreads through direct contact with respiratory secretions or saliva or through fomites. The risk of spreading the virus increases the longer and the closer the contact a person has with someone who has mumps.

When a person is ill with mumps, he or she should avoid contact with others from the time of diagnosis until at least 5 days after the onset of parotitis by staying home from work or school and staying in a separate room if possible. Top of Page Complications Some complications of mumps are known to occur more frequently among adults than children. Death from mumps is exceedingly rare. In recent U.S. mumps outbreaks (2006, 2009 to 2010), orchitis occurred in 3.3 to 10% of adolescent and adult males. In 60% to 83% of males with orchitis caused by mumps, only one testis is affected. Such orchitis, even bilaterally, very rarely causes sterility. Among adolescent and adult females in recent outbreaks, mastitis rates have been ≤1% and oophoritis rates have been ≤1%. Other rare complications of mumps include pancreatitis, deafness, meningitis, and encephalitis, which have occurred in less than 1% of cases in recent U.S. outbreaks. There have been no mumps related deaths reported in the United States during recent mumps outbreaks.

Mumps during Pregnancy Like other infections, there is a theoretical risk that mumps during the early months of pregnancy may cause complications. One study from 1966 that was conducted before the introduction of MMR vaccine reported an association between mumps infection during the first trimester of pregnancy and an increase in the rate of spontaneous abortion or intrauterine fetal death 1 , but was not found in a more recent study 2 . Another study with methodological flaws showed that congenital malformations may occur from mumps during pregnancy, but because the author did not compare rates with infants born to women not affected with mumps, these findings must be interpreted with caution 3 ; other papers have not reported similar findings 4 . Learn more about preventing infections during pregnancy . Vaccination Vaccination is the best way to prevent mumps. This vaccine is included in the combination measles-mumps-rubella (MMR) and measles-mumps-rubella-varicella (MMRV) vaccines. Two doses of mumps vaccine are 88% (range 66% to 95%) effective at preventing the disease; one dose is 78% range (49% to 91%) effective.

The first vaccine against mumps was licensed in the United States in 1967, and by 2005, high two-dose childhood vaccination coverage reduced disease rates by 99%. The MMR vaccine protects against currently circulating mumps strains. See Mumps Vaccination for vaccination recommendations for different groups. Top of Page Case Classification For information about how to classify mumps cases, visit the National Notifiable Diseases Surveillance System (NNDSS) page for mumps or the Laboratory Testing Section of the Manual for the Surveillance of Vaccine-Preventable Diseases (5th Edition, 2012), Chapter 9: Mumps . Reporting Mumps Cases Each state and territory has regulations or laws governing the reporting of diseases and conditions of public health importance. These regulations and laws list the diseases that are to be reported and describe those people or groups responsible for reporting, such as healthcare providers, hospitals, schools, laboratories, daycare and childcare facilities, and other institutions.

For information about reporting mumps cases to CDC, see the Reporting Section of the Manual for the Surveillance of Vaccine-Preventable Diseases (5th Edition, 2012), Chapter 9: Mumps Mumps in Vaccinated People During mumps outbreaks in highly vaccinated communities, the proportion of cases that occur among people who have been vaccinated may be high (see example below). This should not be interpreted as meaning that the vaccine is not effective. The effectiveness of the vaccine is assessed by comparing the attack rate in people who are vaccinated with the attack rate in those who have not been vaccinated. In outbreaks in highly vaccinated populations, people who have not been vaccinated against mumps usually have a much greater mumps attack rate than those who have been fully vaccinated. Vaccination and Mumps Outbreak: an Example Example: Let’s say that an outbreak occurs among 1,000 people and that 950 of these 1,000 people have received two doses of the vaccine and 50 are unvaccinated (i.e., vaccine coverage is 95%). If there is a 30% attack rate among people who haven’t been vaccinated, 15 unvaccinated people would get the disease.

Among the 950 vaccinated people, the attack rate would be 3%, so 29 vaccinated people would get the disease. Therefore, of the 44 people who got sick during the outbreak, the majority (29, or 66%) would have been vaccinated. This doesn’t imply that the vaccine didn’t work. In fact, the people who hadn’t been vaccinated were 10 times more likely to get sick as those who had been vaccinated, it’s just that there were a lot fewer unvaccinated people at risk. Furthermore, if none of the 1,000 people had been vaccinated, the outbreak would have resulted in 300 cases rather than only 44. In this scenario, we would say that the vaccine is 90% effective in preventing the disease after two doses, which is the same as saying that the attack rate in the unvaccinated group is 10 times higher than the attack rate among people who have received two doses of vaccine. The formula to calculate vaccine effectiveness is (attack rate in unvaccinated group minus attack rate in vaccinated group) divided by attack rate in unvaccinated group, or (ARU-ARV)/ARU.

Mumps Guide: Causes, Symptoms and Treatment Options Mumps What Is It? Mumps is an infection with a virus that causes swelling of the parotid glands in front of each ear. The parotid glands make saliva. Mumps is caused by the mumps virus, a type of paramyxovirus that spreads from person to person through coughs, sneezes and saliva, as well as through contact with contaminated items and surfaces (used tissues, shared drinking glasses, dirty hands that touched a runny nose). Once the mumps virus enters the body, it passes into the bloodstream and can spread to many different glands and to the brain: Salivary glands — Mumps causes pain and swelling in the parotid gland and in other salivary glands located under the tongue and jaw. Testes — In the testes, mumps infection can cause swelling, pain, tenderness and, sometimes, permanent shrinkage (atrophy), although it rarely causes sterility. Ovaries — In women, mumps infection of the ovaries can cause pain in the lower abdomen but doesn't lead to infertility. Pancreas — The mumps virus may cause inflammation and infection of the pancreas and abdominal pain.

Brain — Once it enters the bloodstream, the mumps virus also can travel to the brain, where it may cause meningitis (inflammation and infection of membranes covering of the brain) and encephalitis (brain infection). This brain involvement (which is very rare) sometimes leads to long-term complications, such as deafness, paralysis (weakness, especially of facial muscles), hydrocephalus and seizures. Rarely, the mumps virus can affect other parts of the body, such as the joints, thyroid gland or lungs. When a pregnant woman develops mumps, there may be some increased risk of fetal death and miscarriage if the mother is in her first trimester. However, the infection probably does not increase the risk of birth defects. People with mumps are contagious during a period that begins 48 hours before and ends 6 to 9 days after the beginning of the mumps symptoms. Before an effective vaccine became available in the late 1960s, there were almost 190,000 reported cases of mumps each year in the United States.

Now, thanks to the mumps vaccine, the number of annual cases has decreased by more than 99%, so that only 1 out of 1 million people in the United States gets mumps. Symptoms In about 15% to 20% of patients, mumps does not cause any symptoms. When symptoms occur, they usually begin 14 to 18 days after exposure to someone with a mumps infection. In about half of patients, symptoms of mumps infection may include fever, headache, sore throat, muscle aches, poor appetite and malaise (a general feeling of sickness). The mumps virus causes pain and swelling in front of the earlobe, called parotitis. Because of the pain of parotitis, chewing and swallowing may be very uncomfortable, and the patient may not feel like eating. Infrequently, male teenagers and adults with mumps can develop swelling and pain in one or both testes (orchitis). In women, the ovaries may be involved, which can cause lower abdominal pain.

In patients of either sex, but more commonly in adults than in children, there also may be more serious complications including: Mumps pancreatitis, which causes pain in the upper abdomen Aseptic (not bacterial) meningitis, which causes headache, stiff neck and drowsiness Mumps encephalitis, which causes high fever and unconsciousness, although this occurs in less than one in 1,000 patients with mumps Diagnosis Your doctor will ask about your exposure to any person who is known to have mumps or facial swelling. Even if you did not have face-to-face contact with this person, your doctor will want to know if you attended the same school, lived in the same household or dormitory, or worked in the same building. Your doctor also will want to know whether you were immunized against mumps, when you were immunized, and the number of doses of mumps vaccine you received. Mumps vaccine often is given as part of the measle/mumps/rubella vaccine, or MMR, shot. Your doctor will suspect that you have mumps if you have had tender parotid swelling on both sides for at least two days and if you have a history of being exposed to someone with mumps.

In patients without parotid swelling, the diagnosis can be confirmed with blood tests that measure specific antibodies (defensive proteins made by the immune system) against the mumps virus. Also, the mumps virus itself may be detected in samples of urine, saliva or cerebrospinal fluid (fluid surrounding the brain and spinal cord), which is obtained with a lumbar puncture, or spinal tap. Expected Duration Symptoms of mumps generally last about 10 days. Once you recover, you usually are immune from getting the mumps virus for the rest of your life. Prevention You can prevent mumps with the mumps vaccine, which is usually given as part of the MMR combination. This live-virus vaccine generally is not recommended for pregnant women or for patients who are taking certain medications or have medical problems that suppress the immune system. Because patients with mumps are contagious for about 48 hours before they develop symptoms, it usually is not necessary to isolate them from other members of the household once symptoms begin. This is because family members probably were exposed to the virus during that 48-hour period before symptoms began. Children with mumps usually are excluded from school or child care for five days after parotid gland swelling begins.

Local public health officials usually are involved to help control outbreaks. Treatment In patients who are generally healthy, the symptoms of mumps are treated with: Acetaminophen ( Tylenol ) to reduce fever and relieve general body discomfort Warm or cold compresses to relieve pain and swelling in the parotid glands A soft diet to reduce the need for chewing — avoid fruit juices and tart beverages that stimulate the salivary glands and make gland pain worse Cool compresses and support for the scrotum to reduce pain and swelling in the testicles Aspirin should not be used in children with mumps because of the risk of Reye's syndrome, a serious brain problem that develops in children who have certain viral illnesses and have been treated with aspirin. When To Call a Professional Call your doctor if you or someone in your family develops symptoms of mumps, even if they have been vaccinated against mumps. Also, if a mumps outbreak occurs in your school or workplace, call your doctor to determine if you are immune to mumps. If you are a woman who is considering becoming pregnant, be certain that your immunizations are up to date. Prognosis People recover completely from mumps.

In males, there is a small risk of sterility if the infection affects both testicles (bilateral orchitis), but this is unusual. External resources National Center for Infectious Diseases Office of Health Communication Centers for Disease Control and Prevention Mailstop C-14 Mumps Complications - Mayo Clinic Complications of mumps are potentially serious, but rare. Inflammation Most mumps complications involve inflammation and swelling in some part of the body, such as: Testicles. This condition, known as orchitis, causes one or both testicles to swell in males who've reached puberty. Orchitis is painful, but it rarely leads to sterility — the inability to father a child. Pancreas. The signs and symptoms of this condition, known as pancreatitis, include pain in the upper abdomen, nausea and vomiting. Ovaries and breasts. Females who've reached puberty may have inflammation in the ovaries (oophoritis) or breasts (mastitis). Fertility is rarely affected. Brain. A viral infection, such as mumps, can lead to inflammation of the brain (encephalitis). Encephalitis can lead to neurological problems and become life-threatening. Membranes and fluid around the brain and spinal cord.

This condition, known as meningitis, can occur if the mumps virus spreads through your bloodstream to infect your central nervous system. Other complications Hearing loss. In rare cases, mumps can cause hearing loss, usually permanent, in one or both ears. Miscarriage. Although it isn't proved, contracting mumps while you're pregnant, especially early on, may lead to miscarriage. Mumps. Centers for Disease Control and Prevention. Accessed July 24, 2015. Mumps. World Health Organization. Accessed July 24, 2015. Longo DL, et al., eds. Mumps. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: The McGraw-Hill Companies; 2015. Accessed July 24, 2015. Cunningham FG, et al. Infectious diseases. In: Williams Obstetrics. 24th ed. New York, N.Y.: The McGraw-Hill Companies; 2014. Accessed July 24, 2015. Mumps vaccination. Centers for Disease Control and Prevention. #notvacc.

Accessed July 24, 2015. Autism spectrum disorder (ASD). Centers for Disease Control and Prevention. Accessed July 24, 2015. AskMayoExpert. Mumps (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. NINDS Reye's syndrome information page. National Institute of Neurological Disorders and Stroke. Accessed July 24, 2015. Products and Services

Question: Mumps can spread, rarely, where in adult males, with permanent procreational effect?
Answer: Testicles