The consequences of mumps

Mumps was a common childhood disease when I was a child. We grew up learning that it was better to get mumps as a child because getting it as an adult would make you sterile. No doubt that idea arose from symptoms like swollen glands, swollen testicles, etc. When I looked in PubMed though, I couldn't find much data on sterility (at least not easily).

I did find data on hearing loss.

Death is not a common outcome of mumps. Between 1953 and 1962, there were 162,344 cases of mumps in the U.S. every year and only 39 deaths per year. People, mostly children, did die from mumps, but other diseases had higher fatality rates. In 2004, there were no cases and no deaths. For some reason 2006 was strange. There was an outbreak among unvaccinated people with 6584 cases (1). Nobody died that year although 85 had to be hospitalized (2).

Why do we vaccinate children to protect them against mumps? With less than a hundred deaths per year, why do we care?

The argument could be made that preventing even a few deaths is worthwhile. I'm sure the parents of the lost children would have rather had the vaccine.

The argument can also be made that it's a good thing to prevent hearing loss. Deafness was a well-known consequence of a mumps infection. It's not lethal, but neither is it easy.

How much of a problem is this? We can learn from the other countries who have unintentionally done the experiment. In Japan, mumps vaccines are more optional than they are in the U.S. or Canada. This means that are larger groups of children who haven't been vaccinated. Their experience can teach us what happens when we don't vaccinate against this disease.

The Acute Profound Deafness Research Committee of the Japanese Ministry of Health wanted to know what happens to children who don't get vaccinated. They studied reports from three years; 1987, 1993, and 2001 and found 300, 400, and 650 cases of mumps-related deafness (3). They also reported that the hearing loss was often permanent.

Reference:

  1. Sandra W. Roush, MT, MPH; Trudy V. Murphy, MD; and the Vaccine-Preventable Disease Table Working Group 2007. "Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Diseases in the United States" JAMA 298:2155-2163.
  2. Dayan, G. et. al. 2008. Recent Resurgence of Mumps in the United States. NEJM Volume 358:1580-1589.
  3. Kawashima Y, Ihara K, Nakamura M, Nakashima T, Fukuda S, Kitamura K. 2005. Epidemiological study of mumps deafness in Japan. Auris Nasus Larynx. 2005 Jun;32(2):125-8.

More on mumps.

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As someone who didn't get mumps as a child, I'm really not too keen on finding out what the consequences for an adult male can be the hard way.

I didn't get chickenpox as a child either - when that one caught up with me at age 26, it was spectacularly unpleasant.

As a child in the mid-50's, I had mumps, measles, and chickenpox. I certainly remember the unpleasantness, but there were no lasting effects on me. I do remember one child on our street who had serious hearing damage from mumps.

I also recall pools and beaches being closed during polio scares, and someone down the street vanishing for some months into "the san" (tuberculosis sanatorium).

Among other shortcomings, the anti-vaccination crowd have no sense of history.

By Scott Belyea (not verified) on 28 Aug 2008 #permalink

In children that are pubescent or older about a third will develop a mumps orchitis (inflammation of the testes) that can result in testicular atrophy. That's the origin of the fertility issue, it is real, sterility can certainly occur.

I caught mumps at Ft. Chaffee while on active duty for training. I swole up like a chipmonk, but had no pain or other symptoms. I spent two weeks in a pleasant base hospital, then then had two weeks sick leave. So it worked out OK for me.

By Jim Thomerson (not verified) on 28 Aug 2008 #permalink

I was deafened by either mumps or measles - I had them close together when I was 2 so it is hard (ultimately futile) to ascribe responsibility to either. I had chronic ENT problems with intractable infections and a childhood of insomnia and pain caused by earaches that were so bad that I had an accompanying nightmare with them. (It involved an endless chain of people striking the Rank gong and each blow felt as if I had been kicked.)

My hearing was partially restored later but in later life (40s) I have substantial hearing-loss again and I've had an intractable infection for several years. I've never established a regular sleep pattern.

I don't understand parents who don't vaccinate their children. No - neither of the illnesses threatened my life but they have had life-long consequences. I remember childhood friends who were left with heart-damage following secondary infections after what is now a preventable childhood illness. - No, not dead, but profound and long-lived impacts on quality of life.

By Toni Wellstone (not verified) on 29 Aug 2008 #permalink

I remember getting chicken pox as an adult - in grad school. The experience was bad but not as horrible as it could have been. My son got his chicken pox vaccination as a baby but got a mild case of it when some unvaccinated child passed to her classmates - about 3 students AND the teacher got it. Granted, the children (who were vaccinated) all got very mild cases (luckily) and now boosters for chicken pox is necessary. Unfortunately, the teacher got a worse case.

It's too bad that the parents make the choices for their children whether to vaccinate or not - I think if kids have a choice whether to endure a fleeting second of pain or go through a possibly debilitating illness, they'd choose the former.

Living in the bay area - there's so many parents who don't vaccinate their children - they infuriate me. These parents NEED to read your blog. They are the ones to go to a developing country and see how bad some childhood illnesses can be.

By Ying-Tsu Loh (not verified) on 31 Aug 2008 #permalink

The time I remember getting mumps at age 10, my mother was surprised... because I had already had mumps! I was miserable, and not very pleasant to be around. That was in 1968, the year the Jeryl Lynn mumps vaccine was approved.

I have since learned from news reports of the 2006 outbreak of mumps in the Midwest (where 4 people lost their hearing) that there are those who do not get an immunity to mumps. Oh, great... there might be a possibility I could get it again.