Mumps in Berkeley

"Sorry about your testicles, Greg."

There are now close to 30 confirmed or probable cases of mumps on the campus of the University of California at Berkeley (henceforth “Cal” – Go Bears!), and that number will no doubt increase.

Most people are a bit mystified about mumps. It’s that chipmunk cheek infection that little kids get, right? is a typical response I hear from parents in my practice when I ask them about it. Well, yes, mumps is fairly chipmunk-cheeky, but it can do a lot more than make a child look like an extra in a Chip-n’-Dale cartoon.

Here’s a science-heavy description from the American Academy of Pediatrics’ Red Book.

Mumps is a systemic disease characterized by swelling of one or more of the salivary glands, usually the parotid glands. Approximately one third of infections do not cause clinically apparent salivary gland swelling and may manifest primarily as respiratory tract infection. More than 50% of people with mumps have cerebrospinal fluid pleocytosis, but fewer than 10% have symptoms of central nervous system infection. Orchitis is a common complication after puberty, but sterility rarely occurs. Other rare complications include arthritis, thyroiditis,mastitis, glomerulonephritis, myocarditis, endocardial fibroelastosis, thrombocytopenia, cerebellar ataxia, transverse myelitis, ascending polyradiculitis, pancreatitis, oophoritis, and hearing impairment.In the absence of an immunization program, mumps typically occurs during childhood. Infection occurring among adults is more likely to be severe, and death resulting from mumps and its complications,although rare, occurs most often in adults. Mumps during the first trimester of pregnancy is associated with an increased rate of spontaneous abortion. Although mumps virus can cross the placenta, no evidence exists that this results in congenital malformation.

Chip-n'-Dale, pre-mumps

In layman’s terms, mumps virus:

  • attacks the salivary glands (swollen parotid glands = chipmunk cheeks), though that’s not always present
  • will cause central nervous system infection in about 1 out of 10 victims (anything from hellish headaches to encephalitis–serious inflammation of the lining of the brain)
  • increases the chances of a first trimester miscarriage
  • commonly causes swelling and inflammation of the testicles in adolescents and adults (just as bad as it sounds, fellas), and a few men will become sterile as a result
  • can cause a boatload of rare complications, including arthritis, loss of balance, heart and thyroid problems, inflammation of the ovaries, and hearing loss
  • every now and then kills someone

And in case you think mumps was a no-big-deal infection for our hardy ancestors, there’s this from the 1914 edition of Household Discoveries and Mrs. Curtis’s Cookbook (my Grandma Nell Sloan’s childcare bible; regular readers will be hearing a lot from Mrs. C in future posts). I’ve condensed it a bit:

Mumps is a glandular swelling in the angle between the jaw and the ear. It is a highly contagious but wholly unnecessary and preventable disease. The early symptoms are fever with pain below the ear on one or both sides. Within two days there is great and painful enlargement of the neck and side of the cheek. The swelling persists from seven to ten days, then gradually subsides. A second or third attack may occur and troublesome complications are common. It is always advisable to consult a physician.

Note: Mrs. Curtis does not call for the doctor very often.

I’ll talk about the reasons behind this outbreak and recent recurrences of other vaccine-preventable diseases in a future post.

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Filed under Infectious diseases, Mrs. Curtis, Vaccines

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