ORCHITIS IN DH AFTER MUMPS...

[Schmauskin]

My poor DH has recently been very poorly with mumps. He was bedridden for 2 weeks with an extremely high temperature and severe pain in his swollen jaw and head. 7 days into the illness, he developed Orchitis i.e. swelling in his testicles. This was extremely painful and very concerning for us, as it can render a man sterile. Does anyone have any information/experinece of the condition, in particular the long term effects on sperm count/fertility? 12 month DD now has suspected mumps, but much milder thank goodness...

[aloha]

Orchitis on both sides? That is very unlucky. Your poor dh. The chances of being rendered permanently sterile are absolutely minute. I don' t have the stats available atm but can check. It really is tiny.

[aloha]

Orchitis Can occur 4-5 days after start of parotitis but often appears without it. Presents with chills, sweats, headache and backache with swinging temperature and severe local testicular pain and tenderness. Scrotum is swollen and oedematous with impalpable testicles. Usually only one is affected but sometimes both and again second testicle may become affected as other subsides, usually after 3-4 days. Unusual before puberty and develops in 1 in 5 cases of mumps in adolescent males. In 1/3 of cases, some degree of atrophy of the testicle but azoospermia is rare and only temporary. Fears of sterility have been greatly exaggerated.

Meningitis and encephalitis Usually occurs without parotitis. Meningitis usually mild and self limiting and occasionally may be transient paralysis of limbs. CSF protein and lymphocytes are increased. With encephalitis, patient is confused and may lapse into coma and remain so for days, weeks or months. 2% cases are fatal.

Investigations In patients with meningitis but without parotitis, can confirm the diagnosis with detection of mumps specific antibodies in the serum.

Management
Drugs No specific treatment. Analgesia, may require morphine for 1-2 days in severe orchitis. Prednisolone for 2-3 days for severe parotitis or orchitis can provide dramatic relief but not reduce swelling.

Complications Orchitis - in 1/3 of cases, some degree of atrophy of the testicle but azoospermia is rare and only temporary. Fears of sterility have been greatly exaggerated.

[aloha]

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Fact sheet
Click here to view quick-reference fact sheet.

Resources
Click here to access a full range of MMR information sheets and resources available on www.mmrthefacts.nhs.uk
Other useful web links
www.mmrthefacts.nhs.uk
www.immunisation.nhs.uk
www.hpa.org.uk 
www.nhsdirect.nhs.uk
www.nhsdirect.wales.nhs.uk
www.nhs24.com
www.cdc.gov
www.who.org
www.dh.gov.uk/PolicyAndGuidance (Green Book)
www.kidshealth.org
www.nlm.nih.gov/medlineplus
www.medinfo.co.uk
www.wiredforhealth.gov.uk
www.medicinenet.com


References
Department of Health (1996), Immunisation against Infectious Disease (The Green Book), www.dh.gov.uk/PolicyAndGuidance (accessed 20/06/04)

Chin, J. (ed), Control of Communicable Diseases manual, 17th edition, American Public Health Association, 2000

Ross, S., 2003 Nurseries and schools, In Lawrence J & May D, Infection Control in the Community, Churchill Livingstone, New York, 2003, pp 103-128
 
Transmission
Incubation
Illness
Treatment
Exclusion
Notification
Complications
Prevention
Vaccine
Contraindications


Transmission

Infection is by droplet spread or by direct contact with the saliva of an infected person.

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Incubation

From 12 to 25 days (on average, from 16 to 18 days).

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Illness

Symptoms include headache and fever for a few days before swelling of the parotid glands. Thirty per cent of children have no symptoms.
Confirmation of diagnosis can be by oral fluid testing.

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Treatment

There is no specific treatment for mumps; treatment is based on alleviating symptoms. Encourage patients to drink lots of clear fluids to replace body water lost through fever. Paracetamol can be used to reduce the fever. (Aspirin should not be given to children, as its use is associated with Reye�s Syndrome - a severe neurological disorder.)

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Exclusion

If susceptible contacts are present, exclusion from school or work is recommended until five days after disease onset.

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Notification

Yes, refer to your local policy/infection control team for further information.

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From teh official site for health visitors etc

Complications

Important complications of symptomatic mumps include swelling of the ovaries (oophoritis), testes (orchitis), aseptic meningitis and deafness. There is no firm evidence that orchitis causes sterility. Mumps was the commonest cause of viral meningitis in children before 1988 when the MMR vaccine was introduced.

[aloha]

Encouraging results were found in a study of 72 young Israeli soldiers who suffered mumps. Of these, 19 had suffered mumps orchitis. Following recovery, some men had more abnormal sperm than expected and their sperm tended to be less active. All sperm samples were considered within the fertile range, however. Interestingly, men who smoke cigarettes and catch mumps are statistically more likely to develop mumps orchitis than are non-smokers.

[Schmauskin]

aloha - THANK YOU!! I wish I'd pushed the docs to give him morphine now as he was in agony, poor chap. I guess now we shall just go ahead and start trying for a second baby next summer as planned and hope for the best. fingers crossed!