Male Infertility Can be caused by Mumps
Male infertility is seen in 30% of men who are affected by mumps in childhood. Mumps is a viral infection usually affecting children of 5 to 9 years. It used to outbreak as a wide spread infection every 2 to 5 years before the vaccination was invented. It causes a mild disease affecting the parotid gland and characterised by swelling of cheek on one side. In 15 % cases complications may arise affecting the brain inform of meningitis, encephalitis, deafness etc. Rare complications affecting heart and kidney also has been reported.
How does this virus spread?
Mumps virus is transmitted via direct contact or by airborne droplets. The virus starts shedding in saliva from 7 d before until 8 d after onset of symptoms. This indicates the infective period of virus during which it spreads widely. Mumps virus binds to sialic acid of the lining cells in the upper respiratory tract and slowly enters the blood stream. From blood this can spread to organs like brain, kidney and testes in male. Bilateral involvement of parotid gland or the testis makes the virus spread aggressively. This may be due to shedding of virus in high quantity in saliva and urine respectively. In these children sperm production may be affected and predispose them to male infertility.
Mumps transmission is also promoted by areas where people may congregate, including airports, urban areas, colleges, and large households.
Nonspecific symptoms of weakness, body pain, headache, low-grade fever, and decreased appetite occur initially. Of these cases 30 % develop swelling of parotid gland. Salivary gland inflammation decreases after one week with full recovery by ten days.
Exposure to infection during early pregnancy leads to higher risk of spontaneous abortion. There are no associated congenital malformations in children whose mothers were exposed to mumps at any time during pregnancy.
Incidence of mumps orchitis has dramatically declined since the introduction of the childhood vaccination programme. There are great concerns about mumps outbreaks and the associated risk of infertility. Mumps orchitis rarely leads to sterility but it may contribute to sub-fertility. It can also can lead to oligospermia, azoospermia, and asthenospermia. Immunisation is the best policy to avoid this viral disease.
Mumps can be diagnosed by isolating the virus from a cultured swab of one of the inflamed salivary glands, particularly the parotid duct. Mumps may also be diagnosed from a buccal or throat swab using polymerase chain reaction (PCR). Treatment for mumps infection is limited to symptomatic relief like pain killers and antipyretics.
Prevention of male infertility with vaccine
The MMR vaccine is recommended for routine use in the prevention of measles, mumps, and rubella. The trivalent vaccine reduces the number of injections from three to one in a two-dose series and protects against all three diseases simultaneously.
This vaccine is supplied as a single-dose vial. It must be kept cool and out of light, because of the live, attenuated viruses’ instability to heat and light. Current recommended schedule is to receive the first dose at 12-15 months followed by the second dose at 4-6 years.