In affected boys and men, swelling of the testicle normally begins 4 to 8 days after the swelling of the parotid gland. Occasionally, swelling can occur up to 6 weeks after the swelling of the glands. Any testicle pain can be eased using painkillers such as paracetamol or ibuprofen you buy from the pharmacy or supermarket. If the pain is particularly severe, contact your GP, who may prescribe you a stronger painkiller. 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. About 1 in 15 females who get mumps after puberty experience swelling of the ovaries oophoritis , which can cause:.
The symptoms of oophoritis usually pass once the body has fought off the underlying mumps infection. About mumps 2. Symptoms of mumps 3. Causes of mumps 4. Diagnosing mumps 5. Treating mumps 6. Complications of mumps. About mumps Mumps is a contagious viral infection that used to be common in children before the introduction of the MMR vaccine. When to see your GP It's important to contact your GP if you suspect mumps so a diagnosis can be made.
Who is affected Most cases of mumps occur in people between 17 and 34 years of age who have not received 2 doses of the MMR vaccine. How mumps is spread Mumps is spread in the same way as colds and flu — through infected droplets of saliva that can be inhaled or picked up from surfaces and transferred into the mouth or nose. If you have mumps, you can help prevent it spreading by: regularly washing your hands with soap using and disposing of tissues when you sneeze avoiding school or work for at least five days after your symptoms first develop Preventing mumps You can protect your child against mumps by making sure they're given the combined MMR vaccine for mumps, measles and rubella.
Treatment for mumps There's currently no cure for mumps, but the infection should pass within one or two weeks. Treatment is used to relieve symptoms and includes: getting plenty of bed rest and fluids using painkillers, such as ibuprofen and paracetamol — aspirin shouldn't be given to children under 16 applying a warm or cool compress to the swollen glands to help relieve pain Read more about treating mumps Complications Mumps usually passes without causing serious damage to a person's health.
Symptoms of mumps The symptoms of mumps usually develop 14 to 25 days after becoming infected with the mumps virus this delay is known as the incubation period. These can include: headache joint pain feeling sick dry mouth mild abdominal pain feeling tired loss of appetite a high temperature fever of 38C When to seek medical advice If you suspect mumps, it's important to call your GP.
Causes of mumps Mumps is caused by the mumps virus, which belongs to a family of viruses known as paramyxoviruses. How mumps is spread Mumps is an airborne virus and can be spread by: an infected person coughing or sneezing and releasing tiny droplets of contaminated saliva, which can then be breathed in by another person an infected person touching their nose or mouth, then transferring the virus onto an object, such as a door handle, or work surface; if someone else touches the object shortly afterwards, they can transfer the virus into their respiratory tract sharing utensils, such as cups, cutlery or plates with an infected person People with mumps are usually most infectious from a few days before their parotid glands swell until a few days afterwards.
Diagnosing mumps If you suspect that you or your child has mumps, it's important to see your GP for a diagnosis. Your GP can also check your temperature to see if it is higher than normal. The infection usually passes within a week or two. In the meantime, the measures below may help.
The best way to do this is to: stay away from school, college or work until five days after you first developed symptoms wash your hands regularly, using soap and water always use a tissue to cover your mouth and nose when you cough and sneeze, and throw the tissue in a bin immediately afterwards.
Complications of mumps There are several problems that often occur with mumps. Common complications Swollen testicle Pain and swelling of the testicle orchitis affects one in four males who get mumps after puberty.
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 The symptoms of oophoritis usually pass once the body has fought off the underlying mumps infection. Viral meningitis Viral meningitis can occur if the mumps virus spreads into the outer protective layer of the brain the meninges.
Pancreatitis About 1 in 20 cases of mumps lead to short-term inflammation of the pancreas acute pancreatitis. Other symptoms of acute pancreatitis can include: feeling or being sick diarrhoea loss of appetite high temperature tenderness of the belly less commonly, yellowing of the skin and the whites of the eyes jaundice Although pancreatitis associated with mumps is usually mild, you may be admitted to hospital so your body functions can be supported until your pancreas recovers.
Rare complications of mumps Rare but potentially serious complications of mumps include an infection of the brain itself, known as encephalitis. What is Leukocytospermia? What is Male Chlamydia? Does age affect fertility in men? Do sperm count decrease with age? What is Sperm Donation? What is Testicular Atrophy? What is the normal motility of sperm? What is the sperm regeneration cycle? What Causes Male Infertility? What is varicocele? What is XYY Syndrome? Why is My Urine Foamy? What are the defects of seminal vesicles and how it affects fertility?
What are testicular infections? What analysis is carried out for studying male infertility? What is Vasectomy Reversal? What is TESA and how is it done?
These findings suggest that testicular cells exhibit different innate antiviral responses against MuV replication. To understand the mechanisms underlying MuV-induced orchitis, a recent study investigated the pattern recognition receptors-initiated innate immune responses of testicular cells to MuV infection These investigations suggest that TLR2 plays a crucial role in initiating the innate immune responses to MuV infection in testicular cells.
Usually, viral replication in infected cells is restricted by cellular innate antiviral responses. Remarkably, GCs and TMs are equipped with autophagy machineries, and autophagy restricts MuV replication in these cells. These findings suggest a cell type-specific innate antiviral mechanisms against MuV replication in testicular cells.
Notably, viral infection in male GCs may be sexually transmitted to female partners and fetus, thus leading to virus parallel and vertical transmission The antiviral defense of male GCs is particularly important not only for male fertility but also for limiting virus transmission. The innate antiviral responses in most type of cells after viral infection produce type 1 IFNs and various pro-inflammatory cytokines The increased levels of certain pro-inflammatory cytokines can be harmful to spermatogenesis However, autophagy directly uptakes and degrades viruses that invade GCs, without the induction of pro-inflammatory cytokines Therefore, autophagy of male GCs should be suitable for the antiviral defense without harming spermatogenesis.
The cytokines induced by viral infection can mediate organ dysfunction and tissue damage We recently found that MuV infection induced the production of various pro-inflammatory cytokines and inhibited testosterone synthesis in LCs The BTB plays an important role in maintaining normal spermatogenesis.
Moreover, a recent study showed that the exposure of SCs to inflammatory mediators derived from ZIKV-infected macrophages also led to the degradation of the ZO-1 protein, which correlated with increased BTB permeability During spermatogenesis, a large number of novel antigens are produced by post-meiotic spermatids in seminiferous tubules after immune self-tolerance has been established The production of autoantibodies against GC antigens is a common feature for orchitis patients.
This may explain why mumps orchitis often causes male infertility in postpubertal and young adult men but rarely affects children when the spermatids have not yet been produced in the testes.
The deleterious effects of MuV infection on male GCs have also been examined in a recent study CXCL10 is a pleiotropic cytokine capable of exerting various functions, including the chemotaxis of leucocytes and induction of apoptosis Laboratory animal models are critical for the studies on the pathogenesis of MuV-induced diseases.
Unfortunately, mice are not susceptible to MuV infection. Although MuV efficiently replicates in mouse testicular cells in vitro , this is not evident in vivo The detrimental effects of ZIKV on the testis are only occurred in mice lacking interferon signaling but not in WT mice A recent study showed that mice lacking type 1 interferon signaling were susceptible to MuV infection Alternatively, a mouse cell-adapted MuV strain may be used to establish an orchitis model, but how far the observations in mouse models are relevant to human remains questionable.
The recent outbreaks occurring in highly vaccinated populations have sparked renewed interest in mumps and complications, particularly orchitis. There is a growing concern that a group of mumps cases has shifted from children to young adults and is associated with a high rate of orchitis and severe reproductive problems.
The mechanisms behind the development of mumps and orchitis are unknown. Several recent studies on MuV based on primary cells have improved our understanding of mumps virus pathogenesis with regard to MuV receptors-testicular cells interaction, innate immune responses to MuV infection, and detrimental effects on testicular function using mouse models.
However, a number of knowledge gaps remain. MuV can effectively replicate in mouse testicular cells in vitro. The testis is an immunoprivileged organ for the protection of the spermatozoon from adverse immune response Whether the testicular immune privilege status provides a refuge for MuV replication to escape immune surveillance requires clarification.
Rare orchitis cases after the MMR vaccination were reported, suggesting a potential risk of the vaccination 38 — 41 , The pathogenesis of the vaccination-related orchitis remains uncertain and is worth investigating further. In-depth understanding of these questions would help in the development of preventative and therapeutic approaches for mumps orchitis and male infertility.
DH and HW designed the concept and wrote the manuscript. DT and FW collected materials and prepared figures. All authors contributed to the article and approved the submitted version.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Lancet — Mumps orchitis. J R Soc Med —5. Mumps orchitis in the post-vaccine era : a single-center series of 67 patients and review of clinical outcome and trends. Med Baltimore — Rozina EE, Hilgenfeldt M. Comparative study on the neurovirulence of different vaccine strains of parotitis virus in monkeys.
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