Blog | Monday, January 26, 2015

Mumps checks the National Hockey League


If you're old enough, you remember kids sent home from school, cheeks swollen like chipmunks. Mumps is a very contagious disease, and one that most people younger than me have never seen. This is a good thing, since mumps in children can sometimes lead to deafness. In adults, it can swell the testicles, breasts, and the brain. Painfully. Thankfully, mumps was nearly eradicated, dropping to just 248 cases in 2004. And then Wakefield happened.

Certainly Andrew Wakefield cannot be held solely responsible for the rise in cases of measles and mumps in the U.S. and UK, but in my opinion he certainly bears some responsibility. In 1998 Wakefield published a paper in the Lancet claiming that the MMR (measles, mumps, rubella) vaccine was linked to autism. His paper was eventually retracted, and Wakefield struck off the rolls of doctors in the UK. The British Medical Journal published a series of pieces by journalist Brian Deer convincingly laying out the case for fraud in Wakefield's part. The study was not only junk science, but probably not even based on real evidence.

Despite this, MMR vaccination dropped in the UK and the U.S. There have been a number of mumps outbreaks over the last several years, some associated with unvaccinated Americans who travelled abroad and brought the disease back to their under-vaccinated community.

The most recent outbreak though is a new one, and potentially quite serious. Players in the National Hockey League have been hit by an outbreak which seems to have started in Anaheim. Mumps doesn't always cause the classic swelling and often looks like a cold, making prevention by isolation difficult. And when it hits adults, it can be devastating, with the testicular inflammation and possibility of brain swelling. Given the travel habits of professional athletes, there is reason to think more cases are on the way. Some cases of mumps are no doubt due to failure of the vaccine to prevent the disease. This is why universal vaccination is even more important. The more of us who are immune, the less likely the disease is to spread to those who aren't protected. There is no good reason, after nearly wiping out the disease, that we should put up with the rise in mumps outbreaks.

We need to reexamine our vaccination practices, both to make sure vaccination is as near to universal as possible and to research into preventing vaccine failure (e.g. booster shots). The Andrew Wakefields and Jenny McCarthys of the world cannot be blamed for every outbreak, but they play a role, as does every parent who decides not to vaccinate their child on time and completely. They are the problem. (Meanwhile, as you watch your favorite NHL team, try not to think about what it be like to play the rough game with swollen huevos.)

Peter A. Lipson, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. After graduating from Rush Medical College in Chicago, he completed his internal medicine residency at Northwestern Memorial Hospital. This post first appeared at his blog at Forbes. His blog, which has been around in various forms since 2007, offers "musings on the intersection of science, medicine, and culture." His writing focuses on the difference between science-based medicine and "everything else," but also speaks to the day-to-day practice of medicine, fatherhood, and whatever else migrates from his head to his keyboard.