Świnka – Rokowania, prognozy i postęp choroby

Świnka
Rokowania, prognozy i postęp choroby

Świnka, wywołana przez paramyksowirus, to choroba głównie dziecięca o zwykle dobrym rokowaniu i samoograniczającym się przebiegu, z objawami ustępującymi w ciągu około 14 dni. Powikłania, takie jak aseptyczne zapalenie opon mózgowych (ok. 10% przypadków) i zapalenie mózgu (5/1000 przypadków), mają zazwyczaj łagodny przebieg, choć zapalenie mózgu wiąże się z 1,4% śmiertelnością. Czuciowo-nerwowa głuchota występuje rzadko (0,5-5/100 000 przypadków), a trwała utrata słuchu dotyczy 0,005% zakażeń. U mężczyzn po okresie dojrzewania zapalenie jąder pojawia się w 20-50% przypadków, często jednostronne, z zanikiem jądra w 30-50% i ryzykiem hipopłodności (13%) lub bezpłodności w przypadku obustronnego zajęcia (30-87%). U kobiet po dojrzewaniu zapalenie jajników występuje u około 5%, z rzadkimi przypadkami niepłodności i przedwczesnej menopauzy.

Prognozy Świnki (Mumps Prognosis)

Powikłania i ich rokowanie
Powikłania neurologiczne
Czuciowo-nerwowa głuchota
Zapalenie jąder i wpływ na płodność
Inne powikłania
Śmiertelność
Wpływ szczepień na prognozę
Odporność po przebytej infekcji
Kolejne rozdziały

Prognozy Świnki (Mumps Prognosis)

Świnka (mumps) to choroba wywołana przez zakaźny paramyksowirus, występująca głównie u dzieci. Rokowanie u pacjentów ze świnką jest zazwyczaj doskonałe, a większość przypadków kończy się pełnym wyzdrowieniem bez powikłań długoterminowych.¹² Pacjenci leczeni objawowo zwykle dochodzą do zdrowia bez komplikacji, a śmiertelność jest bardzo rzadka.³ Choroba jest zwykle samoograniczająca się, a objawy ustępują samoistnie w ciągu dwóch tygodni, gdy układ odpornościowy eliminuje wirusa z organizmu.⁴ W rzadkich przypadkach objawy mogą nasilić się ponownie po około 2 tygodniach.⁵

Powikłania i ich rokowanie

W erze przed wprowadzeniem szczepionek, powikłania świnki występowały u prawie połowy zakażonych mężczyzn i 25% zakażonych kobiet. Badania współczesnych epidemii świnki wykazują jednak konsekwentnie niższe wskaźniki powikłań w porównaniu z okresem przed wprowadzeniem szczepień, co sugeruje, że wysoki poziom szczepień w społeczności może chronić przed cięższymi zakażeniami świnką.⁶

Badanie przeprowadzone podczas dużej, wieloletniej epidemii świnki w Izraelu wykazało statystycznie istotnie niższe wskaźniki powikłań i hospitalizacji wśród zaszczepionych osób zakażonych świnką w porównaniu do niezaszczepionych przypadków. Niemniej jednak, powikłania świnki mogą nadal wystąpić u zaszczepionych osób.⁷

Powikłania neurologiczne

Aseptyczne zapalenie opon mózgowych występuje u około 10% pacjentów i może być mylone z bakteryjnym zapaleniem opon mózgowych. Zapalenie to ma zwykle łagodny przebieg i prowadzi do pełnego wyzdrowienia bez długotrwałych powikłań, zazwyczaj ustępując w ciągu 3-10 dni.⁸⁹

W przypadkach zapalenia opon mózgowo-rdzeniowych i mózgu, wyższe poziomy białka w płynie mózgowo-rdzeniowym i niższy stosunek glukozy w płynie mózgowo-rdzeniowym do glukozy we krwi są związane z dłuższymi okresami hospitalizacji.¹⁰

Dla pacjentów z zapaleniem mózgu rokowanie jest ogólnie korzystne. Zgłaszane wskaźniki zapalenia mózgu w przebiegu świnki wynoszą 5 przypadków na 1000 zgłoszonych przypadków świnki. Trwałe następstwa są rzadkie, jednak uszkodzenia neurologiczne i śmierć mogą wystąpić przy średnim wskaźniku śmiertelności w przypadkach zapalenia mózgu wynoszącym 1,4%.¹¹ Około 1% pacjentów z zajęciem ośrodkowego układu nerwowego umiera z powodu świnki.¹²

Poinfekcyjne zapalenie mózgu ma tendencję do względnie łagodnego przebiegu, podczas gdy poinfekcyjne zapalenie mózgu i rdzenia kręgowego ma wskaźnik śmiertelności do 10%.¹³

Czuciowo-nerwowa głuchota

Czuciowo-nerwowa głuchota jest poważnym powikłaniem dotyczącym ośrodkowego układu nerwowego. Występuje rzadko, z szacowaną częstością 0,5-5 przypadków na 100 000 zgłoszonych przypadków świnki.¹⁴ Trwała głuchota po śwince jest rzadka i, jeśli występuje, dotyczy głównie jednostronnego słuchu (tylko 20% jest obustronna).¹⁵ Większość przypadków głuchoty spowodowanej świnką dotyczy tylko jednego ucha i ma charakter tymczasowy, ale trwała utrata słuchu występuje w 0,005% zakażeń.¹⁶

Zapalenie jąder i wpływ na płodność

Zapalenie jąder (orchitis), zwykle jednostronne, zgłaszano jako powikłanie w 20-50% klinicznych przypadków świnki u mężczyzn po okresie dojrzewania.¹⁷ Zapalenie jąder w przebiegu świnki zazwyczaj ustępuje w ciągu dwóch tygodni. W 20% przypadków jądra mogą być wrażliwe przez kilka kolejnych tygodni.¹⁸

Pewien stopień zaniku jąder występuje w około 35% przypadków zapalenia jąder w przebiegu świnki.¹⁹ Zanik, czyli zmniejszenie rozmiaru zajętego jądra, występuje w 30-50% przypadków zapalenia jąder, co może prowadzić do nieprawidłowości w tworzeniu nasienia i płodności, takich jak:

Niska liczba plemników
Brak plemników w nasieniu
Zmniejszona ruchliwość plemników
Obniżona płodność (hipopłodność) w 13% przypadków
Rzadko całkowita bezpłodność²⁰²¹

Nieprawidłowości w tworzeniu nasienia mogą utrzymywać się przez miesiące do lat po wyzdrowieniu z początkowego zakażenia, a okres ten wydłuża się wraz ze wzrostem nasilenia zapalenia jąder. Badanie tych przypadków wykazuje zmniejszoną objętość jąder, tkliwość jąder i uczucie niespójności podczas badania jąder.²²

Bezpłodność jest związana z ciężkimi przypadkami zapalenia jąder dotyczącymi obu jąder, po których następuje zanik jąder, który może rozwinąć się do roku po początkowym zakażeniu. W przypadkach obustronnego zapalenia jąder, 30-87% doświadcza bezpłodności. Istnieje słaby związek między zapaleniem jąder a późniejszym rozwojem zapalenia najądrza i guzów jąder.²³

Inne powikłania

Zapalenie jajników (oophoritis) to łagodne zapalenie jajników i występuje u około 5% kobiet po okresie dojrzewania.²⁴ Niezwykle rzadko, niepłodność i przedwczesna menopauza wystąpiły w wyniku zapalenia jajników w przebiegu świnki.²⁵

Inne rzadkie powikłania obejmują:

Zapalenie mięśnia sercowego i osierdzia – mogą prowadzić do włókniasto-elastycznego zgrubienia wsierdzia
Zapalenie tarczycy
Zapalenie gruczołu piersiowego
Wirusowe zapalenie płuc
Zapalenie nerek
Zapalenie stawów
Małopłytkowość purpurowa²⁶²⁷

Śmiertelność

Śmierć z powodu świnki jest rzadka; większość zgonów (50%) występuje u pacjentów powyżej 19 roku życia.²⁸ Ogólny wskaźnik śmiertelności w przypadku świnki wynosi 1,6-3,8 osób na 10 000, a zgony te występują zazwyczaj u osób, u których rozwija się zapalenie mózgu.²⁹

Wpływ szczepień na prognozę

Trzecia dawka szczepionki MMR jest skuteczna w zapobieganiu śwince, a u ponad 14 000 osób, które otrzymały trzecią dawkę, nie zgłoszono żadnych poważnych zdarzeń niepożądanych. Korzyść w postaci dodatkowej ochrony zapewnianej przez trzecią dawkę szczepionki zawierającej wirus świnki przewyższa niskie ryzyko wystąpienia niepożądanych zdarzeń poszczepiennych.³⁰

Poziom dowodów potwierdzających kluczowe wyniki dotyczące stosowania trzeciej dawki szczepionki zawierającej wirus świnki u osób narażonych na zwiększone ryzyko zachorowania na świnkę z powodu epidemii określono jako 4 dla zapobiegania śwince, nie określono dla zapobiegania powikłaniom świnki i 2 dla poważnych zdarzeń niepożądanych.³¹

Odporność po przebytej infekcji

Dla większości osób, infekcja prowadzi do dożywotniej odporności na przyszłe zakażenia. Ponowne zakażenia wydają się być łagodniejsze i bardziej atypowe niż pierwsze zakażenie.³² W grupach wysokiego ryzyka, takich jak osoby z obniżoną odpornością, rokowanie uważa się za takie samo jak dla innych grup.³³

Hospitalizacja z powodu świnki zazwyczaj nie jest wymagana, co potwierdza dobrą ogólną prognozę dla tej choroby.³⁴

Kolejne rozdziały

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Materiały źródłowe

#1 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#2 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
The prognosis for patients with uncomplicated mumps is excellent. […] For patients with encephalitis, the prognosis is generally favorable. Reported rates of mumps encephalitis cite 5 cases per 1000 reported mumps cases. Permanent sequelae are rare; however, neurologic damage and death can occur with the average encephalitis case-fatality rate of 1.4%. […] Approximately 10% of patients develop a mild form of aseptic meningitis, which can be confused with bacterial meningitis. […] Sensorineural deafness is a serious complication involving the CNS. […] It occurs infrequently, with an estimated frequency of 0.5-5 cases per 100,000 reported mumps cases. Permanent deafness after mumps is rare and, if it occurs, primarily affects unilateral hearing (only 20% bilateral). […] Orchitis (usually unilateral) has been reported as a complication in 20-50% of clinical mumps cases in postpubertal males.
#3 Azthena logo with the word Azthena
https://www.news-medical.net/health/Mumps-Prognosis.aspx
Mumps, a notifiable disease in many countries, is a condition caused by a contagious paramyxovirus and occurs predominantly in the pediatric population. […] Patients who are symptomatically treated usually recover well. Sterility and deafness due to mumps are serious but rare disease consequences. Most patients who develop complications like meningoencephalitis usually have a favorable outlook. However, there may be neurological damage in a few cases and some may unfortunately have fatal outcomes.
#4 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#5 Mumps – Children’s Health Issues – Merck Manual Consumer Version
https://www.merckmanuals.com/home/children-s-health-issues/common-viral-infections-in-infants-and-children/mumps
Almost all people with mumps recover fully without problems, but in rare cases symptoms may worsen again after about 2 weeks.
#6 Mumps – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube
https://www.ncbi.nlm.nih.gov/books/NBK534785/
The prognosis for a patient with mumps is typically excellent. After aseptic meningitis, recovery is generally complete. Deafness can occur after mumps but is also rare. […] In the pre-vaccine era, complications of mumps were estimated to occur in up to half of males and 25% of females infected with mumps. Orchitis was the most common complication among males, occurring in about 1 in 5 cases of mumps among males, whereas aseptic meningitis was the most prevalent mumps complication across genders. Studies of mumps outbreaks in the modern area have consistently reported lower rates of complications compared to those reported in the prevaccine era, suggesting that high levels of community-wide vaccination may protect against more severe mumps infections. Comparative studies of complication rates among vaccinated and unvaccinated populations have been limited by low numbers of unvaccinated children in the United States. However, a study conducted during a large multi-year mumps outbreak in Israel found statistically significantly lower rates of complications and hospitalization among vaccinated people infected with mumps compared to unvaccinated cases. Nonetheless, complications of mumps can still occur among vaccinated people, including orchitis, oophoritis, meningitis, encephalitis, sensorineural hearing loss, mastitis, and pancreatitis.
#7 Mumps – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube
https://www.ncbi.nlm.nih.gov/books/NBK534785/
The prognosis for a patient with mumps is typically excellent. After aseptic meningitis, recovery is generally complete. Deafness can occur after mumps but is also rare. […] In the pre-vaccine era, complications of mumps were estimated to occur in up to half of males and 25% of females infected with mumps. Orchitis was the most common complication among males, occurring in about 1 in 5 cases of mumps among males, whereas aseptic meningitis was the most prevalent mumps complication across genders. Studies of mumps outbreaks in the modern area have consistently reported lower rates of complications compared to those reported in the prevaccine era, suggesting that high levels of community-wide vaccination may protect against more severe mumps infections. Comparative studies of complication rates among vaccinated and unvaccinated populations have been limited by low numbers of unvaccinated children in the United States. However, a study conducted during a large multi-year mumps outbreak in Israel found statistically significantly lower rates of complications and hospitalization among vaccinated people infected with mumps compared to unvaccinated cases. Nonetheless, complications of mumps can still occur among vaccinated people, including orchitis, oophoritis, meningitis, encephalitis, sensorineural hearing loss, mastitis, and pancreatitis.
#8 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
The prognosis for patients with uncomplicated mumps is excellent. […] For patients with encephalitis, the prognosis is generally favorable. Reported rates of mumps encephalitis cite 5 cases per 1000 reported mumps cases. Permanent sequelae are rare; however, neurologic damage and death can occur with the average encephalitis case-fatality rate of 1.4%. […] Approximately 10% of patients develop a mild form of aseptic meningitis, which can be confused with bacterial meningitis. […] Sensorineural deafness is a serious complication involving the CNS. […] It occurs infrequently, with an estimated frequency of 0.5-5 cases per 100,000 reported mumps cases. Permanent deafness after mumps is rare and, if it occurs, primarily affects unilateral hearing (only 20% bilateral). […] Orchitis (usually unilateral) has been reported as a complication in 20-50% of clinical mumps cases in postpubertal males.
#9 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
Mumps meningitis typically resolves within 3â10 days without long-term complications. In meningoencephalitis cases, higher protein levels in CSF and a lower CSF glucose to blood glucose ratio are associated with longer periods of hospitalization. Approximately 1% of those whose CNS is affected die from mumps. Post-infectious encephalitis tends to be relatively mild, whereas post-infectious encephalomyelitis has a case-fatality rate of up to ten percent. Most cases of mumps deafness affect just one ear and are temporary, but permanent hearing loss occurs in 0.005% of infections. Myocarditis and pericarditis that occur as a result of mumps may lead to endocardial fibroelastosis, i.e. thickening of the endocardium. With extreme rarity, infertility and premature menopause have occurred as a result of mumps oophoritis.
#10 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
Mumps meningitis typically resolves within 3â10 days without long-term complications. In meningoencephalitis cases, higher protein levels in CSF and a lower CSF glucose to blood glucose ratio are associated with longer periods of hospitalization. Approximately 1% of those whose CNS is affected die from mumps. Post-infectious encephalitis tends to be relatively mild, whereas post-infectious encephalomyelitis has a case-fatality rate of up to ten percent. Most cases of mumps deafness affect just one ear and are temporary, but permanent hearing loss occurs in 0.005% of infections. Myocarditis and pericarditis that occur as a result of mumps may lead to endocardial fibroelastosis, i.e. thickening of the endocardium. With extreme rarity, infertility and premature menopause have occurred as a result of mumps oophoritis.
#11 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
The prognosis for patients with uncomplicated mumps is excellent. […] For patients with encephalitis, the prognosis is generally favorable. Reported rates of mumps encephalitis cite 5 cases per 1000 reported mumps cases. Permanent sequelae are rare; however, neurologic damage and death can occur with the average encephalitis case-fatality rate of 1.4%. […] Approximately 10% of patients develop a mild form of aseptic meningitis, which can be confused with bacterial meningitis. […] Sensorineural deafness is a serious complication involving the CNS. […] It occurs infrequently, with an estimated frequency of 0.5-5 cases per 100,000 reported mumps cases. Permanent deafness after mumps is rare and, if it occurs, primarily affects unilateral hearing (only 20% bilateral). […] Orchitis (usually unilateral) has been reported as a complication in 20-50% of clinical mumps cases in postpubertal males.
#12 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
Mumps meningitis typically resolves within 3â10 days without long-term complications. In meningoencephalitis cases, higher protein levels in CSF and a lower CSF glucose to blood glucose ratio are associated with longer periods of hospitalization. Approximately 1% of those whose CNS is affected die from mumps. Post-infectious encephalitis tends to be relatively mild, whereas post-infectious encephalomyelitis has a case-fatality rate of up to ten percent. Most cases of mumps deafness affect just one ear and are temporary, but permanent hearing loss occurs in 0.005% of infections. Myocarditis and pericarditis that occur as a result of mumps may lead to endocardial fibroelastosis, i.e. thickening of the endocardium. With extreme rarity, infertility and premature menopause have occurred as a result of mumps oophoritis.
#13 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
Mumps meningitis typically resolves within 3â10 days without long-term complications. In meningoencephalitis cases, higher protein levels in CSF and a lower CSF glucose to blood glucose ratio are associated with longer periods of hospitalization. Approximately 1% of those whose CNS is affected die from mumps. Post-infectious encephalitis tends to be relatively mild, whereas post-infectious encephalomyelitis has a case-fatality rate of up to ten percent. Most cases of mumps deafness affect just one ear and are temporary, but permanent hearing loss occurs in 0.005% of infections. Myocarditis and pericarditis that occur as a result of mumps may lead to endocardial fibroelastosis, i.e. thickening of the endocardium. With extreme rarity, infertility and premature menopause have occurred as a result of mumps oophoritis.
#14 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
The prognosis for patients with uncomplicated mumps is excellent. […] For patients with encephalitis, the prognosis is generally favorable. Reported rates of mumps encephalitis cite 5 cases per 1000 reported mumps cases. Permanent sequelae are rare; however, neurologic damage and death can occur with the average encephalitis case-fatality rate of 1.4%. […] Approximately 10% of patients develop a mild form of aseptic meningitis, which can be confused with bacterial meningitis. […] Sensorineural deafness is a serious complication involving the CNS. […] It occurs infrequently, with an estimated frequency of 0.5-5 cases per 100,000 reported mumps cases. Permanent deafness after mumps is rare and, if it occurs, primarily affects unilateral hearing (only 20% bilateral). […] Orchitis (usually unilateral) has been reported as a complication in 20-50% of clinical mumps cases in postpubertal males.
#15 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
The prognosis for patients with uncomplicated mumps is excellent. […] For patients with encephalitis, the prognosis is generally favorable. Reported rates of mumps encephalitis cite 5 cases per 1000 reported mumps cases. Permanent sequelae are rare; however, neurologic damage and death can occur with the average encephalitis case-fatality rate of 1.4%. […] Approximately 10% of patients develop a mild form of aseptic meningitis, which can be confused with bacterial meningitis. […] Sensorineural deafness is a serious complication involving the CNS. […] It occurs infrequently, with an estimated frequency of 0.5-5 cases per 100,000 reported mumps cases. Permanent deafness after mumps is rare and, if it occurs, primarily affects unilateral hearing (only 20% bilateral). […] Orchitis (usually unilateral) has been reported as a complication in 20-50% of clinical mumps cases in postpubertal males.
#16 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
Mumps meningitis typically resolves within 3â10 days without long-term complications. In meningoencephalitis cases, higher protein levels in CSF and a lower CSF glucose to blood glucose ratio are associated with longer periods of hospitalization. Approximately 1% of those whose CNS is affected die from mumps. Post-infectious encephalitis tends to be relatively mild, whereas post-infectious encephalomyelitis has a case-fatality rate of up to ten percent. Most cases of mumps deafness affect just one ear and are temporary, but permanent hearing loss occurs in 0.005% of infections. Myocarditis and pericarditis that occur as a result of mumps may lead to endocardial fibroelastosis, i.e. thickening of the endocardium. With extreme rarity, infertility and premature menopause have occurred as a result of mumps oophoritis.
#17 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
The prognosis for patients with uncomplicated mumps is excellent. […] For patients with encephalitis, the prognosis is generally favorable. Reported rates of mumps encephalitis cite 5 cases per 1000 reported mumps cases. Permanent sequelae are rare; however, neurologic damage and death can occur with the average encephalitis case-fatality rate of 1.4%. […] Approximately 10% of patients develop a mild form of aseptic meningitis, which can be confused with bacterial meningitis. […] Sensorineural deafness is a serious complication involving the CNS. […] It occurs infrequently, with an estimated frequency of 0.5-5 cases per 100,000 reported mumps cases. Permanent deafness after mumps is rare and, if it occurs, primarily affects unilateral hearing (only 20% bilateral). […] Orchitis (usually unilateral) has been reported as a complication in 20-50% of clinical mumps cases in postpubertal males.
#18 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#19 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
A degree of testicular atrophy occurs in about 35% of cases of mumps orchitis. […] Complete sterility is rare. […] Impaired fertility occurs in 13% of patients. […] Oophoritis is a benign inflammation of the ovaries and occurs in about 5% of postpubertal females. […] Other rare complications include myocarditis, thyroiditis, mastitis, viral pneumonia nephritis, arthritis, and thrombocytopenia purpura. […] Death due to mumps is rare; the majority of fatalities (50%) occur in patients older than 19 years.
#20 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#21 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
A degree of testicular atrophy occurs in about 35% of cases of mumps orchitis. […] Complete sterility is rare. […] Impaired fertility occurs in 13% of patients. […] Oophoritis is a benign inflammation of the ovaries and occurs in about 5% of postpubertal females. […] Other rare complications include myocarditis, thyroiditis, mastitis, viral pneumonia nephritis, arthritis, and thrombocytopenia purpura. […] Death due to mumps is rare; the majority of fatalities (50%) occur in patients older than 19 years.
#22 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#23 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#24 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
A degree of testicular atrophy occurs in about 35% of cases of mumps orchitis. […] Complete sterility is rare. […] Impaired fertility occurs in 13% of patients. […] Oophoritis is a benign inflammation of the ovaries and occurs in about 5% of postpubertal females. […] Other rare complications include myocarditis, thyroiditis, mastitis, viral pneumonia nephritis, arthritis, and thrombocytopenia purpura. […] Death due to mumps is rare; the majority of fatalities (50%) occur in patients older than 19 years.
#25 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
Mumps meningitis typically resolves within 3â10 days without long-term complications. In meningoencephalitis cases, higher protein levels in CSF and a lower CSF glucose to blood glucose ratio are associated with longer periods of hospitalization. Approximately 1% of those whose CNS is affected die from mumps. Post-infectious encephalitis tends to be relatively mild, whereas post-infectious encephalomyelitis has a case-fatality rate of up to ten percent. Most cases of mumps deafness affect just one ear and are temporary, but permanent hearing loss occurs in 0.005% of infections. Myocarditis and pericarditis that occur as a result of mumps may lead to endocardial fibroelastosis, i.e. thickening of the endocardium. With extreme rarity, infertility and premature menopause have occurred as a result of mumps oophoritis.
#26 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
A degree of testicular atrophy occurs in about 35% of cases of mumps orchitis. […] Complete sterility is rare. […] Impaired fertility occurs in 13% of patients. […] Oophoritis is a benign inflammation of the ovaries and occurs in about 5% of postpubertal females. […] Other rare complications include myocarditis, thyroiditis, mastitis, viral pneumonia nephritis, arthritis, and thrombocytopenia purpura. […] Death due to mumps is rare; the majority of fatalities (50%) occur in patients older than 19 years.
#27 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
Mumps meningitis typically resolves within 3â10 days without long-term complications. In meningoencephalitis cases, higher protein levels in CSF and a lower CSF glucose to blood glucose ratio are associated with longer periods of hospitalization. Approximately 1% of those whose CNS is affected die from mumps. Post-infectious encephalitis tends to be relatively mild, whereas post-infectious encephalomyelitis has a case-fatality rate of up to ten percent. Most cases of mumps deafness affect just one ear and are temporary, but permanent hearing loss occurs in 0.005% of infections. Myocarditis and pericarditis that occur as a result of mumps may lead to endocardial fibroelastosis, i.e. thickening of the endocardium. With extreme rarity, infertility and premature menopause have occurred as a result of mumps oophoritis.
#28 Mumps: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/784603-overview
A degree of testicular atrophy occurs in about 35% of cases of mumps orchitis. […] Complete sterility is rare. […] Impaired fertility occurs in 13% of patients. […] Oophoritis is a benign inflammation of the ovaries and occurs in about 5% of postpubertal females. […] Other rare complications include myocarditis, thyroiditis, mastitis, viral pneumonia nephritis, arthritis, and thrombocytopenia purpura. […] Death due to mumps is rare; the majority of fatalities (50%) occur in patients older than 19 years.
#29 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#30 Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) for Third Dose of Mumps Virus-Containing Vaccine in Persons at Increased Risk for Mumps Disease During an Outbreak | ACIP | CDC
https://www.cdc.gov/acip/grade/mumps.html
The benefits outcomes considered critical were preventing mumps disease and preventing complications of mumps disease and the harms outcome considered critical was occurrence of serious adverse events (SAEs) after vaccination. […] A third dose of MMR vaccine is effective in preventing mumps and no serious adverse events were reported in more than 14,000 third dose recipients. […] Together, the benefit of added protection of a third dose of mumps virus-containing vaccine outweighs the low risk for vaccine adverse events. […] The evidence types supporting critical outcomes for use of third dose of mumps virus-containing vaccine in persons at increased risk for mumps disease because of an outbreak was determined to be 4 for preventing mumps, not determined for preventing mumps complications, and 2 for serious adverse events.
#31 Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) for Third Dose of Mumps Virus-Containing Vaccine in Persons at Increased Risk for Mumps Disease During an Outbreak | ACIP | CDC
https://www.cdc.gov/acip/grade/mumps.html
The benefits outcomes considered critical were preventing mumps disease and preventing complications of mumps disease and the harms outcome considered critical was occurrence of serious adverse events (SAEs) after vaccination. […] A third dose of MMR vaccine is effective in preventing mumps and no serious adverse events were reported in more than 14,000 third dose recipients. […] Together, the benefit of added protection of a third dose of mumps virus-containing vaccine outweighs the low risk for vaccine adverse events. […] The evidence types supporting critical outcomes for use of third dose of mumps virus-containing vaccine in persons at increased risk for mumps disease because of an outbreak was determined to be 4 for preventing mumps, not determined for preventing mumps complications, and 2 for serious adverse events.
#32 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#33 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.
#34 Mumps – Wikipedia
https://en.wikipedia.org/wiki/Mumps
The prognosis for most people who experience mumps is excellent as long-term complications and death are rare. Hospitalization is typically not required. Mumps is usually self-limiting and symptoms resolve spontaneously within two weeks as the immune system clears the virus from the body. In high-risk groups such as immunocompromised persons, the prognosis is considered to be the same as for other groups. For most people, infection leads to lifelong immunity against future infection. Reinfections appear to be more mild and atypical than the first infection. The overall case-fatality rate of mumps is 1.6â3.8 people per 10,000, and these deaths typically occur in those who develop encephalitis. […] Mumps orchitis typically resolves within two weeks. In 20% of cases, the testicles may be tender for a few more weeks. Atrophy, or reduction of size, of the involved testicle occurs in 30â50% of orchitis cases, which may lead to abnormalities in sperm creation and fertility such as low sperm count, absence of sperm in semen, reduced sperm motility, reduced fertility (hypofertility) in 13% of cases, and rarely sterility. Hypofertility can, however, occur in cases without atrophy. Abnormalities in sperm creation can persist for months to years after recovery from the initial infection, the length of which increases as the severity of orchitis increases. Examination of these cases shows decreased testicular volume, tenderness of the testicles, and a feeling of inconsistency when handling the testicles. Infertility is linked to severe cases of orchitis affecting both testes followed by testicular atrophy, which may develop up to one year after the initial infection. Of bilateral orchitis cases, 30â87% experience infertility. There is a weak association between orchitis and later development of epididymitis and testicular tumors.