The Overlooked Duo

Mumps and rubella vaccines-I suspect if they could talk they would express feelings a lot like Rodney Dangerfield’s-that they get little respect, their infections often overlooked alongside the deadlier measles virus. 

It’s true, they don’t get a lot of press because they are so effectively prevented by the MMR vaccine-but let's see what you remember from school about these wallflower diseases.

Following is a list of consequences of mumps and/or rubella disease seen either in the infected individual or in an infant born to an infected mother. Some may be a consequence of both diseases, others may not be related to either one. See if you can match the disease(s), A-D, with the potential consequences, 1-8. 

A. Mumps          B. Rubella           C. Both              D. Neither
 

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Please click here for answers and brief discussions.

Answers

1. Pancreatitis A. Mumps only.
About 4% of individuals with mumps developed pancreatitis

2. Deafness C.  Both mumps/rubella.
Deafness is a common consequence of congenital rubella syndrome (CRS).  Mumps was actually a major cause of sudden onset deafness in children, sometimes temporary and sometimes permanent, in the prevaccine era.

3. Orchitis A. Mumps only.
Orchitis occurs in 12% to 66% of post pubertal males depending on the study. It is bilateral 60% to 80% of the time. I suspect these facts made this vaccine an “easy sell” to adolescent males when it became available in 1967.

4. Oophoritis A. Mumps only.
Oophoritis occurs in  about 5% of post pubertal females infected with mumps.

5. Sterility in both sexes A. Mumps only.
While orchitis leads to some degree of testicular atrophy in about half the cases, sterility in males is rare, even in cases of bilateral orchitis from mumps. On the other hand, mumps infection in pre-pubertal girls did have a significant statistical relationship with infertility, perhaps due to a disturbance of follicular maturation. Rubella is not associated with sterility.

6. Cataracts B. Rubella only.
A rubella infection in a mother's first trimester puts the fetus at high risk of developing CRS with cataracts, deafness, mental retardation, and congenital heart disease. This was not a rarity. In 1964-65 during a rubella epidemic that caused infection in 12.5 million Americans, 20,000 babies were born with CRS.

7. Spontaneous abortion C. Both mumps and Rubella.  
Rubella was estimated to have caused more than 11,000 fetal deaths with either elective or spontaneous abortion in 1964-65. Mumps can also cause spontaneous miscarriage, but at a much lower rate, in women infected in the first trimester.

8. Birth defects B. Rubella only.
Mumps is not associated with any birth defects.