Urologists at a leading Irish hospital have reported an alarming increase in the number of teenage boys and young men developing mumps orchitis, in a paper published in the April issue of the urology journal BJUI.
They are urging colleagues to offer the measles, mumps and rubella vaccine to unvaccinated males in the 15-24 age group and educate them about the condition, which causes one or both testicles to swell and can lead to fertility problems.
Niall Davis, a urology research registrar, teamed up with colleagues at the Mater Misericordiae University Hospital in Dublin to carry out an extensive review of five decades' worth of research and statistics.
"Boys who did not receive the measles-mumps-rubella vaccine during the mid 1990s are now collecting in large numbers in secondary schools and colleges and this provides a perfect breeding ground for the virus" he said.
"It's estimated that as many as 40 percent of males who develop mumps after puberty can suffer from orchitis. This is of considerable concern as epidemics of mumps orchitis are now being reported more frequently in many countries worldwide."
During the pre-vaccine era, mumps was most likely to affect children ages 5 to 7, with epidemics every four to five years. Globally 290 cases per 100,000 people were diagnosed between 1977 and 1985. Since the introduction of the MMR in 1968, there has been a dramatic reduction in cases, with the United States reporting a 99 percent fall.
But 15 years ago there was a global shortage of the MMR vaccine and media scares about links to autism, inflammatory bowel disease and Crohn's disease led to reduced uptake, despite subsequent reviews that concluded that such links did not exist.
In some urban parts of the United Kingdom, uptake fell from 91 percent to 58 percent and public concern linking MMR to autism still remains high.
"It is those unvaccinated boys that we are now seeing in our urology department,” Davis said. "It's estimated that as many of 42 percent of patients with mumps experience at least one complication. As well as swollen testicles, these can include inflammation of the ovaries, aseptic meningitis, acute inflammation of the brain, deafness and pancreatitis.
"The recent resurgence in the disease means that a significant proportion of 15 to 24 year-olds living in heavily populated environments are affected."