Dear Dr G,I read with interest your explanation of how German measles affects women and how the disease itself has minimal effect in men.I am somewhat surprised you did not outline the risks associated with another dangerous virus, mumps, which can have a more detrimental impact on young adult males.As a child, I contracted mumps after missing vaccination at school.I was horrified when I learned mumps may sometimes lead to infertility, and this information has caused me concern.Many people tend to think of mumps as only a childhood illness, but I understand complications can occur when adults are infected.As I am venturing into adulthood, I worry the aftermath of mumps may cause havoc to both my sexual and reproductive health.I would like to put you on the spot so you can address how mumps may affect sexual and reproductive health in young men.What exactly is mumps and how is the infection transmitted?How common are complications such as inflammation of the testicles, reduced fertility, or other long-term effects?Are these risks rare, or should young adults be more cautious?I also hope you can explain whether vaccination still provides good protection in adulthood and what steps people can take to reduce their risk of infection.I believe this is an important public health topic that many readers, especially young adults and parents, would benefit from understanding better.Yours sincerely,Mumps Matthew For many people, mumps is remembered as a common childhood illness marked by swollen cheeks, fever and a few days away from school. However, beneath this seemingly harmless infection lies a virus that can sometimes lead to serious complications, especially among adolescents and young adults. Although vaccination has dramatically reduced the number of cases worldwide, mumps remains an important public health concern because outbreaks still occur and complications can affect long-term health and fertility. Mumps is a contagious disease caused by the mumps virus, which belongs to the Paramyxovirus family. The illness mainly affects the salivary glands, particularly the parotid glands near the ears, producing the characteristic swelling of the face and jaw. The disease has been recognised since ancient times. The Greek physician Hippocrates described symptoms resembling mumps as early as the fifth century BCE. However, it was not until 1934 that scientists Claude Johnson and Ernest Goodpasture proved mumps was caused by a virus spread through saliva and respiratory droplets. Before the development of vaccines, large epidemics occurred every few years, especially among schoolchildren. Most people contracted the infection during childhood, and outbreaks spread rapidly in crowded communities. The introduction of the measles-mumps-rubella (MMR) vaccine changed the situation dramatically. In countries with strong immunisation programmes, the incidence of mumps dropped by more than 90%. Nevertheless, the disease has not disappeared. Thousands of cases continue to be reported globally every year, particularly in places where vaccination rates have declined, or where young adults live in close-contact environments such as universities, dormitories and military camps. The virus spreads easily through coughing, sneezing, talking, or sharing utensils and drinks. Once it enters the body through the nose or mouth, it multiplies in the respiratory tract before spreading through the bloodstream to other organs. Children infected with mumps often develop fever, headache, tiredness, muscle aches and swelling of the salivary glands. In many cases, the illness resolves within 1–2 weeks without lasting problems. However, complications become more common and more severe in adolescents and adults. One of the most worrying complications among post-pubertal males is orchitis, which is inflammation of the testicles. This condition can develop several days after the onset of facial swelling and may cause severe pain, swelling, tenderness and fever. Although most men recover fully, some may experience shrinkage of the affected testicle. In rare cases, particularly when both testicles are involved, fertility may be reduced. Complete infertility is uncommon, but the possibility has caused understandable concern among many young men. Mumps may also affect other organs, including the pancreas, brain and inner ear, sometimes leading to meningitis, encephalitis or hearing loss. Vaccination has proven to be one of the greatest achievements in modern medicine. The MMR vaccine provides strong protection against mumps and significantly reduces the risk of serious complications. High vaccination coverage also contributes to herd immunity, protecting vulnerable members of society who cannot be vaccinated. Unfortunately, misinformation and vaccine hesitancy in some communities have allowed outbreaks to re-emerge in recent years. Public education therefore remains essential in reminding people that diseases once considered “mild childhood illnesses” can still produce serious consequences. Scientists believe mumps can potentially be controlled to very low levels through widespread vaccination, strong public health systems and rapid outbreak response. Although complete global elimination remains difficult because immunity may decrease over time and vaccination coverage differs between countries, the dramatic decline in cases over recent decades demonstrates prevention works. The story of mumps reminds us medical progress should never be taken for granted. Infectious diseases that once caused widespread suffering can return if societies become complacent. Continued scientific research, vaccination programmes and public awareness are necessary to protect future generations from preventable illnesses. American astronomer Carl Sagan once said: “The consequence of today is determined by actions of the past” Dr G is often put on the spot by infertile men questioning whether the aftermath of mumps results in irreversible damage to fertility. His view is: “We will definitely prevent the consequence of today, when we are determined in the actions of vaccination tomorrow!”
