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You're never too old for mumps

<b>Rob Sharp</b> was sick, feverish and hallucinating &ndash; and his face wasn't the only body part that swelled to unnatural proportions.

Tuesday 14 July 2009 00:00 BST
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Mumps is probably the least cool disease a man can contract. If you say you have dengue fever it sounds like you are the kind of enigmatic, jet-setting cove who shoots lions before breakfast. But say "I've got mumps", and people immediately picture you with huge testicles. And there are many people in life whom you don't want imagining your testicles, especially in any kind of distressed state. These are, in no particular order: your parents, your boss, your colleagues, your friends, your ex-girlfriend's friends and family, the woman in the chemist, her friends and family, and, er, readers of a national newspaper.

For people like me, who are in their mid-20s (I'm 28) mumps is becoming increasingly common. The NHS says incidences of mumps over the first three months of 2009 (the most recent statistics available) were double what they were in late 2008. The hugely controversial MMR vaccine was only introduced nationwide in 1988, so my age-group, which were no longer infants when this happened, are particularly vulnerable. We are also more likely to catch it because of our youthful predilection for hanging around crowded university dorms and sleazy nightclubs, and, to make matters worse, mumps is very easy to catch, being spread by droplet infection. One side-on splutter on the Tube and you're done for. It has a 21-day incubation period, meaning you can contract it, walk away, play tennis for three weeks and then be laid up in bed quicker than you can say "I have massive balls" – and mean it.

My own mumps experience began in early June when my then-girlfriend sent me a rather alarming text message. She had been feeling ropy for a few days, had been suffering from a fever and had taken some days off work. Communication went quiet for a couple of days and then she said she'd been to see her GP. "He thinks it's mumps," she said, helpfully, in her next missive.

I was thrown into a blind panic, firstly, of course, for her wellbeing and secondly, necessarily, for my own (would I have to spend any money on her?). I was also under the impression that mumps was something that kids got, so felt slightly freakish, and not in a good way. I phoned up my mother and asked if I'd had mumps as a child. "Er, I dunno," she replied.

Further stressed out, I immediately looked up as much on it as I could find online, and leafed through my diary, trying to think who could have given it to my girlfriend (my conclusion was that it was the odd-looking guy in the pet shop. He charged £20 for fish-tank gravel and some emaciated plants; the mumps were free).

Ignoring some of the more outlandish comments on health websites – "I had mumps in March. It was well bad. Went in both balls and they swelled up like f**k" – I saw that the principal symptom was swelling of the parotid or salivary glands just in front of the ear. This happens in 60 per cent of cases. I discovered that this could be painful, and that it came quite early on. Complications include a bad fever, headaches, and maybe the odd rash. The thing is, that only tells part of the story. Firstly, because mumps is a virus it cannot be treated. That's the real pain. And the symptoms, certainly in my case, were to become much worse than I was initially led to believe.

Later that day, while I was cooking for my girlfriend, I could feel my own facial glands bulging. I was certainly beginning to feel ill, anyway, so I made my excuses and left as soon as I could, burying any notion of a Florence-Nightingale-like bedside vigil for her. Very soon it was clear to me that I had got it too. I was shivering – which, even with my central heating, is uncommon in June – and feeling fatigued. That first night, I woke up on several occasions drenched in sweat. If it hadn't been for the fact that my girlfriend had already been told by her doctor that she had it, I might have thought it was glandular fever, which I had when I was 18.

Initially, it was easy to cope with. I alternated doses of paracetamol and ibuprofen to relieve my fever. I still had an appetite for the first few days, although I was confined to bed. Unfortunately I had recently moved offices so my doctor was over in Canary Wharf, and this was an hour away. Typically, I could not find an NHS doctor to register with around my area at short notice (take note). I ended up ringing my GP in Canary Wharf and they charged me £50 for a four-minute chat on the telephone. The doctor wearily said she could not diagnose the mumps because she could not see what I looked like; it sounded as though she was reading something off a website.

I went back to my parents' place in Surrey. Initially, I was comfortable, I was reading, and, although my appetite was beginning to wane, I could sleep more or less normally. It was no worse than a serious bout of the flu. The swelling around my face did not reach the proportions which had troubled my girlfriend, and quickly began to recede. Interestingly, a doctor was called out to see me and excitedly said he would have to test me for swine flu, but once I had explained my symptoms he said it wasn't necessary.

A few days later, though, my condition rapidly deteriorated. One of the more famous complications of mumps, as already discussed, is orchitis, or testicular swelling. I was conscious that my balls had grown in size and were causing me some discomfort when I walked. I got around this by cupping them when I wandered from room to room. While such moves were popularised by Buster Gonad in Viz, my testicles' increased size did not lead me to become involved in a series of hilarious scrapes in which they are put to various uses, such as providing a useful place for birds to nest.

But I did become immensely familiar with them and could deduce, with no little pride, that each was now the size of a medium-sized bag of jelly babies. Unfortunately, this was accompanied by some other uncomfortable symptoms. I could not fall asleep for five minutes without waking up drenched in sweat.

As I was no longer sleeping at night, I was often dropping off. By this point I had not eaten for several days, and ended up losing quite a lot of weight. When I awoke with my fever I would immediately feel very sick, and would spend several minutes vomiting. If I tried to walk, it would make me feel dizzy, and also much more nauseous. I thought I saw Jesus.

It got to the stage where I needed to be taken to hospital. With some difficulty I managed to get to A&E. I waited and was eventually seen by a doctor in the infectious diseases unit (mumps is generally only infectious when you are displaying its symptoms). My consultation ended with an examination of my testicles. The medic began kneading my balls like he was following a particularly difficult Jamie Oliver recipe. "Does that hurt?" he asked. "Aaaargh," I replied.

He said I had bilateral swelling, and that my right ball had swollen up much more than the left. He said he would need to consult a surgeon. "A surgeon," I repeated, grimacing, texting my girlfriend, who was now my first port of call on all things mumps-related. Visions of testicular amputation flashed before my eyes. She said there was nothing to worry about: I was not going to have my balls chopped off, it was just that surgeons knew more about the internal workings of our bodies. Excellent news. Bizarrely, this was not explained to me by the doctor. He just returned after an hour and said I could leave. I was not given any further information, or any tests. Although happy to be getting out of there, I could barely walk out of the ward and had to stop twice to rest because I felt so dizzy. I continued in this state for several days. The swelling eventually receded, though it took another five days or so after my hospital visit, around two weeks after I had first developed symptoms. I gradually started spending more time out of bed; I returned to work several days after that.

Thankfully, my dalliance with mumps caused me to suffer no long-term ill-effects. I recently consulted with a GP and he said that the only danger to my fertility, say, would be when my testicles returned to their normal size – this can sometimes be accompanied by atrophying, reducing one's sperm count. But because the severe swelling was only on one side, I was still likely to have one healthy testicle. This was the news I'd been waiting for.

At long last, my balls are now back to normal, much to the relief of my friends, colleagues and family, who had all been very concerned. When I say "normal", though, that does come with one minor proviso: they were pretty huge to begin with. It is my cross to bear.

A vicious virus: Mumps on the rise

* Epidemic parotitis, otherwise known as mumps, is a very contagious disease caused by an infection of the parotid salivary glands.

* The symptoms, which include a high fever and pain and swelling in the jaw, usually take between 14 and 21 days to appear after contact with a carrier.

* In milder cases, the acute phase lasts up to three days, but it can last for a week or longer. Mumps is caused by a virus and unfortunately there is no "cure", only symptomatic treatments for the fever and pains such as paracetamol and ibuprofen.

* Mumps is on the rise. There were more than 1,000 confirmed cases in the first two months of this year, more than three times the number of cases in the same period in the previous two years. Most cases affect people in their teens and twenties. This is thought to be because routine vaccination was not introduced until 1988. During the last epidemic in 2005 there were 43,378 reported cases.

Complications of mumps include orchitis, which is the swelling of the testicles, which can potentially affect fertility. Around 20 to 30 per cent of men who contract mumps develop orchitis.

Other rare complications include meningitis, which may appear up to 10 days after mumps; pancreatitis, the inflammation of the pancreas; and permanent deafness.

Mumps is still an issue in developing countries due to the lack of immunisation available to children. Mumps is one of the six most common preventable diseases, according to UNICEF. Only last year there were 19,550 notified cases when a mumps epidemic broke out in Moldova.

Cindy Yau

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