Mumps in NHL: How the heck did this happen and can it be stopped? (F.A.Q.)

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NEW YORK, NY - DECEMBER 08: Sidney Crosby #87 of the Pittsburgh Penguins prepares to take the faceoff against the New York Rangers at Madison Square Garden on December 8, 2014 in New York City. The Rangers defeated the Penguins 4-3 in overtime. (Photo by Bruce Bennett/Getty Images)

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NEW YORK, NY - DECEMBER 08: Sidney Crosby #87 of the Pittsburgh Penguins prepares to take the faceoff against the New York Rangers at Madison Square Garden on December 8, 2014 in New York City. The Rangers defeated the Penguins 4-3 in overtime. (Photo by Bruce Bennett/Getty Images)

Sidney Crosby of the Pittsburgh Penguins was formally diagnosed with the mumps last week, bringing one of the NHL’s strangest medical stories in years to the forefront of hockey conversation. 

What are we dealing with? How did it get this out of hand? Where did it start?

Here’s are those and other frequently asked questions about the mumps.

Q. What is a mump?

Not one mump, many mumps. The mumps are a viral infection that “affects the parotid glands — one of three pairs of saliva-producing (salivary) glands, situated below and in front of your ears,” according to the Mayo Clinic.

That’s where painful swelling occurs, resulting in what we saw with Crosby, who looked like a Squirrel-man keeping a cantaloupe in his cheek for the winter.

There’s also fever, headaches and fatigue. Extreme cases can include the infection spreading to the testicles or ovaries, potentially causing infertility, and potentially even meningitis if the disease spreads to the outer protective layer of the brain.

So, in summary: Adorable name – it sounds like an animated pop band comprised entirely of puppies – but some serious consequences if it gets out of hand.

As Francois Beauchamin said, "Mumps has to be the worst thing I've ever had in my life.” And keep in mind he spent two seasons dealing with the Toronto media.

Q. OK, so how does one prevent or treat the mumps?

Two different issues, so let’s tackle the second one first: There is not cure for it, so the only treatment is enough rest and fluids to allow the body to ante-up enough antibodies to knock it out.

As far as prevention, we’ve had a Mumps vaccine for decades. The ‘ole MMR – Mumps, Measles and Rubella shot – are typically administered early in life (around one year old) and then again before starting school (age five). In the pre-vaccination days, 90 percent of all children had the mumps before they turned 14.  In 2013, the CDC reported there were only 584 cases of mumps reported in the U.S., although that number spiked to 1,078 through Nov. 29 this year.

Perhaps the only surprise there is that the majority of those cases were not in the NHL.

Q. Now that you’ve mentioned it … why the heck have the mumps cut through the NHL like a Darcy Tucker spearing?

How much time you got?

Q. I’m reading this at lunch, as I do most stories of wide outbreaks of nauseating viral infections.

It spreads through the salvia, mostly. So one theory is the old “don’t share your water bottle” mantra has been summarily ignored. Another is that players exchange bodily fluids on the ice all game, so that’s where it’s been passed, through coughing or sneezing or spitting. 

Q. Ew.

The ice during an NHL game is a petri dish of disgusting. It’s a miracle that by the end of each period, new lifeforms aren’t emerging from its primordial soup.

But there’s another issue with the Mumps: According to Dr. Peter Lin of CBC, it can take up to 2-3 weeks for the disease to manifest but you’re still contagious during that time. Which brings us back to something like sharing water bottles, because a teammate who looks completely healthy could be a Mump Factory.

Q. But isn’t everyone immunized? Weren’t some players, like Olympians like Sidney Crosby, immunized earlier this year?

Yes and yes. But it may not matter. 

Matt McCarthy had a great piece on the Mumps outbreak on Deadspin, writing:

Mumps outbreaks are rare, so updating the vaccination schedule hasn't really been on our radar. But it may soon be. Throwing a wrench into all of this is that some players with the disease recently did receive a booster. The Penguins claim Crosby was vaccinated against mumps in February; he had antibodies in his system, just not enough. And that's what makes this so challenging for the NHL (or any concentrated workplace). There isn't a simple blood test to confirm with 100 percent certainty that a hockey player (or any person) is truly immune to mumps. That's because the optimal level of antibody to protect from the virus is unknown. NHL teams assumed players were immune when, in fact, they were not.

During the 2006 outbreak, more than 95% of students at one university had been vaccinated against mumps and researchers could not identify a threshold antibody level that correlated with protection. Some got it, some didn't. Yes, it's better to have a lot neutralizing antibodies rather than no antibodies, but we can't say precisely how much you'll need to be safe the next time mumps hits your town. Or your ice rink.

Mumps began making a comeback around six years ago, moving from infecting mostly children to adolescents and adults. The vaccines given in children can have waning effects later in life. Without a booster, those who received the vaccine could still catch mumps later in life. (And medical experts have argued during this outbreak that the failure to deliver another booster later in life is an indication that we’re not doing enough to protect the populace from mumps.) 

But as Lin noted, there is a group of people that simply aren’t protected by the vaccine. “They don’t have the factory to produce the anti-bodies,” he said.

So it’s entirely possible that someone like Crosby, despite receiving the booster, may be in that latter group. 

Q. But why have so many people in the NHL, specifically, have gotten it?

Do you listen to “Serial”?

Q. Sure, who doesn’t? Adnan totally did it.

But there are no pay phones at the Best Buy!

Q. We’re getting off track here.

Right. So on “Serial,” they meticulously rebuild the murder case to try and figure out what actually went down.

So here’s what we know:

Oct. 2014: The St. Louis Blues have several players that test positive for the mumps, according to the Star Tribune. The team later told the LA Times that they “never confirmed the mumps” despite Joakim Lindstrom and Jori Lehtera both having mumps-like symptoms. As of this writing, no Blues' illnesses have been formally defined as the mumps. 

Oct. 17: Keith Ballard misses a game for the Minnesota Wild. Some the Star Tribune reports it was the mumps.

Nov. 5: Francois Beauchemin and Corey Perry of the Anaheim Ducks both come down with the mumps and miss multiple games.

Nov. 29: Tanner Glass of the New York Rangers becomes the first player not with the Ducks or Wild to be diagnosed with the mumps.

Dec. 12: Sidney Crosby appears before cameras looking like Quagmire, and the Penguins eventually diagnose this as the mumps. And suddenly everyone cared about the mumps.

Dec. 14: Beau Bennett of the Pittsburgh Penguins becomes the 15th player publically diagnosed with the mumps from the Ducks, Wild, New York Rangers and New Jersey Devils: Crosby, Bennett, Perry, Beauchamin, Ballard, Glass, Ryan Suter, Emerson Etem, Marco Scandella, Jonas Brodin, Christian Folin, Clayton Stoner, Adam Larsson, Travis Zajac and Derrick Brassard.

Q. So what’s your theory?

Given that the Ducks and Wild were the two teams most affected, there can be only one conclusion: Dany Heatley is the Outbreak Mumpkey.

Q. But what about the Blues maybe having it first?

Then obviously the answer is “stray dogs from Sochi.”

But seriously, Anaheim might still be ground zero for this outbreak. There have been reports of mumps outbreaks at local schools, and that could easily mean a player brought mumps to the locker room after his tyke brought it in from school.

And then we’re off to the races, according to The Journal of Infectious Diseases:

"High population density in communal living situations, such as dormitories or boarding schools, may provide increased opportunities for close contact or saliva exposures and higher dose exposures to mumps virus when introduced, resulting in easier transmission and higher rates of disease than might occur in other parts of society."

Q. What is the NHL doing about this outbreak?

According to the NY Daily News, they’ve been instructing teams on how not to allow the virus to spread, although it’s not exactly all that different from the advice they give to stop the flu. Booster shots for players are up to the players; the NHLPA will not mandate vaccinations, because they wouldn’t even mandate visors for pete’s sake.

Some teams, like the Islanders, have attempted to vaccinate all players and staff. Other teams that are a bit closer to the draft lottery probably haven’t. (Our theory.)

Also, teams like the Wild have totally cleaned and disinfected their dressing rooms.

Q. So can the NHL stop it?

Well, the last time Sidney Crosby had a health crisis, the NHL created an entirely new department in its central office to eradicate head shots.

George Parros for Mumps Czar!

Q. Thank you for this information. It’s been enlightening and a little frightening. But one last thing: Can we laugh at any of this stuff or is it no laughing matter?

We’re not here to judge. We’ll just leave this here, as a bit of a Rorschach Test:

SCRATCHED: Corey Perry, ANA (mumps)

Also it's really impossible to test the comedic potential in this outbreak when no one's created a "My Mumps" parody song, to the tune of "My Humps." 

Greg Wyshynski is not a doctor but he plays one on this blog.

 

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