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zoom RSS ムンプス精巣炎の増加/MMRワクチン 不妊症

<<   作成日時 : 2010/04/07 01:28   >>

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 新たな研究によれば、睾丸が腫脹して不妊症の原因となるムンプス精巣炎と呼ばれるおたふくかぜに関連した睾丸疾患にかかる若年男性がかなり増加しているという。
 15-24才の未接種の男性すべてにMMRワクチンを接種すべきであり、ムンプス精巣炎について教育がされるべきであるという。
 MMRワクチンが1968年に導入された後、ムンプス精巣炎の発症数は世界的に劇的に減少した。しかし、自閉症、クローン病と関連しているとのメディア報道がされたために約15年前から減少に転じた。
 1990年代中旬にMMRワクチンを接種されなかった子どもが現在、中学から大学に多数いて、ムンプスウイルスの培地となっている。思春期以降にムンプスにかかると40%近くが睾丸炎になる。全国で流行している所以である。
 ムンプス精巣炎になると最高で50%が睾丸萎縮となる。
 完全な不妊症は稀だが、約13%が妊娠能力が落ちる。
 回復しても3年後に成人の24%、青年の38%に精子数の異常が見られる。
 精巣炎とガンとの関係は弱く、発症率は0.5%である。
---------------------------------------------------
Unvaccinated Boys at Risk of Mumps-Linked Testicular Problem
Testicles can swell or atrophy as a result, researchers say
-- Robert Preidt
http://health.msn.com/pregnancy/articlepage.aspx?cp-documentid=100256572

画像Testicles can swell or atrophy as a result, researchers say.

FRIDAY, April 2 (HealthDay News) -- A new study reports a significant increase in the number of young males with a mumps-related testicle condition called mumps orchitis, which causes one or both testicles to swell and can lead to fertility problems.

The measles-mumps-rubella (MMR) vaccine should be offered to all unvaccinated males aged 15-24, and they should be educated about mumps orchitis, said Irish urologists who reviewed five decades worth of research and statistics.

After the MMR vaccine was introduced in 1968, the number of cases of mumps orchitis decreased dramatically worldwide. But vaccination rates started to decline about 15 years ago because of a global shortage of the MMR vaccine and media reports that it was linked to autism, inflammatory bowel disease and Crohn's disease.

Even though subsequent research found no such links, there's still widespread public concern about the MMR vaccine.

"Boys that did not receive the [MMR 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 [mumps] virus," Niall Davis, a urology research registrar, said in a news release. "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 countries worldwide."

In their review, Davis and colleagues found that:

* Up to 50 percent of mumps orchitis patients experience testicular atrophy, a reduction in the size of one or both testicles.
* Infertility is rare, but reduced fertility occurs in about 13 percent of patients.
* Three years after recovery, 24 percent of adults and 38 percent of adolescents can still have abnormal sperm counts.
* The association between mumps orchitis and testicular cancer is weak, with an incidence rate of 0.5 percent.

The paper appears in the April issue of the urology journal BJUI.

More information

The Medlineplus Encyclopedia has more about orchitis.
SOURCE: BJUI, news release, March 30, 2010

Copyright @2010 HealthDay. All Rights Reserved.

-----------------------------------------------------
The increasing incidence of mumps orchitis: a comprehensive review

Niall F. Davis, Barry B. McGuire, Jackie A. Mahon, Anna E. Smyth, Kiaran J. O'Malley and John M. Fitzpatrick
Department of Urology and Department of Surgery, Mater Misericordiae University Hospital, University College Dublin, Ireland
Correspondence to Niall Davis, Department of Urology, The Mater Misericordiae Hospital, 47 Eccles St, Dublin 7, Ireland.
e-mail: nialldavis2001@yahoo.com
Copyright © 2010 BJU International
ABSTRACT

There has been a recent increase in mumps orchitis among pubertal and postpubertal males. These outbreaks can be attributed to a reduction in the uptake of measles-mumps-rubella (MMR) vaccine during the early to mid-1990s in children who have now matured. The mumps virus is commonly associated with extra-salivary complications. Unvaccinated postpubertal males diagnosed with mumps virus frequently develop complications such as mumps orchitis. Therefore, it is important that urologists are familiar with the diagnosis, treatment and complications of this condition. Here we review the epidemiology, clinical presentation, diagnostic methods, treatment options and complications of mumps orchitis, as a complication of mumps virus, with particular emphasis on testicular atrophy, subfertility and infertility.

Accepted for publication 22 October 2009
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1464-410X.2009.09148.x About DOI

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