NHL mumps outbreak rare, but 'could happen anywhere'

NHL players aren't any germier than the next professional athlete, and their locker rooms aren't overrun with viruses and bacteria.

The mumps outbreak that has so far affected 15 players on five teams, including Pittsburgh Penguins star Sidney Crosby, is a combination of bad luck and folks not being up to date on their immunizations.

"It has nothing to do with hockey. This could happen anywhere," said Dr. Gregory Poland, a professor of medicine and the director of the Mayo Vaccine Research Group at the Mayo Clinic in Rochester, Minn.

"It has and will happen in colleges. It used to happen regularly in military boot camps," Poland said. "So there's nothing peculiar to this."

It is unusual, however.

Before a vaccine was introduced in 1967, there were 186,000 cases of the mumps each year in the United States. The vaccine reduced those cases by 99 percent.

But there are sizeable parts of the U.S. and Canadian population who were never immunized because they're opposed to vaccines and believe, wrongly, that they are unsafe.

There also are people who are under-vaccinated – often unknowingly.

After several outbreaks in the late 1980s, the Centers for Disease Control increased its recommendation to two doses, one between 12 and 15 months and the other at 4 to 6 years old. Not everyone gets the second dose, however.

The vaccine is about 85% effective, meaning there are some people who won't be immune despite being vaccinated.

Put that all together, and the occasional outbreak is as inevitable as it is rare.

"To be very frank with you, if 13 students at a junior college in rural Arizona had mumps, you and I wouldn't be talking. It gets hyped because it's in (professional athletes)," Poland said.

And because once an outbreak starts, there's little that can be done.

Much like the flu epidemics that sweep through offices and schools each winter, the mumps is viral, spread through saliva and respiratory droplets, i.e., coughing and sneezing. Symptoms can include fever, headache, fatigue, muscle ache, loss of appetite and swelling of the cheeks and throat.

There is no antibiotic for the disease, no over-the-counter medicine that will help. So short of making sure players are up-to-date on their immunizations and observing basic sanitary precautions, the NHL has to let the disease run its course.

"The way to prevent mumps is to make certain that players and staff have been previously immunized. Preventing secondary transmission is not the solution to the problem," said Dr. Daniel Sexton, a professor of medicine at Duke University Medical Center and the director of Duke Infection Control Outreach Network.

The NHL does not require players to be immunized against the mumps but it has recommended it. In a survey Wednesday by USA TODAY Sports, 20 of the 30 teams said they have provided vaccines or booster shots from Nov. 14 to as recently as a week ago. Two teams said they do not disclose medical information. Eight hadn't responded by Wednesday evening.

Though the NHL has not issued a league-wide directive on the outbreak, deputy commissioner Bill Daly said the league consults with an epidemiologist on infectious diseases who "oversees our efforts on this." That information has been shared with the teams.

Most teams are taking basic precautions, including not sharing water bottles, using hand sanitizers and, in the case of the New York Rangers, not having roommates on road trips. Some have canceled public appearances, which are popular at this time of year.

"I have no sense that any club has mishandled this in any way," Daly said. "I think the standards are in place, and the advice we are getting on treatment and containment is the same regardless of who you talk to.

"I have no reason to believe that teams aren't doing everything in their control to minimize this."

The good news is that, for as rare as it is, the mumps usually isn't serious. An end to the outbreak is only a matter of time.

"As more and more of the community gets booster vaccinations, and sometimes the first vaccination, this will start to subside," Daly said.