Sidney Crosby is the biggest name yet to be added to the NHL's growing list of players who have contracted the mumps.
The Pittsburgh Penguins announced Sunday that Crosby, their second-leading scorer, was the 13th NHL player to be diagnosed with the virus. The two-time MVP was held out of weekend games against the Calgary Flames and the Columbus Blue Jackets as a precaution. The 27-year-old had developed significant swelling to the right side of his face.
The team originally believed that the swelling was related to a salivary gland injury that Crosby sustained in a Nov. 29 matchup against the Carolina Hurricanes.
Crosby underwent a CT scan, which showed the injury, and tested for the mumps as precaution. Tests came back negative.
Crosby participated in the team's morning skate on Friday, but his condition worsened and he was held out of Friday's game against Calgary. The club's head physician Dr. Dharmesh Vyas, conducted a series of tests Friday afternoon, including a DNA sample, which were sent to the U.S. Centres for Disease Control. The positive diagnosis came back Saturday evening.
According to Vyas, Crosby's diagnosis came as a "bit of a surprise."
"Every indication was that he was well protected against the disease," he said.
"He had had all of his immunizations as well as had a booster shot as recently as less than a year ago for the (Sochi) Olympics. So, he was well protected from his antibodies standpoint.
The mumps is generally characterized by painful, swollen salivary glands, fever, headache, weakness and fatigue, loss of appetite and pain while chewing or swallowing.
Vyas said Crosby didn't have a "classic presentation" of the virus.
"He … had no symptoms such as fever, or chills, or generalized body aches," he said.
"The majority of mumps is bilateral. It’s on both sides of the face, and again, at that time when we saw him and tested him, it was just one-sided."
Crosby has been isolated from the rest of the team and the Penguins will continue to monitor his health. Based on the infectious period of the virus, the Canadian superstar could rejoin the club after Monday next week, Vyas said. The CDC recommends five days of isolation.
Vyas said the entire team was tested for the mumps two weeks ago, following the outbreak in the NHL, and players and staff who had low levels of immunity to the virus were given shots.
Pittsburgh has been plagued by a rash of unusual injuries this season. Forward Pascal Dupuis is out for the entire season due to blood clots, while 20-year-old defenceman Olli Maata sat out two weeks in November after a cancerous tumour was removed from his thyroid.
The club's general manager, Jim Rutherford, said the team will have to do its best despite holes in the lineup.
"We’re going through a period here that is pretty rough," he said. “We have a lot of guys out, whether it’s from mumps or hockey injuries and obviously Olli (Maatta) with the cancer. So it’s a period that builds character and if you can get through it, it’s going to help you in the long run. But certainly it’s hard."
Other NHL players who have contracted the mumps are: Corey Perry, Francois Beauchemin, Clayton Stoner and Emerson Etem of the Anaheim Ducks, Ryan Suter, Keith Ballard, Marco Scandella, Jonas Brodin and Christian Folin of the Minnesota Wild, Tanner Glass of the New York Rangers and Travis Zajac and Adam Larsson of the New Jersey Devils.
Mumps cases are still rare in North America, but have seen a bit of resurgence since the mid-2000s, after people began avoiding the MMR (measles, mumps and rubella) vaccine because of data falsely linking it to autism.
However, the CDC says it’s possible for those who’ve received the MMR vaccine to still get the mumps. One dose is of the MMR vaccine is 78 per cent and a “very small percentage of people may not be protected even after a second dose,” according to the CDC.
Dr. Gavin Macgregor-Skinner, a public health emergencies expert at Pennsylvania State University, told CTV News Channel Sunday that health officials in Anaheim, Calif. issued a public health alert for the mumps back in September. The NHL's outbreak began with players on the Anaheim Ducks in October.
So far, players on five clubs have been infected, and Macgregor-Skinner says the NHL is a "perfect" breeding ground for the virus.
"Mumps is spread by saliva," he said. "You look at the behaviour on the bench, you look at the behaviour in the locker-room: Sharing water bottles, towels and banging heads on the ice. Anywhere where you may be able to share saliva increases that risk for diseases such as mumps."
Macgregor-Skinner added it is no coincidence that the teams with infected players have faced off against each other since October.
"If you follow the actual epidemiology of this disease you can see that teams have actually played each other since October," he said.
"So, again, the potential of spreading through to many other teams is highly likely."
The Ducks hosted the Wild on Oct. 27, and Minnesota played against the Rangers 10 days later. The Rangers also faced off against the Penguins twice in November. But it remains unclear if players shared the virus with each other or picked it up elsewhere.
Several other clubs affected by the outbreak have asked their players to receive booster shots and have implemented sterilization techniques in team facilities.
The Toronto Maple Leafs have also offered inoculations to their players.
Macgregor-Skinner said this is likely the best course of action, but for many players it may already be too late.
"That’s really the necessary and best public health action at the present," he said.
"Many of these players may still be in the incubation period and may have a really miserable Christmas coming up."