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Dr. Dharmesh Vyas, Jim Rutherford Transcript Regarding Crosby's Mumps Diagnosis

by Staff Writer / Pittsburgh Penguins

Sidney Crosby has been diagnosed with the mumps, the Pittsburgh Penguins announced today.

Crosby will continue to be monitored daily, but specialists believe he should be through the infectious period by Monday.

He will not play in Monday’s home game against the Tampa Bay Lightning.

Penguins head team physician Dr. Dharmesh Vyas and general manager Jim Rutherford met with the media on Sunday morning to discuss Crosby's mumps diagnosis. Here is the full transcript.

DR. VYAS

Mr. Rutherford has asked me to give a timeline on Sidney Crosby having the mumps. I’ll start by telling you sort of how we came about to this diagnosis. At the Carolina game, Sidney sustained an injury to the right side of his neck. At that time, he injured the submandibular, or salivary gland, on his neck. We came back to Pittsburgh and we tested him, including a CT scan, which showed the injury. Also, just to be safe, we tested him for mumps at that time and all the blood tests came as negative. We continued to follow that. He was on medications to bring the swelling down to let the injury resolve and once the medications were stopped, he developed swelling just next to that area. We once again ran a series of tests, including CT scans, and also tested him for mumps at that time. Early tests showed that there was no indication of infection, and we continued to follow him closely. At that time, I should also tell you that during this period, we tested the entire team for mumps. We ran a series of titers, which is antibodies against the virus. Sidney was one of the highest on the team protecting him against the virus. He had had all of his immunizations as well as had a booster shot as recently as less than a year ago for the Olympics. So he was well protected from his antibodies standpoint. He also had no symptoms such as fever, chills, or generalized body aches. But we nevertheless continued to follow him closely. This is a rapidly evolving process. We then did a series of tests on him, including specifically sending out DNA for PCR (Polymerase Chain Reaction) testing to the CDC (Centers for Disease Control and Prevention), which is a highly sophisticated test. We kept him out from the Calgary game in anticipation of test results, and we found out last night that the test results came back positive. He’s been in isolation and he has the mumps. We will continue to follow him closely. This is a self-resolving process and we’ll evaluate him daily.

Could he be ready to go by next week? Is that the presumption?
That’s the presumption, yes. The CDC recommends five days of isolation before the virus infection period is completed, so we’ll follow those recommendations. However, we’ll continue to evaluate him daily and follow him closely to see how he’s doing clinically.

How is he able to contract mumps if he’s been immunized and if he had the booster shot recently?
That’s a great question, and that’s why it came about as a bit of a surprise to us, because every indication was that he was well protected against the disease. We had made sure that the whole team was checked. We immunized all of the players and staff who had low titers in protection of this. That was done approximately two weeks ago, just because of the outbreak of mumps in the NHL. We’re trying to stay ahead of it.

Will you do any further, more elaborate testing with his teammates?
We will only if they develop symptoms. So we’ll continue to monitor them. Should they develop any symptoms, then yes, obviously we would test them further to see what the situation is.

Did the injury in Carolina make it any easier for him to sustain this? Is it related in any way?
We don’t think so. However, it clearly confuses the picture and we had to do a series of tests because of the fact that he had swelling on that side of the neck, and we tried to stay ahead of it because of that.

Were you guys initially ok with him skating Friday morning assuming it was related to that incident in Carolina?
This is a rapidly evolving process. So we tried to do as much testing as possible, and we tried to stay ahead of it with all the different tests that were available to us.

Was he contagious when he skated on Friday and might that affect your plan going forward with testing teammates?
As soon as we have some more infomation about it, we’ll notify. But obviously we will keep all these things in mind, (including) the fact that a player has been vaccinated but nevertheless can still contract the virus. So we’ll definitely continue to maintain a high level of vigilance on this.

Is Monday the only game, for now, that he would definitely be ruled out of?
I can’t say for sure for now. Based on the medical timeline that the CDC provides us, that would be the timeframe that he should be off of the infectious period. However, we’ll continue to evaluate him daily and just take it day-by-day at this point.

The sample that was sent to the CDC, was that after he was cleared to skate Friday morning or before?
The sample was sent on Friday afternoon to the CDC.

Was the swelling of his face on Friday morning something that alarmed you and made you want to take that further step?
Absolutely. It was rapidly evolving and his condition worsened from the day before. And as soon as we noted that, that’s when we sent off additional samples. During this whole period, we’ve had several medical staff involved in his care: ear, nose and throat, oral maxillofacial, infectious disease, internal medicine. Everyone has been evaluating him for this injury as well as the potential for any disease process for a few days.

Aside from the swelling in his face, what are his other symptoms and what will he be dealing with the next couple days?
Mostly the symptoms of mumps would be fevers, chills, none of which he has. Pain at the site, body aches, difficulty swallowing and just a generalized feeling of malaise and being tired. All those symptoms, we’ll continue to watch if he develops any of those. He didn’t have the classic presentation of mumps. 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.

Are there any other precautions you need to take in terms of sterilizing the room, anything like that?
We’ve been actually sterilizing our room since the mumps outbreak started in the NHL. We frequently clean out the rooms and did again yesterday. We’ll do that on a regular basis. Then just generally viral transmission precautions, washing hands, not sharing water bottles as much as we can for a professional hockey team.

What about staff, media or anyone else that he might have come into contact with on Friday? Any recommendations for any of these people?
Sure, absolutely. We’ve talked to all of our staff, we’ve been talking to them since the NHL outbreak started. If they develop any of those symptoms, such as body aches, swelling, fevers, chills, develop pain or tenderness along the jawline, then they definitely need to report it and have it assessed.

Is there anything the NHL can do to get this under control just in general around the league?
Trying to avoid transmission is probably the best way of getting this controlled. There’s no pharmacological, medical treatment for it. It’s just trying to curb the transmission from person to person.




JIM RUTHERFORD

What’s your overall concern level in terms of this spreading to other players on the team, that kind of thing?
Well, it’s obvious we’re concerned about it. It’s a disease that’s going throughout the league and you just don’t know how far it can spread. So like Dr. Vyas said, we’re watching this on a regular basis.

Jim, did the team make a mistake by letting Sid participate in the skate on Friday?
We can only go by the recommendation from the medical people. We’re not going to overrule them on anything. And quite frankly, that decision was approved that he could be here and his condition worsened after the skate. That’s when I got the call from Dr. Vyas. I think it was like 5 o’ clock in the afternoon. He said that he could play in the game, but there would be certainly some risk and at that point, we said we’re not going to do that. We’re not going to do it not only for our team, but for everybody around and the visiting team.

Jim, had you seen him Friday morning, and if so, were you alarmed by the way he looked?
I did not see him, no. I’ve only seen the picture. I was here and aware that he was skating, but I was just going based on what (head athletic trainer) Chris Stewart was telling me and what Dr. Vyas was telling me.

What was your reaction when you saw the picture? It was pretty pronounced.
It was. But in our business, you see those things with players at different times and it’s not always a disease. It comes from hits and things like that. But my understanding of mumps is usually this is two-sided, and it was kind of odd that it was just on the one side.

Jim, he suffered that injury in Carolina the week before when his throat was grabbed. Was there a feeling that was initially maybe the problem and that mumps wasn’t even a concern at first when you saw his face swollen?
No, I think the doctor was looking at everything. But certainly that was one thing that they felt, that it could be related to the gland swelling from the hit against Carolina. But with that being said, that wasn’t the only thing at that point they were zeroing in on. Everybody’s aware the mumps are going through the league and that was a possibility, but at that point, all the tests were negative.

Jim, has the NHL offered any guidance here along the way? Did you hear from any of them?
No.

It seems medically, this team has made a lot of news, even since you’ve gotten here. There’s no common denominator. How does the GM handle that or deal with that?
Well, you just keep going day-by-day. You sympathize with the players. They work hard to be ready to play and play a full season and then they run into injuries and in our case, we’re going through a period here that is pretty rough. 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.
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