Infectious disease outbreaks in competitive sports, 2005-2010.
Collins CJ, O’Connell B. J of Athl Train. 2012; 47(5). 516-518
Due to the close proximity of athletes involved in competitive sports, various infections can easily be spread from athlete to athlete. It is of the utmost importance for medical professionals charged with the care of these athletes to have a current and accurate understanding of what infections are most prevalent. The last study to look at infectious disease outbreaks in competitive sports was conducted more than 5 years ago. Collins and O’Connell completed a literature review to provide a more contemporary picture of the pathogens reported in published outbreaks in athletes. To complete this review, the PubMed database (May 2005-November 2010) was searched using the keywords infection, outbreak, and sport. Articles were limited to English-language articles which reported infectious disease outbreaks in competitive sports, regardless of methodological quality. Twenty-one studies were identified through this process. Outbreaks were reported in North America (United States – 8, Canada – 1), Asia (Japan – 4, Turkey – 2, Iran – 2), and Europe (Germany – 1, France – 1, Belgium – 1, Slovenia – 1). Twelve outbreaks (43%) were reported in high school or collegiate competitors. The most commonly reported disease outbreak was community acquired methicillin-resistant staphylococcus aureus (CA-MRSA). This occurred in 33% (n = 7) of reported studies with 6 in US high school or collegiate athletics. Other pathogens reported were Leptospira spp. (2, 10%), Campylobacter jejuni (1, 5%), Cryptosporidium spp. (1, 5%), echovirus 30(1, 5%), herpes simplex virus (1, 5%), measles virus (1, 5%), and Streptococcuspyogenes (1, 5%). The most common site of infection reported was skin/soft tissue (n = 15, 71%) and all transmissions were reported to be spread person to person either directly or indirectly (no vector-borne or blood-borne outbreaks reported).
This review presents a vital look at the most common disease outbreaks reported in competitive sports and can aid clinicians in applying the appropriate preventative measures to either avoid outbreaks or to contain an outbreak if it does occur. This data can also be utilized by clinicians in the diagnosis of a pathogen. By understanding which infectious diseases are common for their specific geography, competition level (high school, collegiate, etc.), and sport, clinicians can hopefully diagnose the illness early and refer for more appropriate treatment. Caution should be exercised with this data despite any potential benefits, as only 21 studies reported specific outbreaks and published data may not accurately represent small community outbreaks. This number is low for a literature review, and with no indication of methodological quality, the results of each study should be used cautiously. It can be surmised from this review that CA-MRSA is becoming increasingly prevalent in competitive sports, especially in the United States. Clinicians should be aware of early signs and symptoms of CA-MRSA and have a plan in place to treat those suspected. Tell us what you have seen. Have you experienced a higher proportion of CA-MRSA than other infectious diseases in your practice? Do your experiences with infectious diseases seem to adhere to what this review has reported?
Written by: Kyle Harris
Reviewed by: Laura McDonaldCollins CJ, & O'Connell B (2012). Infectious disease outbreaks in competitive sports, 2005-2010. Journal of Athletic Training, 47 (5), 516-8 PMID: 23068588