Infectious disease outbreaks in competitive sports,

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
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

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
Reviewed by: Laura

Collins CJ, & O’Connell B (2012). Infectious disease outbreaks in competitive sports, 2005-2010. Journal of Athletic Training, 47 (5), 516-8 PMID: 23068588