Infectious Diseases in the Athlete: An Overview

Abstract

In the USA, organized sports include not only professional athletes, but also high school students, collegians, and a large but imprecise number of persons participating in community-based leagues and other recreational programs. Infectious diseases represent a significant problem in all competitive sports. While not considered as serious a problem as concussions or frequent musculoskeletal injuries, infectious diseases account for significant loss of playing time and have been associated with outbreaks among teams. 1 The physician must not only treat the individual athlete, but also take the necessary precautions to contain the spread of communicable diseases to other team members, coaches, trainers, and other staff and relatives. Groups of athletes are often at an increased risk of transmission because they are confined to close quarters with teammates in the locker room, at practice, through dormitory living, and during travel. Given the athlete’s expectation to return to play as soon as possible, accurate diagnosis and aggressive treatment of illnesses are essential. Participation and return to play decisions are determined by the nature of the infection, the risk of transmission, and the demand placed on the athlete during practice and competitions. Infectious diseases can occur via person-person transmission such as in the case of herpes gladiatorum in wrestlers 2 or methicillin-resistant Staphylococcus aureus skin infections where skin to skin contact and/or shared personal items (common source) are implicated 3-5 or via a common source transmission as in the case of an enteroviral meningitis outbreak associated with shared use of water bottles 6 or a norovirus outbreak from a common food source (tainted turkey sandwiches from a catered box lunch), which infected a college football team, who then subsequently infected the opposing team via person to person contact. 7 The risk of transmission of blood-borne pathogens (hepatitis B and C or human immunodeficiency virus (HIV)) during sporting events from bleeding wounds or exudative skin lesion of an infected athlete