Managing Herpes Gladiatorum Outbreaks in Competitive Wrestling

Abstract

Skin infections in wrestling have escalated in the past 20 yr. Failure to recognize and manage primary or recurrent herpes gladiatorum (HG) puts all wrestlers who come in direct contact with the affected athlete at risk. In 2007, a major outbreak of HG occurred during the Minnesota State High School wrestling season. Rapid response to the outbreak based upon lessons learned from previous episodes in the state prevented an epidemic from developing that would have threatened the state competitions at the end of the season. When a primary outbreak occurred involving multiple teams, an 8-d isolation period with suspended competition contained the outbreak in more than 90% of exposed individuals. Prophylactic treatment with antiviral medications can reduce recurrent infections, the risk of asymptomatic viral shedding, and can be based upon annual herpes simplex virus (HSV) testing to identify seropositive individuals. Those with recurrent HG or who are HSV seropositive should be placed on seasonal prophylaxis with oral antiviral medication to reduce the risk of HG spread to susceptible teammates or opponents. With proper education of athletes, coaches, and health care providers, HG can be recognized, treated, and controlled.