Infectious diseases in competitive sports

Infectious diseases can be transmitted through competitive sports as a result of person-to-person contact, team contact with a common source and airborne means. A medical literature search identified 38 cases of infectious disease transmission associated with sports between 1964 and 1993. A review of newspaper articles identified 28 reports of infectious disease transmission associated with sporting events. In the medical reports, there were 24 instances of person-to-person transmission, nine instances of infection from a common source and five instances of an airborne spread of infection. Viral, fungal and bacterial agents were identified. The most common person-to-person transmission identified in the medical literature was herpes simplex virus infection. Viral diseases transmitted from a single source often occurred through shared water sources. Measles was the most common disease transmitted through the air.
Objective.--Participation in competitive sports is popular and widely encouraged throughout the United States. Reports of infectious disease outbreaks among competitive athletes and recent publicity regarding infectious disease concerns in sports underscore the need to better characterize the occurrence of these problems. Data Sources.--To identify reports of infectious diseases in sports, we performed a comprehensive search of the medical literature (MEDLINE) and newspaper databases in two on-line services (NEXIS and DIALOG PAPERS). Study Selection.--Articles selected from the literature review included those deschbing cases or outbreaks of disease in which exposure to an infectious agent was likely to have occurred during training for competitive sports or during actual competition. Articles from the newspaper review included reports of outbreaks, exposures, or preventive measures that directly or indirectly involved teams or spectators. Data Synthesis.--The literature review identified 38 reports of infectious disease outbreaks or other instances of transmission through person-to-person (24 reports), common-source (nine reports), or airborne (five reports) routes; the newspaper search identified 28 reports. infectious agents included predominantly viruses but also a variety of fungi and gram-positive and gram-negative bacteria. Conclusions.--Our findings indicate that strategies to prevent transmission of infectious diseases in sports must recognize risks at three levels: the individual athlete, the team, and spectators or others who may become exposed to infectious diseases as a result of sports-related activities. Team physicians and others who are responsible for the health of athletes should be especially familiar with the features of infectious diseases that occur in sports and measures for the prevention of these problems. (JAMA. 1994;271:862-867)