Sports Medicine

, Volume 24, Issue 1, pp 1–7 | Cite as

Prevention of Infectious Disease Transmission in Sports

  • Eric E. Mast
  • Richard A. Goodman
Leading Article


A variety of infectious diseases can be transmitted during competitive sports. Modes of transmission in athletic settings include person-to-person contact, common-source exposures and airborne/droplet spread. This paper reviews the most commonly reported infectious diseases among athletes and discusses the potential for transmission of bloodborne diseases in sports. Guidelines are provided regarding measures to prevent transmission of infectious diseases in athletic settings, including hygiene and infection control practices, vaccination, and education of officials, coaches, trainers and sports participants.


Measle Football Player Aseptic Meningitis National Collegiate Athletic Association Rugby Player 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Selling B, Kibrick S. An outbreak of herpes simplex amongwrestlers (herpes gladiatorum). N Engl J Med 1964; 270: 979–82PubMedCrossRefGoogle Scholar
  2. 2.
    Dyke LM, Merikangas UR, Bruton OC, et al. Skin infection in wrestlers due to herpes simplex virus. JAMA 1965; 194: 153–4CrossRefGoogle Scholar
  3. 3.
    Porter PS, Baughman RD. Epidemiology of herpes simplex among wrestlers. JAMA 1965; 194: 150–2CrossRefGoogle Scholar
  4. 4.
    Wheeler CE, Cabaniss WH. Epidemic cutaneous herpes simplex in wrestlers (herpes gladiatorum). JAMA 1965; 194: 145–9CrossRefGoogle Scholar
  5. 5.
    Verbov J, Lowe NJ. Herpes rugbeiorum. Lancet 1974; II: 1523–4CrossRefGoogle Scholar
  6. 6.
    White WB, Grant-Keis JM. Transmission of herpes simplex virus type 1 infection in rugby players. JAMA 1984; 252: 533–5PubMedCrossRefGoogle Scholar
  7. 7.
    Becker TM, Kodsi R, Bailey P. Grappling with herpes: Herpes gladiatorum. Am J Sports Med 1988; 16: 665–9PubMedCrossRefGoogle Scholar
  8. 8.
    Strauss RH, Leizman DJ, Lanese RR, et al. Abrasive shirts may contribute to herpes gladiatorum among wrestlers. N Engl J Med 1989; 320: 598–9PubMedGoogle Scholar
  9. 9.
    Belongia EA, Goodman JL, Holland EJ, et al. An outbreak of herpes gladiatorum at a high-school wrestling camp. N Engl J Med 1991; 325: 906–10PubMedCrossRefGoogle Scholar
  10. 10.
    Liesegang TJ. Epidemiology of ocular herpes simplex: naturalhistory in Rochester Minn., 1950 through 1982. Arch Op-thamol 1989; 107: 1160–5CrossRefGoogle Scholar
  11. 11.
    Pollard JG. The staphylococcus plagues a football team. J Coll Health. 1967; 15: 234–238Google Scholar
  12. 12.
    Glezen WP, Lindsay RL, De Walt JL, et al. Epidemic pyoderma caused by a nephritogenic streptococci in college athletes. Lancet 1972; I: 301–3CrossRefGoogle Scholar
  13. 13.
    Dorman JM. Scrum strep. N Engl J Med 1981; 305: 467PubMedGoogle Scholar
  14. 14.
    Bartlett PC, Martin RJ, Cahill BR. Furunculosis in a high school football team. Am J Sports Med 1982; 10: 371–4PubMedCrossRefGoogle Scholar
  15. 15.
    Ludlam H, Cookson B. Scrum kidney: Epidemic pyoderma caused by a nephritogenic Streptococcus pyogenes in a rugby team. Lancet 1986; II: 331–3CrossRefGoogle Scholar
  16. 16.
    Sosin DM, Gunn RA, Ford WL, et al. An outbreak of furunculosis among high school athletes. Am J Sports Med 1989; 17: 828–32PubMedCrossRefGoogle Scholar
  17. 17.
    Falak G. Group A streptococcal skin infections after indoor association football tournament. Lancet 1996; 347: 840–1CrossRefGoogle Scholar
  18. 18.
    Frisk A, Heilborn H, Melen B. Epidemic occurrence of trichophytosis among wrestlers. Acta Derm Venereol 1966; 46: 453–6PubMedGoogle Scholar
  19. 19.
    Cohen BA, Schmidt C. Tinea gladiatorum. N Engl J Med 1992; 327: 820PubMedCrossRefGoogle Scholar
  20. 20.
    Stiller MJ, Klein WP, Dorman RI, et al. Tinea corporisgladiatorum: an epidemic of Trichophyton tonsurans in student wrestlers. J Am Acad Dermatol 1992; 27: 632–3PubMedCrossRefGoogle Scholar
  21. 21.
    Beller M, Gessner BD. An outbreak of tinea corporis gladiatorum on a high school wrestling team. J Am Acad Dermatol 1994; 31: 197–201PubMedCrossRefGoogle Scholar
  22. 22.
    Hradil E, Hersle K, Nordin P, et al. An epidemic of tinea corporis caused by Trichophytan tonsurans among wrestlers in Sweden. Acta Derm Venereol 1995; 75: 305–6PubMedGoogle Scholar
  23. 23.
    Torre D, Sampietro C, Ferraro G, et al. Transmission of HIV-1 infection via sports injury. Lancet 1990; 335: 1105PubMedCrossRefGoogle Scholar
  24. 24.
    Goodman RA, Thacker SB, Solomon SL, et al. Infectious diseases in competitive sports. JAMA 1994; 271: 862–7PubMedCrossRefGoogle Scholar
  25. 25.
    Brown LS, Drotman DP, Chu A, et al. Bleeding injuries in professional football: estimating the risk for HIV transmission. Ann Intern Med 1995; 122: 271–4Google Scholar
  26. 26.
    Ippolito G, Del Poggio P, Ariei C, et al. Transmission of zidovudine-resistant HIV during a bloody fight. JAMA 1994; 272: 433–4PubMedCrossRefGoogle Scholar
  27. 27.
    O’Farrell N, Tovey SJ. Transmission of HIV-1 infection after a fight. Lancet 1992; 339: 246PubMedCrossRefGoogle Scholar
  28. 28.
    Centers for Disease Control and Prevention. Human immunodeficiency virus transmission in household settings. MMWR Morb Mortal Wkly Rep 1994; 43: 347, 353-6Google Scholar
  29. 29.
    Kashiwagi S, Hayashi J, Ikematsu H, et al. An outbreak of hepatitis B in members of a high school sumo wrestling club. JAMA 1982; 248: 213–4PubMedCrossRefGoogle Scholar
  30. 30.
    Ringertz O, Zetterberg B. Serum hepatitis among Swedish trackfinders. An epidemiologic study. N Engl J Med 1967; 276: 540–6PubMedCrossRefGoogle Scholar
  31. 31.
    Centers for Disease Control. Aseptic meningitis in a high school football team, Ohio. MMWR Morb Mortal Wkly Rep 1981; 29: 631–2, 637Google Scholar
  32. 32.
    Baron RC, Hatch MH, Kleeman K, et al. Aseptic meningitisamong members of a high school football team. JAMA 1982; 248: 1724–7PubMedCrossRefGoogle Scholar
  33. 33.
    Moore M, Baron RC, Filstein MR, et al. Aseptic meningitis and high school football players, 1978 and 1980. JAMA 1983; 249: 2039–42PubMedCrossRefGoogle Scholar
  34. 34.
    Sudman JH, Gunn RA. Pleurodynia outbreak among athletic teams, Ohio. Atlanta: Centers for Disease Control; 1988: 1–10. (Field Epidemiology Report No. 88-09)Google Scholar
  35. 35.
    Thomas JC, Chun L. Aseptic meningitis in football players. J Sch Health 1990; 60: 11PubMedCrossRefGoogle Scholar
  36. 36.
    Alexander JP, Chapman LE, Pallansch MA, et al. Coxsackievirus B2 infection and aseptic meningitis: a focal outbreak among members of a high school football team. J Infect Dis 1993; 167: 1201–5PubMedCrossRefGoogle Scholar
  37. 37.
    Ikeda RM, Kondracki SF, Drabkin PD, et al. Pleurodynia among football players at a high school: an outbreak associated with coxsackievirus Bl. JAMA 1993; 270: 2205–6PubMedCrossRefGoogle Scholar
  38. 38.
    Davis RM, Whitman ED, Orenstein WA, et al. A persistent outbreak of measles despite appropriate prevention and control measures. Am J Epidemiol 1987; 126: 438–49PubMedGoogle Scholar
  39. 39.
    Atkinson WL, Hadler SC, Redd SB, et al. Measles surveillance-United States, 1991. MMWR Morb Mortal Wkly Rep 1992; 41 (No. SS-6): 1–12Google Scholar
  40. 40.
    Ehresmann KR, Hedberg CW, Grimm MB, et al. An outbreak of measles at an international sporting event with airborne transmission in a domed stadium. J Infect Dis 1995; 171: 679–83PubMedCrossRefGoogle Scholar
  41. 41.
    Robertson SE, Markowitz LE, Berry DA, et al. A million dollar measles outbreak: epidemiology, risk factors, and a selective revaccination strategy. Public Health Rep 1992; 107: 24–31PubMedGoogle Scholar
  42. 42.
    Centers for Disease Control and Prevention. Measles at an international gymnastics competition. MMWR Morb Mortal WklyRep 1992; 41: 109–11Google Scholar
  43. 43.
    Mast EE, Goodman RA, Bond WA, et al. Transmission of bloodborne pathogens in sports: risk and prevention. Ann Intern Med 1995; 122: 283–5PubMedGoogle Scholar
  44. 44.
    Centers for Disease Control and Prevention. General recommendations on immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1994; 43 No. RR-1: 1–38Google Scholar
  45. 45.
    Centers for Disease Control and Prevention. Prevention of varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1996; 45 No. RR-11: 1–36Google Scholar
  46. 46.
    Centers for Disease Control and Prevention. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1996; 45 No. RR-96: 1–30Google Scholar
  47. 47.
    Centers for Disease Control and Prevention. Update: recommendations to prevent hepatitis B virus transmission - United States. MMWR Morb Mortal Wkly Rep 1995; 44: 574–5Google Scholar
  48. 48.
    WHO, International Federation of Sports Medicine. Global programme on AIDS: consensus statement from consultation on AIDS and sports. 1989 Jan 16; GenevaGoogle Scholar
  49. 49.
    American Academy of Pediatrics. Human immunodeficiency virus [acquired immunodeficiency syndrome (AIDS) virus] in the athletic setting. Pediatrics 1991; 88: 640–1Google Scholar
  50. 50.
    Brown LS, Phillips RY, Brown CL, et al. HIV/AIDS policies and sports: The National Football League. Med Sci Sports Exerc 1994; 26: 1420–1CrossRefGoogle Scholar
  51. 51.
    National Collegiate Athletic Association. Bloodborne patho gens and intercollegiate athletics: NCAA Guideline 2H. Overland Park (KS): NCAA, 1993Google Scholar
  52. 52.
    The American Medical Society for Sports Medicine and the American Academy of Sports Medicine. Human immunodeficiency virus and other blood-borne pathogens in sports. Clin J Sport Med 1995; 5: 199–204CrossRefGoogle Scholar
  53. 53.
    Centers for Disease Control. Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public safety workers. MMWR Morb Mortal Wkly Rep 1989; 38 No. S6: 1–37Google Scholar
  54. 54.
    Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens: final rule. Fed Regist 1991; 56: 64005–182Google Scholar
  55. 55.
    Centers for Disease Control. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. MMWR Morb Mortal Wkly Rep 1991; 40 No. RR-13: 1–25Google Scholar

Copyright information

© Adis International Limited 1997

Authors and Affiliations

  • Eric E. Mast
    • 1
  • Richard A. Goodman
    • 2
  1. 1.Hepatitis Branch, Division of Viral and Rickettsial DiseasesNational Center for Infectious Diseases, Centers for Disease Control and PreventionAtlantaUSA
  2. 2.Office of the Director, Epidemiology Program OfficeCenters for Disease Control and PreventionAtlantaUSA

Personalised recommendations