There is growing concern about the impact of infectious diseases in athletes, especially as they relate to exposures in athletic training facilities. This article reviews common pathogens encountered in athletic training facilities, while offering an evidence-based overview of practical preventative measures that can be implemented to reduce the incidence of infectious diseases in close-contact sports such as American football and wrestling.
AndersonB. Managing herpes gladiatorum outbreaks in competitive wrestling: the 2007 Minnesota experience. Curr Sports Med Rep. 2008;7(6):323–327.
3.
AndersonBJ. Effectiveness of body wipes as an adjunct to reducing skin infections in high school wrestlers. Clin J Sport Med. 2012;22(5):424–429. https://doi.org/10.1097/JSM.0B013E3182592439.
AndersonBJMcGuireDPReedMFosterMOrtizD. Prophylactic valacyclovir to prevent outbreaks of primary herpes gladiatorum at a 28-day wrestling camp: a 10-year review. Clin J Sport Med. 2016;26(4):272–278. https://doi.org/10.1097/JSM.0000000000000255.
7.
ArchibaldLKShapiroJPassARandKSouthwickF. Methicillin-resistant staphylococcus aureus infection in a college football team: risk factors outside the locker room and playing field. Infect Control Hosp Epidemiol. 2008;29(5):450–453. https://doi.org/10.1086/587971.
8.
BaronRCHatchMHKleemanKMaccormackJN. Aseptic meningitis among members of a high school football team: an outbreak associated with echovirus 16 infection. JAMA. 1982;248(14):1724–1727. https://doi.org/10.1001/JAMA.1982.03330140034028.
BelongiaEAGoodmanJLHollandEJ, et al. An outbreak of herpes gladiatorum at a high-school wrestling camp. N Engl J Med. 2010;325(13):906–910. https://doi.org/10.1056/NEJM199109263251302.
EggerFFaudeOSchreiberSGärtnerBCMeyerT. Does playing football (soccer) lead to SARS-CoV-2 transmission? A case study of 3 matches with 18 infected football players. Sci Med Footb. 2021;5(suppl 1):2–7. https://doi.org/10.1080/24733938.2021.1895442.
13.
EhresmannKRHedbergCWGrimmMBNortonCAMacdonaldKLOsterholmMT. An outbreak of measles at an international sporting event with airborne transmission in a domed stadium. J Infect Dis. 1995;171(3):679–683. https://doi.org/10.1093/INFDIS/171.3.679.
El-GoharyMvan ZuurenEJFedorowiczZ, et al. Topical antifungal treatments for tinea cruris and tinea corporis. Cochrane Database Syst Rev. 2014;2014(8):CD009992. https://doi.org/10.1002/14651858.CD009992.
16.
ErginŞErginÇErdogˇanBŞKaleliIEvliyaogˇluD. An experience from an outbreak of tinea capitis gladiatorum due to Trichophyton tonsurans. Clin Exp Dermatol. 2006;31(2):212–214. https://doi.org/10.1111/J.1365-2230.2005.01999.X.
17.
FoxCWavraTDrakeDA, et al. Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. Am J Crit Care. 2015;24(3):216–224. https://doi.org/10.4037/AJCC2015898.
HallAJBixlerDHaddyLE. Multiclonal outbreak of methicillin-resistant Staphylococcus aureus infections on a collegiate football team. Epidemiol Infect. 2009;137(1):85–93. https://doi.org/10.1017/S095026880800068X.
23.
HallamJJonesTAlleyJKohutML. Exercise after influenza or COVID-19 vaccination increases serum antibody without an increase in side effects. Brain Behav Immun. 2022;102:1–10. https://doi.org/10.1016/J.BBI.2022.02.005.
24.
HedayatiMTAfsharPShokohiTAghiliR. A study on tinea gladiatorum in young wrestlers and dermatophyte contamination of wrestling mats from Sari, Iran. Br J Sports Med. 2007;41(5):332–334. https://doi.org/10.1136/BJSM.2006.030718.
IkedaRMKondrackiSFDrabkinPDBirkheadGSMorseDL. Pleurodynia among football players at a high school: an outbreak associated with Coxsackievirus B1. JAMA. 1993;270(18):2205–2206. https://doi.org/10.1001/JAMA.1993.03510180075037.
27.
IlkitMSaracliMAKurdakH, et al. Clonal outbreak of Trichophyton tonsurans tinea capitis gladiatorum among wrestlers in Adana, Turkey. Med Mycol. 2010;48(3):480–485. https://doi.org/10.3109/13693780903278051.
28.
KahanovLGilmoreEJEbermanLERobertsJSemerjianTBaldwinL. Certified athletic trainers’ knowledge of methicillin-resistant staphylococcus aureus and common disinfectants. J Athl Train. 2011;46(4):415–423. https://doi.org/10.4085/1062-6050-46.4.415.
29.
KazakovaSvHagemanJCMatavaM, et al. A clone of methicillin-resistant Staphylococcus aureus among professional football players. N Engl J Med. 2005;352(5):468–475. https://doi.org/10.1056/NEJMOA042859.
30.
KrzywańskiJMikulskiTKrysztofiakH, et al. Vaccine versus infection—COVID-19-related loss of training time in elite athletes. J Sci Med Sport. 2022;25(12):950. https://doi.org/10.1016/J.JSAMS.2022.10.004.
31.
LaBelleMWKnapikDMArbogastJW, et al. Infection risk reduction program on pathogens in high school and collegiate athletic training rooms. Sports Health. 2020;12(1):51–57. https://doi.org/10.1177/1941738119877865.
32.
LedoASchubDZillerC, et al. Elite athletes on regular training show more pronounced induction of vaccine-specific T-cells and antibodies after tetravalent influenza vaccination than controls. Brain Behav Immun. 2020;83:135–145. https://doi.org/10.1016/J.BBI.2019.09.024.
LindenmayerJMSchoenfeldSO’GradyRCarneyJK. Methicillin-resistant staphylococcus aureus in a high school wrestling team and the surrounding community. Arch Intern Med. 1998;158(8):895–899. https://doi.org/10.1001/ARCHINTE.158.8.895.
ManningSELeeEBambinoM, et al. Invasive group A streptococcal infection in high school football players, New York City, 2003. Emerg Infect Dis. 2005;11(1):146. https://doi.org/10.3201/EID1101.040559.
McBrydeESBradleyLCWhitbyMMcElwainDLS. An investigation of contact transmission of methicillin-resistant Staphylococcus aureus. J Hosp Infect. 2004;58(2):104–108. https://doi.org/10.1016/J.JHIN.2004.06.010.
NguyenDMMascolaLBrancoftE. Recurring methicillin-resistant Staphylococcus aureus infections in a football team. Emerg Infect Dis. 2005;11(4):526–532. https://doi.org/10.3201/eid1104.041094.
42.
ParadiseSLHuYWE. Infectious dermatoses in sport: a review of diagnosis, management, and return-to-play recommendations. Curr Sports Med Rep. 2021;20(2):92–103. https://doi.org/10.1249/JSR.0000000000000808.
43.
PascoeARFiatarone SinghMAEdwardsKM. The effects of exercise on vaccination responses: a review of chronic and acute exercise interventions in humans. Brain Behav Immun. 2014;39:33–41. https://doi.org/10.1016/J.BBI.2013.10.003.
44.
PrimosWA. Sports and exercise during acute illness: recommending the right course for patients. Phys Sportsmed. 1996;24(1):44–54. https://doi.org/10.3810/PSM.1996.01.1199.
45.
RihnJAPosfay-BarbeKHarnerCD, et al. Community-acquired methicillin-resistant Staphylococcus aureus outbreak in a local high school football team: unsuccessful interventions. Pediatr Infect Dis J. 2005;24(9):841–843. https://doi.org/10.1097/01.INF.0000177287.11971.D4.
46.
RobertsonSEMarkowitzLEBerryDA, et al. A million dollar measles outbreak: epidemiology, risk factors, and a selective revaccination strategy. Public Health Rep. 1992;107(1):24.
47.
RomanoRLuDHoltomP. Outbreak of community-acquired methicillin-resistant staphylococcus aureus skin infections among a collegiate football team. J Athl Train. 2006;41(2):141. https://doi.org/10.1016/s0093-3619(08)70415-5.
48.
SasakiASuzukiHSakaiTSatoMShobugawaYSaitoR. Measles outbreaks in high schools closely associated with sporting events in Niigata, Japan. J Infect. 2007;55(2):179–183. https://doi.org/10.1016/J.JINF.2007.04.004.
49.
SchreiberSFaudeOGärtnerBMeyerTEggerF. Risk of SARS-CoV-2 transmission from on-field player contacts in amateur, youth and professional football (soccer). Br J Sports Med. 2022;56(3):158–164. https://doi.org/10.1136/BJSPORTS-2021-104441.
50.
SchumacherYOTabbenMHassounK, et al. Resuming professional football (soccer) during the COVID-19 pandemic in a country with high infection rates: a prospective cohort study. Br J Sports Med. 2021;55(19):1092–1098. https://doi.org/10.1136/BJSPORTS-2020-103724.
StengerTLedoAZillerC, et al. Timing of vaccination after training: immune response and side effects in athletes. Med Sci Sports Exerc. 2020;52(7):1603–1609. https://doi.org/10.1249/MSS.0000000000002278.
54.
StevensDLBisnoALChambersHF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10–e52. https://doi.org/10.1093/CID/CIU296.
55.
TurbevilleSDCowanLDGreenfieldRA. Infectious disease outbreaks in competitive sports: a review of the literature. Am J Sports Med. 2006;34(11):1860–1865. https://doi.org/10.1177/0363546505285385.
56.
YoungLMMotzVAMarkeyERYoungSCBeaschlerRE. Recommendations for best disinfectant practices to reduce the spread of infection via wrestling mats. J Athl Train. 2017;52(2):82–88. https://doi.org/10.4085/1062-6050-52.1.02.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
