Athletes are at increased risk for numerous infections. High school, collegiate and Olympic athletes who travel and live in close contact environments are at an even higher risk. Infections and their effects—such as fever and fatigue—can adversely affect athletic performance by weakening muscles, decreasing blood flow to the body and predisposing  those affected to other injuries. Up to 50 percent of high school and college training room visits are due to infectious diseases.¹ With more than 7.6 million high students participating in organized sports during the 2010-11 school year², education on disease prevention and sports hygiene is critical to keeping young athletes safe and healthy.
Infections can be spread through respiratory secretions, blood or via skin contact. Some infections can be avoided or prevented by receiving immunizations. Immunizations are an example of primary prevention, which aims to prevent the development of the disease before infection even occurs³. Below, I briefly discuss two important immunizations for young athletes.

Influenza

• About. Virus transmitted by respiratory droplets (coughing, sneezing, talking within close proximity). Contagious one day before symptoms start until five to seven days after becoming sick.
• Symptoms. Fever, chills, muscle or body aches, headache, coughing, runny nose and sore throat. Rare but serious complications include bacterial pneumonia, encephalopathy and even death. Symptoms usually last one week, but can be greater than two weeks. Symptoms make it difficult for the athlete to continue training and competing. Can easily spread to other team members.
• Primary Prevention. Receive yearly flu vaccine at start of flu season (usually in the fall). Two types of vaccines are available: flu shots or nasal spray. Ask your doctor which one you should receive. Protection is not 100 percent, but disease is usually milder in those vaccinated. Vaccines work best in older children and healthy adults.

Meningitis

About

Caused by the bacteria Neisseria meningitides, it’s an infection of the membranes that cover the brain and spinal cord, called the meninges. Transmission is by respiratory and oral secretions. Those at increased risk are infants, adolescents, and young adults (16 to 21 years) and those living in a community setting, such as college dormitories and military barracks. Studies have shown that those living in college dorms have a nine to 23 percent increased risk for this disease.⁴

Symptoms

Sudden fever, headache, neck stiffness, nausea and vomiting, sensitivity to light, confusion. This is a medical emergency. If not treated immediately, it causes permanent neurologic damage, limb loss and even death.

Primary Prevention

Receive the meningococcal vaccine. It’s required in all 11- to 12-year-olds with booster at age 16. All college freshmen living in dormitories should receive the vaccine as well.
Here two excellent links for a complete look at the immunization schedule for adolescents:
Immunize.org
CDC Recommended Immunization Schedule

Sports Hygiene

Sports hygiene also plays an important role in preventing disease, and proper hygiene can help reduce the spread of bacteria. Most skin infections are caused by staphylococcus aureus. A more potent bacterium in the same family, called CA-MRSA, is now particularly prevalent in the sports community. It is known to be more dangerous and difficult to manage and treat than its counterpart. Infections among athletes are commonly acquired by:

• Sharing towels, razors, soaps, water bottles, equipment or whirlpools
• Skin injuries like turf burns and abrasions, and chaffing
• Prolonged physical contact sports—especially football, wrestling and rugby

Because infections are easily acquired in these circumstances, a suspected abscess or cellulitis should be reported to a coach or athletic trainer immediately.

Prevention steps for staph skin infections in athletes recommended by the CDC

• Practice good personal hygiene with frequent hand washings and showering with soap and water after all practices and games.
• Take care of your skin. Keep cuts and abrasions clean and covered until healed, as recommended by your athletic trainer or team doctor. Always wear protective clothing.
• Don’t share personal items that come in contact with the skin. Avoid sharing soaps, towels, razors and equipment.
• Implement routine cleaning schedules for shared equipment (weights, pools, steam room benches).

Fungal infections such as athlete’s foot (tinea pedis), jock itch (tinea cruris) and ring worm (tinea corporis) are common ailments among athletes year round. Here are some tips for prevention:

• Athlete’s foot Wear cotton, non-synthetic socks, wash feet with warm water and soap after games and practices, wear open toed shoes during summer months, and wear sandals when using public showers.
• Jock itch Wear cotton briefs and shower with soap and water immediately after sports. A good talc powder can also be used to prevent athlete’s foot and jock itch.³
• Ring-worm Avoid contact. These lesions should be appropriately treated medically and covered prior to participating in any contact sport such as wrestling.

With these disease prevention tips in mind, I hope everyone who reads this article has a fun and healthy athletic season!

References

1. Christopher A. McGrew, “Acute infections.” In Douglas B. McKeag and James L. Moeller, Eds., ACSM’s Primary Care Sports Medicine. Wolters Kluwer, 2007, pp. 251-60.
2. Jason Koebler, “High School Sports Participation Increases for 22^nd Straight Year,” U.S. News & World Report, Sept. 2, 2011.
3. Luke A, d’Hemecourt P., “Prevention of Infectious Diseases in Athletes.” Clin Sports Med 2007, pp. 321-344.
4. Bilukha OO, Rosenstein N., “Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP).” MMWR Recomm Rep, 2005;54(RR-7): 1-21.
5. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR 2010 Aug 6;59(RR08):1-62