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AAP offers new guidance on preventing spread of infectious diseases associated with organized sports

American Academy of Pediatrics News Sep 28, 2017

Organized sports offer many benefits to youth - but without careful attention to hygiene and sickness prevention protocol, a few infectious bugs can mark defeat for the entire team.

In its clinical report, "Infectious Diseases Associated With Organized Sports and Outbreak Control," the American Academy of Pediatrics details the types, treatments and risk factors of infection, which are especially prevalent in close contact sports such as football and wrestling.

"Joining an athletic team is a fun, physically challenging and healthy way for kids to practice teamwork and sportsmanship, but they do need to understand the importance of good hygiene," said H. Dele Davis, MD, lead author of the report and member of the AAP Committee on Infectious Diseases.

"Besides showering and washing hands, athletes should be discouraged from sharing their water bottles, towels, mouth guards and other personal items," he said.

The report, to be published in the October 2017 issue of the journal Pediatrics, and available online Sept. 25, observes the pediatrician's role in identifying possible skin conditions and other infections during the athletes' pre-participation physical. Student athletes also should be up to date on their vaccinations.

Most sports-related infections are spread by skin contact, contaminated food or water, respiratory droplets or airborne particles. About 10 to 15 percent of injuries that force college-level athletes to take time off from playing a sport are due to infectious disease, according to the AAP.

"Some of these germs can be picked up in weight rooms, on mats and in locker rooms," said Mary Anne Jackson, MD, a co-author of the report and member of the AAP Committee on Infectious Diseases.

"Coaches and trainers should develop a plan for proper cleaning and maintenance of all sporting facilities and equipment."

Common sicknesses spread by skin contact include Methicillin-resistant Staphyloccus aureus (MRSA) associated with high school football and wrestling; Group A Streptococcus; herpes simplex virus; tinea capitis (ringworm); tinea pedis (athlete's foot); scabies and lice.

Airborne infections that can be spread during athletic participation include the varicella zoster virus (chicken pox), measles and mumps.

To minimize risks, the AAP recommends:
  • Teach student athletes proper personal hygiene, including proper laundering of uniforms and avoiding sharing of drinks or personal products, such as razors.
  • Develop a plan for cleaning and maintenance of sporting environment using guidelines such as those published by the American College of Sports Medicine.
  • Pay special attention to proper management of blood and other bodily fluids, just as hospitals have concentrated on preventing hospital-associated infections.
  • Routinely screen athletes during practices and before and after competitions.
While there have been no reports of infections from bloodborne pathogens, such as hepatitis B, hepatitis C or HIV during athletic competitions, the AAP provides specific detailed guidelines for management of infections spread by blood and bodily fluids in a previously published report.

"The best thing coaches can do is identify the problem early, even if it is something as benign-looking as a cold sore, so they can prevent its spread," Stephen G. Rice, MD, PhD, MPH, and a member of the AAP Council on Sports Medicine and Fitness. "We want the students not only to participate in sports, but to have a good experience."
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