Infectious disease outbreaks in competitive sports: a review of the literature.

Recent outbreaks of infectious diseases in athletes in competitive sports have stimulated considerable interest. The environments in which these athletes compete, practice, receive therapy for injuries, and travel, both domestically and internationally, provide varied opportunities for the transmission of infectious organisms. The purpose of this medical literature review is to identify the agents most commonly reported in the medical literature as responsible for infectious disease outbreaks in specific sports and their modes of transmission and to guide targeted prevention efforts. A literature review of English-language articles in medical publications that reported outbreaks of infectious diseases in competitive athletes was conducted in PubMed MEDLINE from 1966 through May 2005. Outbreaks that were solely food borne were excluded. Fifty-nine reports of infectious disease outbreaks in competitive sports were identified in the published medical literature. Herpes simplex virus infections appear to be common among wrestlers and rugby players, with no single strain responsible for the outbreaks. Methicillin-resistant Staphylococcus aureus was responsible for several recent outbreaks of soft tissue and skin infections among collegiate and professional athletes. The most common mode of transmission in outbreaks was direct, person-to-person (primarily skin-to-skin) contact. Blood-borne exposure was implicated in 2 confirmed outbreaks of hepatitis. Airborne and vector transmissions were rarely reported. This review provides an overview of infectious disease outbreaks thought to be either serious enough or unusual enough to report. Appropriate surveillance of the frequency of infections will allow sports medicine staff to identify outbreaks quickly and take necessary measures to contain further transmission and prevent future outbreaks.

Risk factors for injury in high school football players.

BACKGROUND: Many studies have reported the frequency and types of injuries in high school football players. However, few have assessed the relationship between player characteristics and risk of injury. PURPOSE: To describe the epidemiologic characteristics of and risk factors for injury in high school football players and to determine whether players' characteristics could be used to predict subsequent injury. STUDY DESIGN: Prospective cohort study. METHODS: This study was part of a 2-year prospective investigation (1998 to 1999) of risk factors for injury in 717 (343 in the 1998 season and 374 in the 1999 season) high school football players in the Oklahoma City, Oklahoma, School District. Player characteristics (playing experience, position, injury history) and physical parameters (body mass index, weight, height, grip strength) were measured at the beginning of each season. Logistic regression analysis was used to determine whether any of the baseline variables were associated with the odds of subsequent injury. RESULTS: The physical characteristics of players, such as body mass index and strength, were not associated with risk of injury. More playing experience and a history of injury in the previous season were significantly related to increased risk. Linemen were at the highest risk of injury, particularly knee injuries and season-ending injuries. CONCLUSIONS: Future research should focus on decreasing the risk of injury to linemen.

Risk factors for injury in middle school football players.

BACKGROUND: Little is known about the frequency of or risk factors for injuries in middle school or junior high school football players. PURPOSE: To examine the associations of player characteristics (injury history, conditioning, player position, special equipment) and physical parameters (body mass index, weight, height, grip strength) with risk of injury. STUDY DESIGN: Prospective cohort study. METHODS: We documented risk factors for injury in 646 middle school football players, 10 to 15 years of age, in the Oklahoma City, Oklahoma, school district during the 1998 and 1999 seasons. Player characteristics and physical parameters were measured at the beginning of both seasons. Logistic regression methods were used to determine whether baseline variables were associated with the odds of subsequent injury. RESULTS: More playing experience was the only variable significantly associated with the risk of injury in multivariate analyses. This association was observed regardless of the type of injury and even after indirectly controlling for time at risk of injury by restricting analyses to first-string players. Increasing age was significantly associated with the risk of fractures. CONCLUSIONS: Results suggest that physical characteristics play a minor role in risk of injury from football in this age group.

Acute macular neuroretinopathy: a review of the literature.

Acute macular neuroretinopathy (AMNR) is a rare condition that produces transient or permanent visual impairment. Typical cases have acute onset multifocal scotomas that correspond rather precisely with reddish, flat, or depressed circumscribed lesions in the macula. These lesions are wedge-shaped and generally point toward the fovea. The pathophysiology of AMNR is unclear, the causes are uncertain, and there is no specific treatment for this condition. This review summarizes the presentation, possible risk factors, and prognosis of the 41 cases of AMNR reported in the published, English-language literature from 1975 through April 2002. Possible areas for future research into the etiology of this rare condition are discussed.