American College of Sports Medicine
P.O. Box 1440
Indianapolis, IN
46206-1440
November 17, 2003
For immediate release
ORGANIZATIONS PLAN TO REDUCE HERPES GLADIATORUM OUTBREAKS THROUGH EARLIER DIAGNOSIS AND TREATMENT
American College of Sports Medicine and National Federation of State High School Associations to address widespread infection among athletes in high school wrestling programs
INDIANAPOLIS – The American College of Sports Medicine (ACSM) and the National Federation of State High School Associations (NFHS) are collaborating to conduct a timely and thorough review of high school wrestling health and safety guidelines, addressing one of the most common infections caused by athletic activity: herpes gladiatorum. Herpes gladiatorum (HG), a virus that causes skin lesions on the body, is highly contagious through personal contact during wrestling practice and competition. Prevention techniques are the focus of this collaboration, since early and accurate detection and comprehensive treatment, rather than mat and equipment cleanliness, are increasingly recognized as more effective in containing and minimizing the risk of exposure.
Young athletes at risk of developing HG are typically wrestlers who engage in the lock-up position, which places the face, neck, and arms of the opposing wrestlers in close contact. Lesions indicative of the skin disorder generally occur on the face, neck, and arms as a result, accompanied by symptoms such as inflamed skin rash, sore throat, general malaise, fever, and the appearance of clustered vesicles, which are small fluidcontaining elevations of the skin.
ACSM and NFHS, the rule-making governing body for high school sports, will work to ensure that medical professionals more closely monitor systemic signs or symptoms to diagnose and treat herpes simplex virus-1 (HSV-1), the virus precursor for HG, and require the swift withdrawal of wrestlers from participation until a diagnosis can confirm or rule out infection. In smaller schools and districts with limited athletic personnel, ACSM and NFHS will provide educational resources for coaches, who are often the first and most efficient individual to screen wrestlers for suspicious skin conditions. Further, the organizations will work with athletes, coaches, and athletic trainers to emphasize that mat disinfection and personal cleanliness, while important, may reduce but will not prevent the types of outbreaks seen in the upper extremities of the body.
A clinical evaluation appearing in the November issue of Medicine & Science in Sports & Exercise®, the official scientific journal of ACSM, calls for a review of standards to address numerous outbreaks that have occurred among high school wrestlers in the past 13 years. Specifically, the author studied and tracked an outbreak involving 19 high schools during a 1999 Minnesota state high school wrestling tournament. This outbreak demonstrated extensive transmission can occur in a short period of time, as wrestlers on seven out of nine teams, and ultimately 61 wrestlers and three coaches contracted HG. Based on this clinical evaluation, preventative factors, including increased vigilance to potential misdiagnosis by individual’s physicians who may not understand how the viral infection develops and spreads, are recommended as key to avoiding and controlling future outbreaks.
ACSM members will work within NFHS networks to develop opportunities for qualified and certified healthcare providers to implement early detection and rapid diagnosis efforts on local levels. This will enhance on-site screenings and skin checks, provide an educational mechanism to culture samples from suspicious skin lesions, and develop a protocol for promptly removing questionable individuals from participation, as well as prescribing a course of treatment before allowing return to play.
“These outbreaks gave us solid and viable information to help governing bodies assess guidelines for youth sports,” said William O. Roberts, M.D., ACSM president-elect. “Team physicians, researchers, and the institutions that support them know that health education and disease prevention is like technology—there are always better answers out there.
ACSM and NFHS are dedicated to looking forward to ways to protect young athletes and supply coaches and trainers with the information they need to avoid future occurrences in this sport.”
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 20,000 International, National, and Regional members are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.
NOTE: Medicine & Science in Sports & Exercise® is the official journal of the American College of Sports Medicine, and is available from Lippincott Williams & Wilkins at 1-800- 638-6423. For a complete copy of the research paper Vol. 35, No. 11, pages 1809-1814 or to speak with a leading sports medicine expert on the topic, contact the Communications and Public Information department at 317-637-9200 ext. 127 or 117. Visit ACSM online at
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