FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 325:906-910 September 26, 1991 Number 13 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

BACKGROUND AND METHODS. Herpes simplex virus type 1 (HSV-1) has been identified as a cause of cutaneous or ocular infection among athletes involved in contact sports; in this context it is known as herpes gladiatorum. In July 1989, we investigated an outbreak among 175 high-school wrestlers attending a four-week intensive-training camp. Cases of infection were identified by review of medical records, interview and examination of the wrestlers, and culture of skin lesions. Oropharyngeal swabs were obtained for HSV-1 culture, and serum samples for HSV-1 serologic studies. HSV-1 isolates were compared by restriction-endonuclease analysis. RESULTS. HSV-1 infection was diagnosed in 60 wrestlers (34 percent). The lesions were on the head in 73 percent of the wrestlers, the extremities in 42 percent, and the trunk in 28 percent. HSV-1 was isolated from 21 wrestlers (35 percent), and in 39 (65 percent) infection was identified by clinical criteria. Five had conjunctivitis or blepharitis; none had keratitis. Constitutional symptoms were common, including fever (25 percent), chills (27 percent), sore throat (40 percent), and headache (22 percent). The attack rate varied significantly among the three practice groups, ranging from 25 percent for practice group 1 (lightweights) to 67 percent for group 3 (heavyweights). Restriction-endonuclease analysis identified four strains of HSV-1 among the 21 isolates. All 10 isolates from practice group 3 were identical (strain A), and 5 of 7 isolates from practice group 2 (middleweights) were identical (strain B), which suggested concurrent transmission of different strains within different groups. HSV-1 was not isolated from any oropharyngeal swabs. CONCLUSIONS. Herpes gladiatorum may cause substantial morbidity among wrestlers, and it is primarily transmitted by direct skin-to-skin contact. Prompt identification and exclusion of wrestlers with skin lesions may reduce transmission.

Source Information

Division of Field Services, Centers for Disease Control, Minnesota Department of Health, Minneapolis 55440.

This article has been cited by other articles:

• Ban, F., Asano, S., Ozawa, S., Eda, H., Norman, J., Stroop, W. G., Yanagi, K. (2008). Analysis of herpes simplex virus type 1 restriction fragment length polymorphism variants associated with herpes gladiatorum and Kaposi's varicelliform eruption in sumo wrestlers. J. Gen. Virol. 89: 2410-2415 [Abstract] [Full Text]  
• Turbeville, S. D., Cowan, L. D., Greenfield, R. A. (2006). Infectious Disease Outbreaks in Competitive Sports: A Review of the Literature. Am J Sports Med 34: 1860-1865 [Abstract] [Full Text]  
• Rihn, J. A., Michaels, M. G., Harner, C. D. (2005). Community-Acquired Methicillin-Resistant Staphylococcus aureus: An Emerging Problem in the Athletic Population. Am J Sports Med 33: 1924-1929 [Abstract] [Full Text]  
• Adams, B. B (2000). Transmission of cutaneous infections in athletes. Br. J. Sports. Med. 34: 413-414 [Full Text]  
• Uchio, E., Takeuchi, S., Itoh, N., Matsuura, N., Ohno, S., Aoki, K. (2000). Clinical and epidemiological features of acute follicular conjunctivitis with special reference to that caused by herpes simplex virus type 1. Br J Ophthalmol 84: 968-972 [Abstract] [Full Text]  
• Lindenmayer, J. M., Schoenfeld, S., O'Grady, R., Carney, J. K. (1998). Methicillin-Resistant Staphylococcus aureus in a High School Wrestling Team and the Surrounding Community. Arch Intern Med 158: 895-899 [Abstract] [Full Text]  
• Goodman, R. A., Thacker, S. B., Solomon, S. L., Osterholm, M. T., Hughes, J. M. (1994). Infectious Diseases in Competitive Sports. JAMA 271: 862-867 [Abstract]  
• Adler, A. I., Altman, J. (1993). An Outbreak of Mud-Wrestling--Induced Pustular Dermatitis in College Students: Dermatitis Palaestrae Limosae. JAMA 269: 502-504 [Abstract]