Your Student Athlete

27 08 2013

Kids are back in school and signing up for sports.

Some parents wonder about their infected children playing sports and possibly infecting others in the process.  Parents also wonder how concerned they should be about their children becoming infected from other players living with undiagnosed or undisclosed infections.

Playing sports can be risky in many ways and part of that risk is the potential to become infected with all sorts of germs.

Parents of children living with diagnosed infectious diseases worry that they may be responsible for infecting another child.  They wonder if they should inform the coach or the school.  They worry that the adults in charge don’t really follow standard precautions, thereby increasing the risk of infections.  They want their kids to enjoy life and they want to do the right thing.

The American Academy of Pediatrics issued a policy statement on this dilemma in December, 1999: HIV and Other Blood-Borne Viral Pathogens in the Athletic Setting. In it, the Academy made clear, “Because of the low probability of transmission of their infection to other athletes, athletes infected with HIV, hepatitis B or hepatitis C should be allowed to participate in all sports.”

The AAP’s Redbook still supports this policy.

Participation, however, assumes all athletes and coaches will follow standard precautions to prevent and minimize exposure to bloodborne viruses.

There is no reason to exclude any student from sports if they’re infected with HIV, HBV or HCV.  Nor is there a reason to disclose the infection.  There are many people living with undiagnosed infections, so it is more prudent to ensure everyone is practicing standard precautions rather than simply excluding those with known infections and not properly protecting all athletes from undiagnosed infections.

Dr. Steven J. Anderson, a pediatrics professor at the University of Washington and a team doctor for many high school athletic teams, ballet companies and the U.S. Olympic Diving Team, suggests children should have access to any sport, except boxing, which the Academy opposes for all youths because of its physical risks.

Pediatricians can avoid reporting a student’s infection, the Academy noted, by making it clear on any participation forms that they support the Academy’s position that all students can participate in all sports and that pediatricians must respect an athlete’s right to confidentiality.

But strict compliance with standard precautions is critical for this open embrace of all athletes, regardless of their infectious status.  Dr. Anderson notes that, as a parent, he would make sure that there is a plan in place to handle blood spills, including latex gloves, occlusive dressings, appropriate sterilizing solutions, disposal bags and even a printed protocol for coaches, athletes and officials.

Dr. Anderson does feel that students with infectious hepatitis A (spread through close physical contact with contaminated food, water or skin) or with liver or spleen enlargement should be restricted from contact or collision sports until the liver or spleen has returned to normal size, and the person is no longer contagious.

An article that ran in 2004 in the British Journal of Sports Medicine talked about possible methods of transmission in sports and reported incidents of transmission:

Bleeding or oozing injuries could, in theory, transmit the virus through the mucous membrane or injured skin of other athletes.  This risk is considered extremely low.  However, contact and collision sports like wrestling or boxing increase that risk.  The risk goes down a bit for those playing basketball or soccer, and those playing sports with little physical contact, such as tennis or baseball, are at the lowest risk.

It has been suggested that bloodborne infections may be transmitted through sharing a water container, because bleeding around the mouth is common in contact sport.  Therefore it is recommended that water containers should be available individually for each player in contact sports. Athletes should use squeeze water bottles which they do not put in their mouth.

Bloodborne infections can be transmitted through blood doping. There is also a risk from sharing needles which may be associated with drug abuse in sport. Injectable drugs used in sports include steroids, hormones, and vitamins.

Three separate cases of HIV infection associated with sharing needles among bodybuilders have been reported, two in the United States and one in France.  It has also been reported that three soccer players from one amateur club were infected with HCV as a result of sharing a syringe to inject intravenous vitamin complexes. Syringes have often been shared by athletes who inject vitamins minutes before a game.

A 1993 study estimated that, in the United States, there were one million people who were either current or past users of anabolic androgenic steroids. Of these, 50% were intramuscular drug users, and about 25% had shared needles. Therefore it seems that the risk of transmission in this way may be considerable among athletes, especially bodybuilders.

So, if your family is getting involved in sports, it would be worth your time to:

  • Get caught up on all vaccinations
  • Practice standard precautions
  • Wash your hands a lot or, if hands aren’t visibly soiled, use alcohol handrubs
  • Don’t share needles with anyone for any purpose




Germs – It’s a Symbiotic Thing

26 04 2010

We have 100 trillion microbes in and on our bodies. Most of these little critters don’t affect us—no harm, no foul.  Some germs even help out with digestion and other functions, and some cause illness.

Despite the fact that we’re walking bags of bugs, we don’t want to think about it and we definitely don’t want to get more germs, at least not the disease-causing kind.

Photo courtesy "bmann"

To prevent disease and general yuckiness in the home and elsewhere, we are a sponge-and-cleaner wielding people. Some of us more than others. (That’s right, Mom, I’m talking about you.)

We can’t keep our homes and offices germ-free, nor should we.  We have a symbiotic relationship with the germs in our world that requires a delicate balance of healthy intimacy to maintain.

But, we don’t want pathogenic germs to get the upper hand.  They’re the germs capable of causing disease.

Being clean and tidy helps keep the nasty numbers down, but germs will always be with us. Our bodies fight pathogens off all day long as we go about our business.

And when we actually do get around to cleaning, we tend to focus on obvious trouble spots (bathrooms, kitchens) while ignoring places we don’t typically think of as germ hot zones. We’re talking about our offices, our phones, our keyboards.

Dr. Charles Gerba, a professor of microbiology at The University of Arizona at Tucson, has done a lot of research on viruses and bacteria in offices.

His work reveals startling facts. For instance, the germiest place in any type of office is something you use every day. “The phone is typically the dirtiest piece of equipment in an office because it goes straight to your mouth, and you never clean or disinfect it,” says Gerba.

Right behind phones are desks, which often pull double-duty as restaurant tables, and keyboards, which are tricky to clean and good at collecting things like dirt, hair, food particles, dust and bacteria. Many of us like to grab a bite while catching up on email, but studies may make you rethink that: keyboards are usually much germier than toilet seats.

Things get complicated if many people share a computer. This is bad news if you absent-mindedly bite your nails or touch your nose or eyes while working.

Women’s offices tend to have more germs in them, as women tend to bring in and take out more items like bags and purses, which can carry germs that get transferred to office equipment.

However, men’s wallets are often found to be germier than women’s purses.

So, how can you protect yourself at work without turning into a worrywart? In an interview with Entrepreneur, Gerba suggested you:

  • Wipe down your desk and surrounding items with a disinfecting wipe once a week.
  • Keep a hand sanitizer at your desk and use it throughout the day.
  • If you tend to eat at your desk on a regular basis, think again–this behavior is inviting bacteria to grow at your fingertips.
  • Wash coffee mugs and glasses on a regular basis.
  • If you’re sick, don’t go to work.

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