Page 124 - Athletic Health Handbook
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sports with increased exposure risks Figure 2: Joint statement from the AOSSM and AMSSM (modified)
and in chronic HBV carriers that are
e-antigen positive. The most effective 1. Pre-event preparation includes proper care for existing wounds.
way to prevent transmission of HBV
in the athletic setting is by immuniz- 2. Necessary equipment or supplies or both important for compliance
ing all children and adolescents with universal precautions should be available to caregivers.
against HBV as recommended by the
American Academy of Pediatricians. 3. During the sports event, early recognition of uncontrolled bleeding is the
responsibility of officials, athletes, and medical personnel.
Hepatitis C Virus (HCV)
4. The athletes should be advised that it is their responsibility to report all
HCV is also transmitted through wounds and injuries in a timely manner, including those recognized before
contact with body fluids. Symptoms the sporting activity.
are similar to HBV. Laboratory studies
to confirm the diagnosis include 5. The care provider managing an acute blood exposure must follow the
Hepatitis C antibody. The transmis- guidelines of universal precautions.
sion risks of HCV are more poorly
understood but the risk of infection 6. Minor cuts or abrasions or both commonly occur during sports. These
following exposure is probably less types of wounds do not require interruption of play or removal of the
than HBV but greater than HIV.9 participant from competition.
There have been no documented
cases of HCV transmission in sports. 7. Lack of protective equipment should not delay emergency care for life
threatening injuries.

8. Any equipment or area soiled with blood should be wiped immediately.

9. Post event consideration should include reevaluation of any wounds
sustained during the sporting event.

10. Procedures performed in the training room are also governed by
adherence to universal precautions.

11. Some of the members of the athletic health-care team may be considered
to be covered under OSHA guidelines.

Human Immunodeficiency Virus since been reported in Asia, North suspected of SARS illness should
America, and Europe. The majority be placed in respiratory isolation.
Human Immunodeficiency Virus of patients described were previously Universal precautions should always
(HIV) is a virus that affects the T-Cells healthy adults, 25 to 70 years. The be observed.
of the immune system. Clinical incubation period of the illness is
symptoms are non-specific. The risk typically two to seven days. The illness With increasing travel among
of HIV infection via skin or mucous generally begins with a prodrome athletes there is a greater risk of
membrane contact with blood or of fever (>38ÂșC) sometimes with exposure to SARS. The official Inter-
other bodily fluids during sports chills and rigors, possibly headache, national Olympic Committee (IOC)
participation is extremely low. There malaise, and myalgias. After three to position is to liaise daily with the
have been no documented cases of seven days lower respiratory symp- WHO and follow their policy which
HIV transmission in sports. toms begin with the onset of a dry, is to advise persons to minimize
non-productive cough or dyspnea. In travel to countries which are listed by
The American Orthopaedic Soci- 10 to 20 percent of cases these symp- the WHO as being affected by SARS,
ety for Sports Medicine (AOSSM) toms progress to hypoxemia and can and that SARS related issues would
and the American Medical Society require mechanical ventilation. The be dealt with on a case by case basis.12
for Sports Medicine (AMSSM) case fatality among persons meeting
published a joint statement on HIV criteria for SARS is around 3 percent. Conclusion
and other blood-borne pathogens in
sports.10 The essential components of Chest radiographs can be normal, Athletes may be exposed to infectious
the statement are shown in Figure 2. A however a significant number develop diseases during athletic participation.
full text of the statement can be found early focal infiltrates that progress to Participation and return to sport are
at http://www.amssm.org/hiv.html. more generalized, patchy interstitial determined by the nature of the infec-
In addition, in 1999 the American infiltrates. Early on white cell counts tion, its risk of transmission,and the
Academy of Pediatrics released their have been normal or decreased. After sport played by the athlete. Decisions
recommendations for infections in the onset of the illness >50 percent of should be made on a case-by-case
the athletic setting.11 patients have leukopenia and thrombo- basis utilizing the most current infor-
cytopenia with elevated creatine phos- mation available. Most importantly,
Severe Acute Respiratory Syndrome phokinase and transaminase levels. any recommendation made should
address the safety of the athlete as
According to the World Health Organ- At present, no effective treatment well as all participants involved.
ization (WHO), Severe Acute Respi- regimen is known. Individuals
ratory Syndrome (SARS) was first
described in February 2003, and has

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