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Blood-Borne Pathogens in Sports
- Jouko Karjalainen, MD; and
- Goran Friman, MD
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TO THE EDITOR:
In their timely article, Mast and colleagues [1] stated that the only outbreak of hepatitis B in sports reported in the medical literature was that seen among sumo wrestlers in Japan in 1980. However, a much larger epidemic occurred among Swedish orienteers (track-finders) in the early 1960s [2]. In that epidemic, more than 600 infected competitors had clinical symptoms, and at least as many subclinical cases occurred. Some cases were also found among orienteers in Norway and Finland. Because no serologic test for hepatitis was available at that time, the orienteers' hepatitis was initially considered a distinct entity and was even given a diagnosis number (070,01 hepatitis silvatica) in the official disease classification used in Scandinavia from 1969 to 1986. Serum samples were stored, and subsequent testing showed the pathogen to be the hepatitis B virus [3].
Orienteering is a sport in which runners, with the aid of a map and compass, try to find control points in the terrain. At the time of the hepatitis outbreak, the clothes worn by the competitors usually consisted of shorts, short-sleeved shirts, socks, and shoes. Competitors rarely used leg shields. During the races, most of the runners received skin scratches on their extremities. Blood contact probably occurred after the competitions, when hundreds of orienteers bathed in stagnant or slow-moving water. The incidence of hepatitis decreased immediately after preventive measures were introduced. All competitions were cancelled for one season, and protective clothing became compulsory. After some time, adherence to these new rules slackened and hepatitis cases reappeared. After rules were re-enforced, no more cases were discovered. With the exception of a small outbreak in 1981, no further hepatitis B epidemics have been reported among orienteers.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
