Infection Prevention in Athletes by Anderson Deverick;

Author:Anderson, Deverick; [Yosipovitch, MD Gil]
Language: eng
Format: epub
Publisher: Wolters Kluwer Health
Published: 2020-02-05T11:55:01+00:00

Respiratory Illness

From “colds” to “the flu,” viral respiratory illnesses are common at all ages. Almost all viral respiratory illnesses are transmittable from one person to the next. In contrast, the majority of bacterial respiratory illnesses are not easily transmitted. An important exception that team medical personnel must recognize is “whooping cough” (caused by the bacterium Bordatella pertussis).

Develop a protocol for diagnosis and treatment of respiratory or influenza-­like illness.

Obtain diagnostic tests for influenza from players with influenza-­like illness when typical symptoms of influenza occur during “flu season.”

Rationale: Influenza is classically associated with the acute onset of fever, chills, muscle pains, headache, cough, loss of appetite, and generalized feelings of weakness. This pattern of illness is highly predictive of influenza in the setting of a documented outbreak or high community prevalence. However, these symptoms are not a reliable way to diagnose sporadic cases of influenza in the absence of an outbreak, as numerous other common viral pathogens can cause an illness indistinguishable from influenza. Also, the severity of influenza can vary substantially between individuals infected with the same strain of influenza, leading to a false assumption that a simple uncomplicated viral illness is present.

Testing provides two important benefits to overall team health. First, players may then be provided anti-­influenza medications such as oseltamivir (Tamiflu) 75 mg two times per day by mouth for 5 days to decrease the duration of symptoms. Use of this medication for treatment of influenza may shorten the duration of symptoms by 1 to 2 days. A second treatment option, baloxavir (Xofluza) was approved by the FDA in 2018 for treatment of influenza; a single dose of 40 mg (if <80 kg) or 80 mg (if >80 kg) is given at the time of diagnosis. Second, knowledge that a player has influenza can allow medical staff to initiate a tiered response protocol as described in Chapter 5.

Tips and Advice: Diagnosis of Influenza-like Illness

Testing is best achieved by referring the player to the team physicians, as specific testing strategies may differ by site.

However, be sure polymerase chain reaction (PCR)-­based molecular tests are used at the office to ensure more reliable results.

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