Infectious diseases in rugby players: incidence, treatment and prevention

Participation in rugby football can expose individuals to a variety of infectious diseases both on and off the field of play. The close physical contact and trauma inherent in playing rugby facilitates the transmission of viral, bacterial and fungal pathogens between players and may also lead to the acquisition of potentially lethal infections from the environment, such as tetanus. In the past few years there have been a number of reported outbreaks of infection amongst rugby players in the medical literature. The appearance of HIV infection has focused attention on the potential for transmission of this and other blood-borne viruses such as hepatitis B and C viruses from bleeding wounds sustained on the rugby field. As a result, various expert bodies have produced guidelines on the management of players with bleeding wounds. Opportunities are now available to rugby players to play outside their own countries, including the third world. This can bring them into contact with a wide range of travel-associated infections, some of which may be life threatening. In view of the above it is clear that rugby players and those who coach and manage rugby teams require information and education on the subject of infection and its prevention, as well as access to appropriate medical care and expertise. Many of the infections seen in rugby players are preventable, e.g. by promoting hygienic facilities and conduct in changing rooms and on the field of play, by exclusion of infected players from contact with others and, in some cases, by immunisation or chemoprophylaxis. Players who present with infections should be assessed, correctly diagnosed (using laboratory investigations where appropriate) and treated, and measures should be taken to prevent spread to team-mates and other contacts while respecting the confidentiality of the individual. Any outbreaks of infection should be reported to the appropriate authorities. There is evidence to suggest that strenuous physical exercise such as playing rugby can make individuals susceptible to certain types of infection and prolong time to recovery. More information is required on the true frequency and effects of infection in rugby players.