Prophylactic valacyclovir to prevent outbreaks of primary herpes gladiatorum at a 28-day wrestling camp

Herpes gladiatorum (HG) plagues the sport of wrestling, especially in high school wrestlers and summer camps they attend. This study evaluated the usage of valacyclovir to prevent acquisition of primary HG, due to herpes simplex virus type 1 (HSV-1), in high school wrestlers at a 28-day wrestling camp. At the beginning and end of camp, IgM and IgG anti-HSV-1 antibodies were collected. Out of 332 male wrestlers, aged 13-20, who entered camp, 94 elected to participate in blood sampling. Sixty-four were on antiviral medication. Among the 94 wrestlers, 28 (29.8%) had positive IgG anti-HSV-1 titers. Of this group, 66 of 94, were HSV-1 IgG seronegative. At the end of camp, 55 of these original seronegative individuals elected to participate in blood sampling and none had detectable IgM anti-HSV-1 and -2 antibodies. Compared to previous years without antiviral usage, introducing prophylactic valacyclovir reduced clinical HG outbreaks by 87% at this 28-day wrestling camp. Due to the high prevalence of this virus in high school wrestlers, serological testing should be done at the beginning of each season. HSV-1 seropositive individuals should consider being on antiviral medication throughout the season to minimize the risk of transmitting the virus to other wrestlers.