Download Chapter 29: Additional Health Conditions

Infectious Disease in Athletics
Role of the Immune System
• Collection of disease fighting cells that
neutralizes foreign substances
– Illness results when immune system does not
neutralize foreign substances (antigens)
– Cell-mediated response, humoral immune
response (B-cells that produce antibodies), or
nonspecific immune response (inflammation)
• Auto-immune response against the body
leads to damage of body’s own tissues
Viral Infections
• Rhinovirus (Common Cold)
– Etiology
• Over 100 different rhinoviruses
• Transmitted by either direct or indirect contact
(cough, sneeze, speaking, touching contaminated
article)
– Sign and Symptoms
• Begins w/ scratchy, sore throat, stopped-up nose,
watery discharge and sneezing
• Second batch may produce thick yellow nasal
discharge, watering eyes, mild fever, sore throat,
headache, malaise, myalgia, dry cough
– Secondary - laryngitis, tracheitis, acute bronchitis,
sinusitis, and otis media
– Management
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Symptomatic treatment (may last 5-10 days)
Non-prescription cold medications
Eat a balanced diet, consume 64 oz. of water
Avoid emotional stress and extreme fatigue
• Influenza (Flu)
– Etiology
• Caused by myoviruses (A, B, C)
– Type A is most common
– Virus enters through cell genetic material
– Sign and Symptoms
• Fever (102-103 degrees F), chills, cough, headache, malaise, and
inflamed respiratory mucous membrane w/ coryza
• General aches and pains, headache becomes worse
• Weakness, sweating, fatigue may persist for many days
– Management
• Bed rest and supportive care
• Symptomatic care should be avoided by those under age 18 (
Reye’s syndrome)
• Steam inhalation, cough medicines, and gargles
• Infectious Mononucleosis
– Etiology
• Epstein-Barr virus (member of herpes group) that has incubation
period of 4-6 weeks
• Transmitted through saliva
– Sign and Symptoms
• First 3-5 days -severe fatigue, headache, loss of appetite and
myalgia
• Days 5-15 - fever, swollen lymph nodes and sore throat (50%
will experience enlarged spleen)
• Possible jaundice, skin rash, puffy eyelids
– Management
• Supportive symptomatic treatment
• Acetaminophen for headache, fever and malaise
• Resume training after 3 weeks after onset if spleen not markedly
enlarged/painful, athlete is afebrile, liver function is normal, and
pharyngitis is resolved
• Rubella (German Measles)
– Etiology
• Highly contagious viral disease (childhood disease)
• Results 13-24 days after exposure
• May cause developmental difficulties for fetus in
pregnant females
– Sign and Symptoms
• Temperature elevation, sore throat, drowsiness, swollen
lymph glands and red spots on palate
• Rash
– Management
• Prevent by early childhood immunization
– Measles, mumps, rubella vaccine (MMR)
• Rubeola (Measles)
– Etiology
• Childhood disease
• Incubation time of 10 days following exposure
– Sign and Symptoms
• Sneezing, nasal congestion, coughing, malaise,
photophobia, spots in mouth, conjunctivitis, and
elevated fever (rash appears - causes itching)
– Management
• Inoculation w/ MMR vaccine at 12-15 months and
4-6 years of age
• Bed rest, isolation in dark room and use of
antipyretic and anti-itching medication
• Mumps (Parotitis)
– Etiology
• Contagious viral disease that results in inflammation of
parotid and salivary glands
• Appear in 12-25 days following exposure
– Sign and Symptoms
• Malaise, headache, chills and moderate fever
• Pain in neck - swelling of glands may last up to 7 days
• Pain w/ jaw motion and swallowing; increased or
decreased saliva production
– Management
• Varicella-zoster immune globulin w/in 96 hours of
exposure will prevent clinical symptoms in normal
healthy children
• Acyclovir meds should be administered to adolescents
and adults w/ in 24 hours of exposure
• Anti-itching medications to prevent scratching
Respiratory Conditions
• Sinusitis
– Etiology
• Stems from upper respiratory infection caused by a
variety of bacteria
– Sign and Symptoms
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Nasal mucous swell and block ostium of paranasal sinus
Painful pressure occurring from accumulation of mucus
Skin over sinus may be swollen and painful to the touch
Headache and malaise; purulent nasal discharge
– Management
• If infection is purulent, antibiotics may be warranted
• Steam inhalation and other nasal topical sprays w/
oxymetazalone can produce vasoconstriction and
drainage
• Tonsillitis
– Etiology
• Acute inflammation and bacterial infection of tonsil
epithelium
– Sign and Symptoms
• Tonsil appear red, swollen, w/ yellow exudate in pits
• Pain w/ swallowing, high fever and chills, headache
and neck pain
• Sinusitis, otitis media, tonsillar abscesses may also
develop
– Management
• Culture to check for streptococcal bacteria and
antibiotics for 10 days
• Gargling w/ saline water, liquid diet, and antipyretic
medication
• Frequent bouts of tonsillitis may necessitate removal
• Seasonal Atopic (Allergic) Rhinitis
• Hay fever, pollinosis from airborne pollens
– Etiology
• Reaction to pollen - airborne fungal spores (allergens)
resulting in allergic antibodies causing the release of
histamine
– Sign and Symptoms
• Eyes, throat, mouth and nose begin to itch, followed
by watering eyes, sneezing and clear watery discharge
• Sinus type headache, emotional irritability, difficulty
sleeping, red & swollen eyes and nasal mucus
membranes, and wheezing cough
– Management
• Oral antihistamines and decongestants
• Pharyngitis (sore throat)
– Etiology
• Caused by virus or streptococcus bacteria
• Transmitted by direct contact of infected person or
one who is a carrier
– Sign and Symptoms
• Pain w/ swallowing, fever, inflamed and swollen
glands, malaise, weakness and anorexia
• Mucus membrane may be inflamed and covered w/
purulent matter
– Management
• Throat culture
• Topical gargles and rest
• Antibiotic therapy for streptococcal infection
• Acute Bronchitis
– Etiology
• Infectious winter disease that follows common cold or viral
infection
• Fatigue, malnutrition or becoming chilled could be
predisposing factors
– Sign and Symptoms
• Upper respiratory infection, nasal inflammation and profuse
discharge, slight fever, sore throat and back muscle pains
• Fever lasts 3-5 days while cough can last 2-3 weeks
• Yellow mucus indicates infection
• Pneumonia can complicate condition
– Management
• Avoid sleeping in cold environment, avoid exercise in
extreme cold w/ protection
• Rest until fever subsides, drink 3-4 quarts of water daily,
ingest antipyretic analgesic, cough suppressant, and
antibiotic
• Pneumonia
– Etiology
• Infection of alveoli and bronchioles from viral, bacterial
or fungal microorganisms
• Irritation from chemicals, aspiration of vomitus
• Alveoli fill w/ exudate, inflammatory cells and fibrin
– Sign and Symptoms
• Bacterial will cause rapid onset
• High fever, chills, pain on inspiration, decreased breath
sounds, rhonchi on auscultation, coughing of purulent,
yellowish sputum
– Management
• Treat w/ antibiotics; perform deep breathing exercises to
removal of sputum through heavy coughing
• Analgesics and antipyretics may be useful for
controlling pain and fever
• Cystic Fibrosis (Not infectious)
– Etiology
• Genetic disorder that can manifest as obstructive
pulmonary disease, pancreatic deficiency, urogential
dysfunction and increased electrolyte sweating
• Cause of severe lung disease w/ life expectancy of about
30 years
– Sign and Symptoms
• Bronchitis, pneumonia, respiratory failure,gall bladder
disease, pancreatitis, diabetes and nutritional deficiencies
• High production of mucus
– Management
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Drug therapy to slow progress of disease (ibuprofen)
Antibiotics to control pulmonary disease
Consistent postural drainage to mobilize secretions
High fluid intake to thin secretions and use of humidifier
Sexually Transmitted
Diseases
The Love Bugs
Just the Facts
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SC ranks among the top 10
states for highest rates of
gonorrhea and syphilis
Chlamydia is the most
common STD. In SC the
highest rates of infection
are among women ages 1519 (16%)
STDs/HIV primarily affect
teenagers and young people
50% of gonorrhea and
syphilis cases are among
persons 15-29 years of age
37% of HIV infections are
among this age group
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SC ranks 10th in the country
for the highest rate of AIDS
The highest rate for HIV
infection in SC is in Richland
County
1 in 4 teenagers will acquire
an STD
Risk Assessment
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Person who has multiple sex partners
Unprotected sex (even once)
History of STD or has a current STD
Drug user
Sex partner of drug user
Person who has sex for drugs/money
Sex partner of person who has sex for drugs/money
Between the ages of 12-26
Sexual practices/ Exposure sites
Bacterial STDs
Gonorrhea
Chlamydial Infections
Syphilis
Gonorrhea
• Transmittedvaginal/oral/rectal sex
• Symptoms- 3-10 days
following exposure
• Milky discharge from
penis/vagina/rectum
• Burning/itching on
urination
• If untreated can cause
PID/ectopic pregancy in
women
• Sterility in both sexes
• Joints, heart valves, brain
• Gonorrhea (clap)
– Etiology
• Caused by organism infection - gonococcal bacteria
which is spread through intercourse
– Sign and Symptoms
• In men - experience tingling of urethra followed by
2-3 hours of greenish yellow discharge and painful
urination
• 60% of women are asymptomatic
• Females will experience vaginal discharge
• May result in sterility if not treated or arthritis
– Management
• Penicillin
• Avoid sexual contact until it is known that the
disease is no longer active
Chlamydia
• Most prevelant STD
worldwide
• Transmitted thru vaginal/anal
sex
• Symptoms- up to 75% of
women and 15% of men are
asymptomatic
• In men & women abnormal
discharge and burning on
urination.
• Swelling of the testicles in
men and abdominal pain and
painful intercourse in women
Chlamydia cont….
• Possible consequences
for infected persons:
• If untreated in women
30% will experience
PID, infertility and
chronic pelvic pain
• In men epididymitis,
inflammation of the
testicle and sterility
• Chlamydia
– Etiology
• Caused by bacterial organism
– Sign and Symptoms
• May result in pelvic inflammation and is important
cause of infertility and ectopic pregnancy in females
• In males, inflammation occurs along with purulent
discharge 7-28 days after intercourse
• Painful urination and traces of blood in urine,
vaginal discharge
• Can cause conjunctivitis and pneumonia in
newborns
– Management
• Identify infection and exact organism present
• Treat with antibiotics
Syphilis
• Transmitted through
vaginal/anal/oral sex
• Infection can occur by nonsexual contact if sores, rashes
or mucous patches come in
contact with broken skin
• SymptomsStage 1- painless sores
(chancres) appear on genitals
or any other part of the body
Primary Lesion in Female
Syphilis cont….
• Chancre heals with
several weeks
• Secondary syphilis-if
chancre is not treated,
organism enters the
bloodstream causing
rash, sore throat, fever,
swollen glands and
mucous patches
Syphilis cont….
• Symptoms from secondary syphilis disappear after
several weeks
• Tertiary syphilis occurs years later after spirochete has
damaged major organs
– Damage to heart and vessels
– Brain damage resulting in mental illness
– Damage to spinal cord causing paralysis
– Deafness/blindess
• Syphilis
– Etiology
• A spirochete bacteria is the organism related to syphilis
and enters body through mucous membranes or skin
lesions
– Sign and Symptoms
• 4 stages
– Incubation is usually 3-4 weeks but could be anywhere from
1-13 weeks; painless chancre or ulcer forms that heal w/in 4-8
weeks (can occur on penis, urethra, vagina, cervix, mouth,
hand, foot or around eye)
– Secondary stage occurs 6-12 weeks after initial infection and
is characterized by a rash, lymph swelling, body aches, mild
flu-like symptoms and possible hair loss
– Latent syphilis is characterized by no or few symptoms - but if
untreated it may result in tertiary syphilis
– Sign and Symptoms
– Late stage is characterized by deep penetration of
spirochetes that damage skin, bone, cardiovascular system
and nervous system
– Late stage may develop w/in 3-10 years of infection and
cause neurosyphilis - muscle weakness, paralysis and
various types of psychoses
– Management
• Penicillin is used for all stages
• Other drugs may be required due to increased
resistance
Treatments for Bacterial STDs
• Gonorrhea and chlamydia can be cured with
antibiotic medication however, it cannot undo the
damage done prior to treatment
• Syphilis is treated with penicillin and other 3rd
generation antibiotics but these medications are
only effective in primary and secondary syphilis.
There is no cure for tertiary syphilis.
Viral STDs
Genital Herpes
Human Papillomavirus (genital warts)
HIV
Hepatitis B
Genital Herpes
• Spread by direct sexual skin
to skin contact with infected
site during vaginal/anal/oral
sex
• Symptoms include itching and
burning sensation in buttocks,
• Blisters or painful open sores
in the genital area, anus,
buttocks and thighs
• Sores heal after several weeks
but often recur
• No cure-
• Genital Herpes
– Etiology
• Caused by type 2 herpes simplex virus
– Sign and Symptoms
• Develops 4-7 days following sexual contact
• Begins to crust 14-17 days in primary genital herpes
and 10 days in secondary
• Females may be asymptomatic while males will
experience itching and soreness
• Development of lesions
– Management
• Herpes and pregnancy
• No cure just systemic medication (antiviral
medications) to lessen early symptoms or the disease
Genital Warts
• Cause by HPV
• Occur 1-3 months after
exposure
• Emerging as a common
STD
• No Cure- treatment is
aimed at surgical
removal
• Associated with
increased risk of anal
cancer
• Genital Candidiasis
– Etiology
• Transmitted through sexual activity and appear as
warts on the glans penis, vulva or anus
– Sign and Symptoms
• Cauliflower-like wart or can be singular
• Soft, moist pink or red swellings that develop
cauliflower-like head
• May be mistaken as secondary syphilis or carcinoma
– Management
• When moist - 20-25% polophyllin
• Dry warts - may be frozen with liquid nitrogen
Trichomonas Vaginalis
• Sexually transmitted
• Often secondary to
existing STD
• Called NGU
(nongonoccocal urethritis)
in men
• Causitive agent is
protazoa
• Symtoms are foul, whitish
discharge, itching,
vulvular irritation
• Trichomoniasis
– Etiology
• Caused by the flagellate protozoan trichomonas
vaginalis
– Sign and Symptoms
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Vaginal discharge that is greenish yellow and frothy
Causes irritation of the vulva, perineum and thighs
Painful urination
Males tend to by asymptomatic but may experience
purulent urethral discharge
– Management
• 2 grams of metronidazole cures up to 95% of cases
in women
• Males require 500mg twice daily for 7 days
• Complete cure is required before engaging in
intercourse
Pubic Lice
• Sexually transmitted
• Also by contaminated
linens, clothing or
other articles
• Parasite is the
causative agent
• Symptoms include:
intense itching of
perineal area
Play safe- protect
yourself
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Abstinence is 100% effective
Have sex with only one uninfected partner
Talk to your partner
Consider all potential sex partners as infected
Use condoms, birth control foams, creams or jelly.
These kill many STD germs
• Get checked for STDs
• Know the signs and symptoms of STD
• If you have an STD, your partner must get
treated as well