Commentary

Flu raises questions in sports world

Updated: May 1, 2009, 2:00 PM ET
By Dr. Michael Kaplan | ESPN Medical Analyst

Concerns have been raised during the past week about a potential "swine flu" pandemic. As of Thursday, the influenza virus, subtype H1N1, had caused at least 109 lab-confirmed cases in the United States and one death: a Mexican boy who became sick while visiting Brownsville, Texas. The emergence of this new strain raises a number of questions for the sporting world. Here are some of those questions and their answers:

What is the "swine flu" virus and why is it causing so much concern?

Taking a step back, this is much like any other virus, any other influenza, with a few differences. It's a new strain, one for which we don't have a vaccine yet. It may be six months before we do, in part because the virus itself is evolving. It's a new type of virus, different than influenza A, and it's somewhat less virulent than others in the winter. The other difference is it's very, very contagious, and may be more so than previous viruses. It's also new to our environment, and we think its origin is in Mexico. We're also seeing it in a pandemic distribution, which is to say they [the World Health Organization] have this alert level Phase 5 because it has spread human-to-human in various countries. So the Center for Disease Control activated emergency operations, and that's why there's so much attention and travel warnings recommending folks not go to Mexico for non-essential travel.

How seriously should athletes and fans take the alerts?

They should take them seriously, but not so seriously that there needs to be any panic. What I'd say to athletes, fans and the general public is, because of its highly contagious nature, it's particularly important for people to be fastidious about hygiene -- namely hand-washing. This virus, while it can be spread airborne or ingested, is primarily spread by contact. It can live on surfaces for even two hours. It's important to remember that the regular flu kills many people during a year, particularly the old and infirm, and the very young. (The CDC estimate that 36,000 Americans die from flu-related causes from the regular strain of the virus each year.) The difference with this strain is that it appears to be particularly prevalent in the healthy, adult population.

What kinds of behaviors would fans exhibit that might increase their chances of getting infected?

Well, a sneeze has been clocked to spray out at up to 100 mph, which means it's easier to dodge a fastball than it is a sneeze. If you're in an arena and someone sneezes behind you, the viral fallout can go up to six feet -- and it comes fast. The takeaway here is you don't want to be next to people who are sneezing, sick and coughing. You can't dodge it. If you're within six feet and you're not protected, or they're not protected, then you're at risk.

What should a coach, parent, or team do if one player comes down with flu-like illness?

If the player has mild symptoms of one or two days in duration, they probably should just treat them symptomatically and isolate them from the remainder of the team. If those symptoms persist or become more pronounced -- cold, malaise, fever, nasal congestion, joint pain, headache, things of those nature -- then they probably should bee seen by a medical professional. The majority of folks who have documented H1N1 do not succumb to it, and in fact have symptoms that are manageable. If it is recognized with the appropriate lab test, it's treated with antivirals. If you're sick, stay home, of course. Most of these illnesses will resolve in a few days and won't require medical attention. Those that are more worrisome that present with joint ache, severe cough, weakness, fatigue, headache, dry cough, sudden fever above 102 -- those that make you nervous about swine flu and are not getting better -- that's when you want to go to a clinic or medical facility, where they're now outfitted with a kit to test for swine flu. That test has to be sent to the CDC.

Should teams traveling now, like NBA and NHL playoff teams, or college teams or even Little League teams, do anything different?

They already should be practicing proper hygiene -- always. When athletes come into contact with each other in training rooms or with other people, they should be particularly careful about washing hands between contact, minimizing contacts and good use of towels and uniforms.

Should people go out and get some sort of antiviral, like Tamiflu (oseltamivir), or Relenza (zanamivir)?

You don't need to get antivirals like Tamiflu prophylactically. Just make sure if you're at an arena or stadium that you wash your hands, and make sure the people working in concessions have gloves and that the areas are clean.

Dr. Michael Kaplan is an ESPN medical analyst.