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Can Hepatitis B Be Transmitted on the Football Field?

WebMD Health News
Reviewed by Merle Diamond, MD

Sept. 21, 2000 -- Broken bones and concussions aren't the only hazards football players face on the field, a new study has found. Hepatitis B, a blood-borne virus that attacks the liver and can last a lifetime, can be spread among team sports players through contact with other players' wounds during training, according to a Japanese study of a football team.

The study, which appears in the Archives of Internal Medicine, identified 11 cases of hepatitis B among the Okayama University's football team during a 19-month period. Hepatitis B virus (HBV) can cause lifelong infection, scarring of the liver, liver cancer, liver failure, and potentially death. It is known to be transmitted through blood transfusions, intravenous drug use, and sex with an HBV-infected partner, and the new study suggests that transmission is also possible in contact sports.

Each year in the U.S., more than 200,000 people of all ages get hepatitis B, and close to 5,000 die as a result of HBV, according to statistics from the CDC. But a hepatitis B vaccine to prevent infection is available for all age groups.

The researchers, led by Kazuo Tobe, MD, of the Health and Medical Center at Okayama University, say the virus was apparently transmitted by a single player who was an HBV carrier.

"Our study suggests that ... transmission of HBV may occur even among members of a sports team, probably through contact between players with exposed bleeding wounds," conclude the study's authors

One expert tells WebMD he is surprised this type of HBV transmission -- called horizontal transmission -- doesn't happen more often in team sports.

"Hepatitis B is a virus that, unlike the AIDS virus, is quite stable. So if you have blood infected with hepatitis B and don't clean it up, [the virus] can survive up to eight hours, even dried up on a desk, a chair, or a boxing ring," says Albert B. Knapp, MD, an assistant professor of medicine and gastroenterology at New York University Medical School and an attending physician at Lenox Hill Hospital.

"It's amazing that there are not more cases of horizontal transmission of hepatitis B virus. It is a poorly studied method of hepatitis B virus transmission," he tells WebMD.

As for prevention, Knapp suggests that any blood should be cleaned up immediately with alcohol or water. Additionally, "everyone in any contact sport should be vaccinated for hepatitis B."

"Many times people don't know that they have been infected," he says, adding that it takes three months after infection for symptoms to start appearing.

But Lewis G. Maharam, MD, a sports medicine specialist who is the president of the New York chapter of the American College of Sports Medicine, questions whether the virus can actually be transmitted the way the study says.

"I see sports athletes every day, and if they were interviewed at a university health center and asked about high-risk behaviors [for HBV] such as intravenous drug use or promiscuity, they would say no at the university because they fear that their responses could have repercussions on the team or among friends," says Maharam, who is also the medical director for the New York City Marathon.

Still, he says, full precautions should be taken when blood is present, both on and off the field.


For more information from WebMD, visit our Diseases and Conditions page on Hepatitis.


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