Skin infection halts high school wrestling

Ringworm
According to the State High School League, ringworm is one of the skin infections caused by viruses that can be transmitted.
Minnesota State High School League

High school wresting was suspended across Minnesota on Tuesday because of an outbreak of a skin infection. The Minnesota State High School League says 24 individual cases of herpes gladiatorum have been confirmed.

Byron Olson, state tournament director for the league, says the about a dozen schools are affected.

"So it was decided that eight days of out of the room, no competition, would give us time to have those young wrestlers who have a case of herpes or any other skin condition; it would be a chance to get them under medication and that they would be cured and clean in time for section tournament," he said.

Competition and practice can resume February 6. The state tournament will be held at the end of February.

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Herpes gladiatorum is caused by the herpes simplex 1 virus. It's spread through skin-to-skin contact. Usually patients contract lesions on their mouth. But they can develop in other areas of the body.

"If you were to take somebody who had a cold sore on their lip and rub that lip over somebody else's face all over the place you would end up having herpes gladiatorum; same virus, just different location," said Dr. Bruce Anderson, a member of the Minnesota State High School League's medical advisory committee.

Symptoms
In this slide provided by the Minnesota State High School League, cellulitis is noted by spreading redness. This is the first sign of the infection.
Minnesota State High School League

Anderson says wrestlers are especially prone to catching the virus because their sport requires close contact. According to Anderson more than 70 percent of wrestlers who contract the infection develop lesions on their head, face and neck. He blames it on the lock-up position wrestlers take at the start of their matches, when they press their faces firmly against each other.

The infection caused by the virus can be painful, but Anderson says usually it isn't harmful unless it spreads to the eyes.

"One study out of Mayo Clinic showed that over a 20-year period of time if a person had herpes that got onto the eye, they have over a 60-percent chance of reoccurrences in that area," he said. "And each time an occurrence develops on a cornea, scarring develops and if it reoccurs and reoccurs that could lead to a need for corneal transplants and if an infection gets deeper, possibly even blindness."

The Minnesota State High School League says it has gone to great lengths to prevent the spread of herpes gladiatorum. The league requires wrestling coaches and staff to conduct daily skin inspections on all team members. Kids with suspicious lesions are supposed to be pulled from practice and sent to a doctor before they can resume wrestling.

"I personally don't think there's anything more our wrestling community can do," according to Anderson. "We self-regulate to an outstanding level here. The problem is the medical community is not listening and they're not taking the time." Anderson says even though herpes gladiatorum is a well-known virus in the wrestling community, he says some doctors are not that familiar with the condition.

The Minnesota State High School League just finished a study looking at skin infection rates during the past 10 years. Anderson says the league found that smaller communities have better skin infection control rates than larger communities. He says it's not clear why that's the case. But he thinks it has to do with the type of care in small town clinics.

"In the smaller communities old Doc Brown is always going to look at that kid and sooner or later Doc Brown is going to become very smart in diagnosing these," he said. "We don't have that here. You can go to an urgent care, an ER, see two or three different providers at your clinic, you'll never see the same person twice. That's the problem we have here." Dr. Michael Ainslie, board chair for the Minnesota Medical Association, doubts that urban physicians are unaware of herpes gladiatorum because, he says, the lesions are fairly peculiar. But he says it is true that patients may not be as as likely to see their regular doctor in urban areas.

"It's certainly possible that the medical community doesn't recognize it and the kids go from doctor to doctor to find out what's going on with it. But I'd say most doctors, at least when I was in primary care, have their antennae up for this," Ainslie said.

He suggests that coaches find a doctor who will follow their team during the wrestling season. This practice is more common at the collegiate level where herpes infection rates are much lower.