Skin Lesions Among High School Wrestlers — Arizona, 2014

BACKGROUND: Skin infections are common among athletes; wrestlers have an increased risk because of extensive skin-to-skin contact. In February 2014, Maricopa County Department of Public Health was notified of increased reports of skin lesions among high school (HS) wrestlers after participating in a 2-day wrestling tournament (Tournament A). We sought to identify cases, determine etiology, identify risks factors, and prevent additional cases.

METHODS: Surveys were distributed to all wrestlers on Tournament A-participating teams that reported ≥1 skin lesion among team members. Medical records were reviewed to verify lesion diagnosis. To capture persons infected pre and post tournament, probable cases were defined as a reported skin lesion during January 1–March 1 in a wrestler who participated in Tournament A on January 24–25. A confirmed case included a physician-diagnosed or laboratory-confirmed skin lesion.  

RESULTS: We identified 48 (23 confirmed) cases among male HS wrestlers who attended schools participating in Tournament A. Impetigo was the commonest diagnosis (18 cases, 38%), followed by herpes simplex virus (HSV) (11 cases, 23%). One wrestler with physician-diagnosed HSV reported onset 4 days before the tournament and wrestling with uncovered arm lesions. Seven wrestlers in Tournament A developed HSV afterward and 3 additional wrestlers developed HSV after contact with infected teammates. Another wrestler with physician-diagnosed impetigo reported wrestling with uncovered head and neck lesions; 8 Tournament A wrestlers subsequently developed impetigo, and 4 additional contacts of those wrestlers developed impetigo.  

CONCLUSIONS: Herpes and impetigo were identified among HS wrestlers who participated in Tournament A, likely from wrestlers who competed with uncovered lesions. Wrestlers should follow CDC’s and the National Federation of State High School Associations’ guidelines to prevent skin infection spread.