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Swine Flu: the Spread Teams Can't Defend

By Steve Yanda
Washington Post Staff Writer
Wednesday, September 16, 2009

College football coaches are renowned for the total control they exert over their teams. From the game plan to the postgame meal, all facets of a team's preparation bear the head coach's signature.

But one recent development -- the swine flu outbreak that has ripped through college campuses of late -- has left some coaches struggling to maintain control over their teams' health, and others worrying about what would happen if a significant number of their players were brought down by the virus.

"You just worry about how devastating it is if it gets contagious on our team and our coaching staff," Maryland Coach Ralph Friedgen said. "If one [player] were to get it, what does that do to the others in that suite? That would really cripple us. . . . I'm trying not to panic on it, but I'm concerned about it."

And for good reason. During the first week of August, 11 Maryland athletes from multiple sports -- including football, women's basketball and wrestling -- developed flulike symptoms, according to Kathy Worthington, the school's senior associate athletic director.

Worthington said Maryland's athletic department sent each sick athlete home and canceled individual workouts in all sports from Aug. 6 to Aug. 9, primarily because it was concerned about a potential swine flu outbreak. During that time, all locker rooms and weight-training areas were sanitized. Test results came back a week later and confirmed that none of the ill athletes had the H1N1 virus, known as swine flu.

At a news conference on Sept. 8, Friedgen mentioned that one player was sick and had been isolated from the rest of the team. He said it was unknown whether the player had the virus. Around the same time, flulike symptoms had sidelined 30 players at Mississippi, 16 at Washington State and 10 at Wisconsin -- to name a few teams hampered by the sickness -- so verification has been deemed unnecessary. Many teams presume the worst and treat all cases as if swine flu is the diagnosis.

"We did that more from a public health standpoint," said Greg Stewart, physician for the Tulane football team. "We knew that we had type-A flu around and we knew what symptoms we were looking for and knew that this could spread very quickly, so we went and as soon as [players] came in and were sick, we isolated them. We just made an assumption that they were positive [for swine flu], figuring that we would rather send home a few that didn't have it and isolate them, as opposed to taking some who did have it and not isolate them."

After the morning session of a two-a-days on Aug. 18, eight players reported sick to Stewart and his staff. By nightfall, 18 had flulike symptoms. The tally rose to 31 over the next few days.

The Tulane medical staff faced a decision: treat all of the team's players or let the flu bug run its course. Had the arrival of a vaccine been imminent, Stewart said, the staff might have chosen the former. But the early release of a swine flu vaccine is not expected until mid-October, and physicians from multiple division I-A teams said they do not expect to receive inventories of the vaccines until November or December.

With that in mind, Stewart elected to let the sickness play out, though he said the first thing his staff did was screen all players for a list of symptoms "just to make sure that we didn't have anybody who wasn't telling us that they were sick."

Mississippi quarterback Jevan Snead said he had massive headaches prior to his team's season opener Sept. 6 at Memphis. He played, completing 12 of 22 passes for 175 yards and two touchdowns, and Ole Miss won by 31. But the next morning, Snead's headaches lingered and were accompanied by a fever, chills, aches and a bad cough.

According to Tim Mullins, the head athletic trainer for the Rebels' football team, Snead was one of 14 players to report sick Monday morning. The number swelled as the week progressed, though Snead said the team was fortunate the sickness spread during its bye week. Wide receiver Dexter McCluster spent a night in a local hospital.

Ole Miss running back Enrique Davis reported sick two days before the season opener. He was driven to Memphis in a highway patrol car, kept in his own hotel room and fed room service -- all in order to completely isolate him from his teammates. He recorded six carries for 46 yards in the win over the Tigers and then missed practice the following week while recovering from the flu.

"It's pretty crazy," Snead said. "I've really never seen anything like it."

That's the problem -- no one has. The Centers for Disease Control and Prevention initially recommended a seven-day isolation period for anyone who might have contracted swine flu. Then it reduced the period to four days. Now, players can reintegrate into the high-volume, compact environment of a college football locker room 24 hours after all symptoms have subsided.

Ethan Saliba, the University of Virginia's associate athletic director for sports medicine, said the four-day isolation period recommendation still was in place when "a fair number" of Cavaliers football players came down with flulike symptoms just before the start of training camp. Saliba said the CDC had stopped screening for swine flu, "so the idea was that if it looks like a duck, it probably is a duck." He said the team got through training camp with "very minimal consequences."

Other teams were not so fortunate. Duke lost more than 30 players to flulike symptoms during its training camp. Stewart said Tulane took 400 fewer scrimmage snaps this preseason than it did last year. With so many sick players sidelined, Wisconsin scheduled lighter, shorter workouts leading up to Saturday's double-overtime win over Fresno State. North Carolina played without its starting fullback and a reserve defensive lineman -- both of whom had apparent cases of swine flu -- Saturday in a two-point win at Connecticut.

Several team physicians agreed that swine flu is more contagious, more severe and longer lasting than seasonal flu. They said they implore their players to wash their hands frequently, avoid touching their face and limit contact with others. They also said those measures often aren't enough.

"Even if the stars are in the right alignment and you do everything right, you can still get it," Stewart said. "It doesn't matter what you do; if it's headed your way, you're still going to get it. You can do a lot of stuff to prevent it. You can do a lot of stuff to make it milder. But if it's in the area and it's in your student population, I don't know that there's a whole lot you can do to absolutely keep from getting it."

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