Rugby players should have hepatitis jab, say scientists

Report from the Guardian 1 March 2007

Ian Sample, science correspondentThursday March 1, 2007The Guardian

Professional rugby players should receive mandatory vaccinations for hepatitis B before embarking on a sporting career, to reduce the chance of spreading the disease, scientists said yesterday.
The warning follows research into the prevalence of hepatitis, a potentially lethal liver infection, among people who play contact sports. The study identified a risk of the virus being spread among sportsmen and women through contaminated sweat.
The virus is usually carried in infected blood, putting needle-sharing drug users and those having unprotected sex most at risk. But scientists believe the virus can also be passed on through other contaminated body fluids. The virus attacks the liver and can cause lifelong infection, leading to cirrhosis, liver cancer, liver failure and death.
In the study researchers took blood samples from 70 Olympic wrestlers aged between 18 and 30 and tested them for traces of the hepatitis B virus. In interviews more than a third of the men said they had suffered bleeding or weeping wounds during training and competitions. While none of the men had an active hepatitis infection, traces were detected in the blood of nine (13%) of them.
Further tests revealed traces of the hepatitis virus in eight, or 11%, of the men. The levels of virus found in sweat closely matched those found in the men's blood.
Writing in the British Journal of Sports Medicine yesterday, Selda Bereket-Yücel at the Celal Bayar University in Turkey said no previous studies had been conducted to look for hepatitis virus DNA in sweat. "The results of this study suggest that sweating may be another way of transmitting hepatitis B virus," she said.
In light of the study, the researchers called on professional sports bodies to include hepatitis virus tests at the start of players' careers before urging them to be vaccinated. The researchers conclude: "Clinicians and staff of athletic programmes should aggressively promote hepatitis B virus immunisation. The advice of sports organisations should be changed, making hepatitis B virus immunisation obligatory for contact sports."
Around one in 1,000 people in the UK are thought to have hepatitis B, according to figures from the charity the British Liver Trust. An estimated two billion people are infected worldwide and there are 300 million carriers of the virus. Many people do not realise they have been infected owing to the slow development of symptoms or having none at all, according to NHS Direct.
A spokesman for UK Sport said ethical questions arising over human rights would have to be carefully considered before mandatory tests were brought in, adding that the research would need to be well-proven to justify the move.
Mark Thursz, a consultant hepatologist at St Mary's hospital in London, was cautious about the findings. "It is hard to imagine wrestling without spillage of blood so I think the risk of transmission via sweat should be dismissed or at least played down. On the other hand, the need for testing and vaccination in contact sports should be encouraged," he said.