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. 2012 Oct 23;3(4):296–303. doi: 10.2165/00007256-198603040-00006

Viral Illnesses and Sports Performance

J A Roberts 1,
PMCID: PMC7100835  PMID: 3526508

Summary

Viruses are ubiquitous and cause numerous infections in humans. These may vary from asymptomatic infection to severe debilitating illness. Viruses enter the host cells to replicate, using host synthetic mechanisms, and, thus, are resistant to conventional antibiotics. The human body responds to viral infection by synthesising specific antibody which can be used to aid diagnosis. Infectious mononucleosis (glandular fever) commonly affects the 15 to 30 years age group. It may produce severe debility which may last a month or more. Coxsackie virus infection can produce symptoms of the common cold but may also invade heart muscle and produce myocarditis, a potentially serious disease. Other viruses also produce a wide spectrum of disease.

Recent evidence has shown that people undergoing severe mental or physical stress may have reduced immunity to viral infections. There are risks associated with strenuous physical activity during the acute phase of viral infection, and there are reports of sudden death and serious complications occurring in previously fit young adults who undertake vigorous exercise when in the acute phase of a viral illness. Abnormalities of skeletal muscle have been demonstrated in patients with viral infection and this may explain the loss of performance experienced by athletes after upper respiratory tract infection.

As a general rule, for all but mild common colds, it is advised that the athlete avoids hard training for the first month after infection.

Keywords: Influenza, Respiratory Tract Infection, Common Cold, Infectious Mononucleosis, Sport Performance

References

  1. Arnold DL, Bone PJ, Radda GK, Taylor DJ. Excessive intracellular acidosis of skeletal muscle on exercise in a patient with post viral exhaustion syndrome. Lancet. 1984;1:1367–1369. doi: 10.1016/S0140-6736(84)91871-3. [DOI] [PubMed] [Google Scholar]
  2. Astrom E, Friman G, Pilstrom L. Effect of viral and mycoplasma infections on ultrastructure and enzyme activities in human skeletal muscle. Acta Pathologica Microbiologica et Immu-nologica Scandinavica (Section A) 1976;84:113–122. doi: 10.1111/j.1699-0463.1976.tb00080.x. [DOI] [PubMed] [Google Scholar]
  3. Behan PO, Behan WMH. Epidemic myalgic Encephalomyelitis. In: Rose FC, editor. Clinical Neuroepidemiology. Tunbridge Wells: Pitman Medical; 1980. pp. 374–383. [Google Scholar]
  4. Beneson AS. Acute viral respiratory disease in control of communicable diseases in man. Washington: American Public Health Association; 1975. pp. 262–266. [Google Scholar]
  5. Bolden KJ. Corticosteroids in the treatment of infectious mononucleosis. Journal of the Royal College of General Practitioners. 1972;22:87–95. [PMC free article] [PubMed] [Google Scholar]
  6. Bullock K, Moore RY. Nucleus ambiguous projections of the thymus gland: possible pathways for regulation of the immune response and the neuro-endocrine network. (Abstract.) Anatomy Records. 1980;196:25. [Google Scholar]
  7. Burch GE. Viral diseases of the heart. Acta Cardiologica. 1979;1:5–9. [PubMed] [Google Scholar]
  8. Busse WW. Decreased granulocyte response to isoprotenerol in asthma during upper respiratory infections. American Review of Respiratory Diseases. 1978;115:783–790. doi: 10.1164/arrd.1977.115.5.783. [DOI] [PubMed] [Google Scholar]
  9. Chretien JH, Esswein JG, Holland WG, et al. Predictions of the duration of infectious mononucleosis. Southern Medical Journal. 1977;70:437–439. doi: 10.1097/00007611-197704000-00021. [DOI] [PubMed] [Google Scholar]
  10. Dalrymple W. Infectious mononucleosis and athletic participation. Journal of the American College Health Association. 1965;14/15:257–259. [PubMed] [Google Scholar]
  11. Dorian B, Keystone W, Garfunkel PE, Brown G. Immune mechanisms in acute psychological stress. (Abstract.) Psychosomatic Medicine. 1981;43:84. [Google Scholar]
  12. Domes R, Ter Meulen V. Specificity of IgM antibodies in acute human Coxsackie virus B infections analysed by indirect solid phase enzyme immune assay and Immunoblot technique. Journal of General Virology. 1983;64:159–167. doi: 10.1099/0022-1317-64-1-159. [DOI] [PubMed] [Google Scholar]
  13. Douglas DJ, Hanson PG. Upper respiratory infections in the conditioned athlete. Medicine and Science in Sports. 1978;10:55. [Google Scholar]
  14. Downey H, McKinley CA. Acute lymphadenosis compared with acute lymphatic leukaemia. Archives of Internal Medicine. 1923;32:82–112. doi: 10.1001/archinte.1923.00110190085006. [DOI] [Google Scholar]
  15. Durham SR, Kay AB. Eosinophils, bronchial hyper-reactivity and late-phase reactions. Clinical Allergy. 1985;15:411–418. doi: 10.1111/j.1365-2222.1985.tb02290.x. [DOI] [PubMed] [Google Scholar]
  16. Edmond RTD. Infectious mononucleosis. Medicine. 1975;2:85–87. [Google Scholar]
  17. Empey DW, Laitinen LA, Jacob SL, Gold WM, Nadel JA. Mechanisms of bronchial hyper-reactivity in normal subjects after upper respiratory tract infections. American Review of Respiratory Diseases. 1976;113:131–139. doi: 10.1164/arrd.1976.113.2.131. [DOI] [PubMed] [Google Scholar]
  18. Friman G. Effect of acute infectious disease on isometric muscle strength. Scandinavian Journal of Clinical Laboratory Investigation. 1977;37:303–308. doi: 10.3109/00365517709092633. [DOI] [PubMed] [Google Scholar]
  19. Friman G, Wright JE, Ilback NE, Beisel WR, White JD, et al. Does fever or myalgia indicate reduced physical performance capacity in viral infections. Acta Medica Scandinavica. 1985;217:353–361. doi: 10.1111/j.0954-6820.1985.tb02709.x. [DOI] [PubMed] [Google Scholar]
  20. Grist NR, Bell EJ, Assaad F. Enteroviruses in human disease. Progress in Medical Virology. 1978;24:114–157. [PubMed] [Google Scholar]
  21. Hamblin TJ, Hussein J, Akbar AN, Tang YC, Smith JL, et al. Immunological reason for chronic ill-health after infectious mononucleosis. British Medical Journal. 1983;287:85–88. doi: 10.1136/bmj.287.6385.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Henle W, Henle GE, Horwitz CA. Epstein-Barr virus specific diagnostic tests in infectious mononucleosis. Human Pathology. 1974;5:551–554. doi: 10.1016/S0046-8177(74)80006-7. [DOI] [PubMed] [Google Scholar]
  23. Hoagland RJ. Infectious mononucleosis. New York: Grune and Straton; 1967. [Google Scholar]
  24. Jeammott JB, Borysenko JZ, Borysenko M, McClelland DC, Chapman R, et al. Academic stress, power motivation and decrease in secretion rate of salivary secretory IgA. Lancet. 1983;1:1400–1402. doi: 10.1016/S0140-6736(83)92354-1. [DOI] [PubMed] [Google Scholar]
  25. Jokl E, McClellan JT. Exercise and Cardiac Death. Balitmore: University Park Press; 1971. [Google Scholar]
  26. Jones JF, Ray G, Minnich LL, Hicks MJ, Kibler R, et al. Evidence of active Epstein-Barr virus infection in patients with persistent unexplained illness: elevated anti-early antigen antibodies. Annals of Internal Medicine. 1985;102:1–7. doi: 10.7326/0003-4819-102-1-. [DOI] [PubMed] [Google Scholar]
  27. Kardel T, Holm HH, Rasmussen SN, Mortensen T. Ultrasonic determination of liver and spleen volumes. Scandinavian Journal of Clinical Laboratory Investigation. 1971;27:123–127. doi: 10.3109/00365517109080197. [DOI] [PubMed] [Google Scholar]
  28. Lakic J. Use of cephalexin to treat glandular fever: a pilot study. British Medical Journal. 1983;286:1617–1618. doi: 10.1136/bmj.286.6378.1617. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Lau RCH. Coxsackie B virus infections in New Zealand patients with cardiac and non-cardiac diseases. Journal of Medical Virology. 1983;11:131–137. doi: 10.1002/jmv.1890110207. [DOI] [PubMed] [Google Scholar]
  30. Lehane DE. A sero-epidemiologic study of infectious mononucleosis. The development of EB virus antibody in a military population. Journal of the American Medical Association. 1970;212:2240–2242. doi: 10.1001/jama.1970.03170260036009. [DOI] [PubMed] [Google Scholar]
  31. Maki DG, Reich RM. Infectious mononucleosis in the athlete: diagnosis complications and management. American Journal of Sports Medicine. 1982;10:162–173. doi: 10.1177/036354658201000308. [DOI] [PubMed] [Google Scholar]
  32. McKenzie H, Parrat D, White RG. IgM and IgG antibody levels to ampicillin in patients with infectious mononucleosis. Clinical Experimental Immunology. 1986;26:214–221. [PMC free article] [PubMed] [Google Scholar]
  33. McNeill RS, Nairn JR, Millar JS, Ingram CC. Exercise induced asthma. Quarterly Journal of Medicine. 1966;35:55–67. [PubMed] [Google Scholar]
  34. Mumford JA, Rossdale PD. Virus and its relationship to the ‘poor performance syndrome’. Equine Veterinary Journal. 1980;12:3–9. doi: 10.1111/j.2042-3306.1980.tb02285.x. [DOI] [PubMed] [Google Scholar]
  35. Neiderman JC, McCollum RW, Henle G, et al. Infectious mononucleosis: clinical manifestations in relation to EB virus antibodies. Journal of the American Medical Association. 1968;203:139–142. doi: 10.1001/jama.203.3.205. [DOI] [PubMed] [Google Scholar]
  36. Pether JVS. Bacterial meningitis after influenza. Lancet. 1982;1:804. doi: 10.1016/S0140-6736(82)91854-2. [DOI] [PubMed] [Google Scholar]
  37. Powell DG, Burrows R, Spooner P, Goodridge D, Thomson GR, et al. 4th International Conference of Equine Infectious Diseases. 1978. A study of infectious respiratory diseases among horses in Great Britain 1971–76; pp. 451–460. [Google Scholar]
  38. Reyes MP, Lerner AM. Interferon and neutralising antibody in sera of exercised mice with Cocksackie B3 myocarditis. Proceedings of the Society for Experimental Biology and Medicine. 1976;151:333–338. doi: 10.3181/00379727-151-39204. [DOI] [PubMed] [Google Scholar]
  39. Riemenschneider PA, Whalen JP. The relative accuracy of estimation of enlargement of the liver and spleen by radiographic and clinical methods. American Journal of Radiology. 1965;94:462–468. [Google Scholar]
  40. Roberts J A. Loss of form in young athletes due to viral infection. British Medical Journal. 1985;290:357–358. doi: 10.1136/bmj.290.6465.357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Rutkow IM. Rupture of the spleen in infectious mononucleosis: a critical review. Archives of Surgery. 1978;113:718–720. doi: 10.1001/archsurg.1978.01370180060007. [DOI] [PubMed] [Google Scholar]
  42. Ryan AJ, Evans AS, Hoagland RJ, et al. Infectious mononucleosis in athletes. Physician and Sportsmedicine. 1978;6:40. [Google Scholar]
  43. Shields CE. How I manage infectious mononucleosis. The Physician and Sportsmedicine. 1983;11:57–59. [Google Scholar]
  44. Simon HB. The immunology of exercise. Journal of the American Association. 1984;292:2735–2738. doi: 10.1001/jama.1984.03350190037016. [DOI] [Google Scholar]
  45. Smith WG. Adult heart disease due to Coxsackie virus group B. British Heart Journal. 1966;28:204–208. doi: 10.1136/hrt.28.2.204. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Straus SE, Tosato G, Armstrong G, Lawley T, Preble OT, et al. Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection. Annals of Internal Medicine. 1985;102:7–17. doi: 10.7326/0003-4819-102-1-7. [DOI] [PubMed] [Google Scholar]
  47. Sutton GC, Harding HB, Trueheart RP, Clark HP. Coxsackie B4 myocarditis in an adult: successful isolation of virus from ventricular myocardium. Aerospace Medicine. 1967;38:66–69. [Google Scholar]
  48. Thomasi TB, Trudeau FB, Czerwinski D, Erredge S. Immune parameters in athletes before and after strenuous exercise. Journal of Clinical Immunology. 1982;2:173–178. doi: 10.1007/BF00915219. [DOI] [PubMed] [Google Scholar]
  49. Tobi M, Morag A, Ravid Z, Chowers I, Feldman-Weiss V, et al. Prolonged atypical illness associated with serological evidence of persistent EB virus infection. Lancet. 1982;1:61–64. doi: 10.1016/S0140-6736(82)90210-0. [DOI] [PubMed] [Google Scholar]
  50. Williams JM, Peterson RG, Shea PA, Schmedtje JF, Bauer DC, et al. Sympathetic innervation of murine thymus and spleen. Evidence for a functional link between the nervous and immune systems. Brain Research Bulletin. 1981;6:83–94. doi: 10.1016/S0361-9230(81)80072-X. [DOI] [PubMed] [Google Scholar]

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