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Prophylactic valacyclovir reduced herpes gladiatorum outbreaks among wrestlers
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SAN FRANCISCO — Proper compliance with a prophylactic regimen of valacyclovir may prevent spread of herpes gladiatorum among wrestlers participating in summer camps, according to findings presented here.
Based on results of a study by B.J. Anderson, MD, of Boynton Health Service, University of Minnesota in Minneapolis, treating adolescent wrestlers with 1 g valacyclovir during repeated exposures at camp can be effective in the prevention of primary herpes gladiatorum outbreaks.
B.J. Anderson
Since 1989, outbreaks of herpes gladiatorum caused by HSV-1 have occurred at this 28-day wrestling camp in Minneapolis, where typically more than 300 wrestlers aged 13 to 18 years attend. Before 2003, several outbreaks occurred with as many as 60 students developing a primary outbreak of herpes gladiatorum during the camp.
Camp officials have required all participants to take valacyclovir 1 g once daily for the duration of the camp after a study performed in 2003 with prophylactic valacyclovir showed promise in preventing spread of herpes gladiatorum.
Participants are divided into five groups during camp according to weight, and they only wrestled within their group. Daily skin checks were performed and adolescents with an outbreak were not allowed to participate. All suspicious lesions were evaluated/cultured by a physician.
During the 10-year study, according to Anderson, 2,897 adolescents attended camp and 2,060 (71.1%) entered camp on medication: 2,013 (97.7%) on valacyclovir 1 g once daily; 45 (2.2%) acyclovir 400 mg twice daily; and two (0.1%) on famciclovir 500 mg once daily.
Based on observed outbreaks, the probability of outbreaks occurring while on antiviral medication was 0.49% compared with 3.11% without medication, Anderson said during his presentation. Within individual groups, antiviral medication reduced primary and recurrent outbreaks by 84.2%. When outbreaks occurred, they were reported primarily during the last 2 weeks of camp when noncompliance was at its greatest.
For more information:
Anderson BJ. #G3-1563b. Presented at: 52nd ICAAC; Sept. 9-12, 2012; San Francisco.
B. J. Anderson, MD, can be reached at Boynton Health Service, University of Minnesota, 410 Church St. SE, Minneapolis, MN 55455; email: info@thematdoc.com.
Disclosure: Anderson reports no relevant financial disclosures.