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An Outbreak Associated With Coxsackievirus B1

Robin M. Ikeda, MD; Stan F. Kondracki; Peter D. Drabkin, MPH; Guthrie S. Birkhead, MD, MPH; Dale L. Morse, MD, MS

JAMA. 1993;270(18):2205-2206.

Abstract
Objective.
—Enterviral outbreaks involving athletic teams have been described, although the mode of transmission has been unclear. In September 1991, an outbreak of pleurodynia among high school football players provided an opportunity to identify possible modes of transmission.

Design.
—Retrospective cohort outbreak investigation.

Setting.
—Public high school in upstate New York.

Results.
—Illnes was reported by 17 (20%) of the football players. Behaviors involving contact with common water containers were associated with illness, including eating ice cubes from the team ice chest (relative risk [RR], 9.2; 95% confidence interval [Cl], 1.3 to 65.5) and drinking water from the team cooler (RR, 6.3; 95% Cl, 1.5 to 25.7). Coxsackievirus B1 was isolated in four (50%) of the eight stool specimens collected.

Conclusions.
—Contamination of common water containers by an infected player may have contributed to or initiated the outbreak. In addition to discouraging direct oral contact with common drinking containers, use of individual water containers and ice packs for injuries was recommended.

(JAMA. 1993;270:2205-2206)

Author Affiliations
From the Bureau of Communicable Disease Control, New York State Department of Health, Albany (Drs Ikeda, Birkhead, and Morse, and Messrs Kondracki and Drabkin), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Ikeda).

Footnotes
Reprint requests to Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-60, Atlanta, GA 30341 (Dr Ikeda).

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