National Federation of State High School Associations (NFHS)
Sports Medicine Advisory Committee (SMAC)
Proper precautions are needed to minimize the potential risk of the spread of communicable disease and skin infections during athletic competition. These conditions include skin infections that occur due to skin contact with competitors and equipment. The transmission of infections such as Methicillin-Resistant Staphylococcus aureus (MRSA) and Herpes Gladiatorum, blood-borne pathogens such as HIV and Hepatitis B, and other infectious diseases such as Influenza can often be greatly reduced through proper hygiene. The NFHS SMAC has outlined and listed below some general guidelines for the prevention of the spread of these diseases.
Universal Hygiene Protocol for All Sports:
• Shower immediately after every competition and practice.
• Wash all workout clothing after each practice.
• Wash personal gear (knee pads and braces) weekly.
• Do not share towels or personal hygiene products (razors) with others.
• Refrain from full body (chest, arms, abdomen) cosmetic shaving.
Infectious Skin Diseases
Strategies for reducing the potential exposure to these infectious agents include:
• Athletes must be told to notify a parent or guardian, athletic trainer and coach of any skin lesion prior to any competition or practice. An appropriate health-care professional should evaluate any skin lesion before returning to competition.
• If an outbreak occurs on a team, especially in a contact sport, all team members should be evaluated to help prevent the potential spread of the infection.
• Coaches, officials, and appropriate health-care professionals must follow NFHS or state/local guidelines on “time until return to competition.” Participation with a covered lesion may be considered if in accordance with NFHS, state or local guidelines and the lesion is no longer contagious.
Blood-borne Infectious Diseases
Strategies for reducing the potential exposure to these agents include following Universal Precautions such as:
• An athlete who is bleeding, has an open wound, has any amount of blood on his/her uniform, or has blood on his/her person, shall be directed to leave the activity (game or practice) until the bleeding is stopped, the wound is covered, the uniform and/or body is appropriately cleaned, and/or the uniform is changed before returning to activity.
• Athletic trainers or other caregivers need to wear gloves and take other precautions to prevent blood or body fluid-splash from contaminating themselves or others.
• In the event of a blood or body fluid-splash, immediately wash contaminated skin or mucous membranes with soap and water.
• Clean all contaminated surfaces and equipment with disinfectant before returning to competition. Be sure to use gloves when cleaning.
• Any blood exposure or bites to the skin that break the surface must be reported and immediately evaluated by an appropriate health-care professional.
Other Communicable Diseases
Means of reducing the potential exposure to these agents include:
• Appropriate vaccination of athletes, coaches and staff as recommended by the Centers for Disease Control (CDC).
• During times of outbreaks, follow the guidelines set forth by the CDC as well as State and local Health Departments.
For more detailed information, refer to the "Blood-Borne Pathogens," “Infectious Mononucleosis” and “Skin Conditions and Infections” sections contained in the NFHS Sports Medicine Handbook.
Revised and Approved in October 2012
April 2010 and added to all NFHS Rules Books in October 2010
DISCLAIMER – NFHS Position Statements and Guidelines
The NFHS regularly distributes position statements and guidelines to promote public awareness of certain health and safety-related issues. Such information is neither exhaustive nor necessarily applicable to all circumstances or individuals, and is no substitute for consultation with appropriate health-care professionals. Statutes, codes or environmental conditions may be relevant. NFHS position statements or guidelines should be considered in conjunction with other pertinent materials when taking action or planning care. The NFHS reserves the right to rescind or modify any such document at any time.