An outbreak of furunculosis among high school athletes

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Abstract
Furuncles (boils) are common among teenagers; how ever, few outbreaks have been documented. We inves tigated an outbreak of furuncles that occurred among male athletes of a Kentucky high school during the 1986 to 1987 school year. The overall attack rate was 25% (31/124). The risk of developing a furuncle in creased two to three times in those who had skin injury. Athletes who sustained abrasions more than twice per week ( P < 0.01), who had a cut that required bandaging (P = 0.01), or had an unspecified injury causing a missed practice or game (P = 0.04) were at increased risk. The risk of developing furunculosis did not appear to be related to contact with fomites, but rather, to contact with furuncles. Although athletes shared com mon areas (showers, locker rooms, practice areas), the attack rates for varsity football (36%) and varsity bas ketball (33%) were four times greater than for nonvars ity teams (P < 0.01). Players who had a friend with a furuncle were more than twice as likely to also have had a furuncle (P < 0.01). Exposure to furuncles ap peared to increase the risk of furunculosis independ ently of reported skin injury. Control and prevention should, therefore, focus on both reducing skin injury and reducing exposure to furuncles, rather than at tempting to sterilize inanimate objects.