Norovirus bounces between NBA players

This article originally appeared in the January 2012 issue ofInfectious Disease Alert.

Source: Desai R, et al. Transmission of norovirus among NBA players and staff, Winter 2010-2011. CID 2011; 53: 1115-1117.

Beginning in November 2010, players from several NBA teams were reported as suffering from the "stomach flu". An investigation was launched, querying 400 players and 378 staff members whether they had experienced nausea and/or vomiting sometime between November 10 and December 20. In total, 21 players and 3 staff members met the case definition for acute gastroenteritis from norovirus, based on the presence of symptoms with or without a positive RT-PCR stool test for norovirus. These 24 individuals represented 13 different teams from 11 different states.

The outbreak occurred between November 28 through December 8. Four teams had multiple cases with a total of 15 affected individuals. There was sufficient information available to indicate that 4 of these players were primary cases and 9 were secondary cases. Three of the four primary cases reported close contact with other members of the team during their illness, including contact in the locker rooms or travel together. One reported vomiting while en route to a game.

The authors identified 49 NBA games played during the 11-day outbreak. Two of these games were suspicious for team-to-team transmission of norovirus infection from a "donor team", with players with subsequently confirmed norovirus playing in those games. The authors examined 10 years of NBA "injury" data reports, and found that gastroenteritis was the second most common non-play-related injury in the NBA. They recommend that players with acute gastroenteritis symptoms be segregated from teammates, with restricted play, and strict personal hygiene and handwashing precautions during illness and for a good 24-72 hours after recovery.