The average athlete suffers 4 colds a year, mostly but not exclusively in winter. High performance athletes have concerns as their immunity can be compromised and the effect of a cold can be disproportionately upsetting compared to average individuals. It is a fact that athletes do become sick more often than sedentary persons. This is in part due to the stresses of training and the compromised immune response that has been shown to occur post training.
Most colds are caused by Rhinoviruses and cause nasal discharge, sneezing coughing, sore throat and moderate gland swelling (large glandular swelling is unlikely to be a simple cold). Colds rarely last longer than a week and any “cold” lasting longer than 2 weeks needs to be assessed medically as it may have become a secondary bacterial infection such as Sinusitis or Bronchitis. Alternatively, if not a secondary infection may indicate other problems such as allergy or unexplained Underperformance Syndrome. Flu [Influenza] is a more serious viral infection that occurs sporadically but also occurs in an epidemic spreading rapidly and infecting large number of people. A major flu epidemic is widely predicted as being overdue. The symptoms of flu include the symptoms similar to a cold but with much more severe systemic effect with severe muscle, bone and joint aching, headache light irritation and major fatigue. Influenza is more likely to proceed to complications such as major chest infection.
Prevention of colds and flu includes consciously avoiding contact with anyone with symptoms although this can be difficult as the time of maximum spread is just prior and immediately after onset of symptoms. Incubation for such illnesses can often be 7-10 days which means exposure/contact to infected individuals and actual onset of symptoms has a lag time. Use of hand and/or handkerchief during coughing or sneezing is mandatory to reduce spread. Hand washing can help and in addition the institute supplies a foam hand sanitizer kept in the kitchen. Keeping an individuals own immunity as strong as possible can be protective. Measures that can help are good quantity and quality of sleep. Adequate hydration and nutrition are also important. Social drug use especially alcohol, has been shown to reduce immune capability greatly thus drugs should be excluded.
The consensus recommendations for exercise when affected by a cold or flu:
- If symptoms above the neck only such as nasal congestion, runny nose and mild sore throat then he or she can exercise at reduced level of intensity.
- If symptoms below the neck such as chest congestion, dirty productive cough, aching bones or muscles, fever, shivering or chills, or pus on throat then it is very unwise to exercise.
- Confirmation of Streptococcus(strep) should require a total stoppage of all physical training immediately
The risks of exercise with the above symptoms include Viral Myocarditis [the virus invades the heart muscle causing significant damage]. Anecdotal evidence suggests there is also a risk of Post Viral Fatigue - prolonged period of ill health after the infection and many people believe that some people with Chronic Fatigue Syndrome [M.E.] i.e. over 6 months illness begins with exercising while under infection. Similarly, resumption of exercise post infection should be gradual and much reduced in intensity.
Most importantly, coaches need to respect and regard sickness as a serious illness and be aware that even common colds/influenza can lead to serous health problems if an athlete continues to train while ill. Much of the body’s energy needs to be used in immune defense and not for physical work. Rest is most important during and just after any sickness.
Any athlete who remains sick for more than 7-10 days needs to see a physician and perhaps have some blood chemistry screenings and diagnostic examinations.
Below is a graph of classic forms of influenzas and the months in which they are manifested most.
