On a monday night three years ago, a rash appeared on the back of Scott Perkins's left forearm—about 48 hours after the high school sophomore had participated in a citywide wrestling tournament in Albuquerque. The next day the 15-year-old novice wrestler showed the blistery half-dollar-sized patch to a local dermatologist, who attributed it to impetigo, a minor bacterial infection. Perkins took the news in stride; he decided to wear long-sleeved shirts and sit out wrestling practice until the unsightly lesions went away.
But he soon had more to worry about than missing practice. Later that day Perkins's temperature inexplicably rose to 102�, and his mother ordered him to bed. On Wednesday white canker sores popped up on the back of his throat, and a cold sore covered more than half of his lower lip. Too sick to hold down food, he lived on water for 4� days.
On Friday the fever soared to 105�, and Perkins took to a tub of cold bathwater to bring it down. He also decided that it would be a good idea to call his mom at work. "I was in a quandary as to whether I'd get him to the emergency room in time or whether he'd have a seizure in the car," says his mother, Barbara Thorpe, who was then a nurse at the University of New Mexico Medical Center. Fortunately, Scott's temperature dropped in the cold bath, returning to normal so quickly, in fact, that he was back in school by the following Monday. But the bizarre illness left its mark: He now weighed 14 pounds less than he had a week earlier.
What Perkins and his mother had yet to learn was that he had received something more than a spirited tussle on the mat during the Albuquerque tournament; he had also picked up a case of herpes gladiatorum, a lifelong viral infection so little known outside the sports of wrestling and rugby that most physicians are unfamiliar with the disease.
Too often when people hear the word herpes, they immediately think "sexually transmitted disease." In fact, the herpes gladiatorum infection, which is caused by the herpes simplex type 1 virus, is spread through the kind of skin-to-skin contact that occurs during wrestling. The infection begins when the virus—the same herpes virus that causes cold sores—enters a wrestler's body through a break in the skin after he touches an opponent's herpes-related rash or cold sore. (Wrestlers with a history of these infections pose little risk of passing along the disease as long as they show no signs of active lesions.) The disease also can travel indirectly from one wrestler to another when an athlete competes on a wrestling mat contaminated with the secretions from another athlete's rash or cold sore.
"If somebody gets his shoulder or face pushed into the mat with enough force to abrade it, that can drive the virus into the skin," says Dr. Jack Harvey of the Orthopedic Center for the Rockies in Fort Collins, Colo. Harvey is chief physician for U.S.A. Wrestling, the Colorado Springs-based national governing body for the amateur sport.
After an incubation period of two to seven days, the virus creates a tingling and burning sensation on the skin, and the infected wrestler develops a rash or cold sore—generally on the face, upper arm or torso. It's not unusual for the same skin irritation to flare up several times per season and to take about two weeks to disappear. While suffering the infection, the wrestler may also have a headache, fever, swelling of the lymph glands, chills and a feeling of general malaise. Many wrestlers never experience anything more uncomfortable than feeling slightly under the weather, but some, such as Perkins, fare much worse. Herpes rashes can leave permanent scarring, and while the fever and fatigue seldom return after the first attack, the virus resides in the infected person's body for the rest of his life and can provoke recurrences of the rash or cold sores—particularly during times of physical and mental stress. That phenomenon creates an untimely dilemma for wrestlers, who frequently have their greatest number of outbreaks just before or during a high-pressure competition. This, of course, is when the disease has the best chance of zapping athletes on other teams.
"I had one wrestler who got so stressed at the time of the district and state competitions that he popped out in herpes two out of three years," says Dr. Harvey.
The type of uniform that athletes wear also has a lot to do with the odds of catching the disease. Those in sports such as football and hockey face fewer risks from infected opponents or teammates because their helmets, pads and jerseys help prevent the virus from reaching the skin. "You're not going to get any more body contact than with wrestling," says Jim Hoegh, the team trainer at the University of Iowa, a perennial wrestling power. He estimates that 13 of the 45 wrestlers on his team had flare-ups this past season, and that about the same number were infected the year before. "It's a high-risk population," he says.
Given the nature of the sport, the disease can move through a wrestling squad faster than chicken pox through a kindergarten class. In 1989, for example, herpes gladiatorum infected 60 of the 175 wrestlers at a Minnesota wrestling camp. In 1988 the disease hit 16 Wisconsin high school wrestlers as well as their coach, and then spread to five wrestlers on two other teams that competed against this first group.