Horizontal transmission of hepatitis B virus among players of an American football team

Eleven cases of hepatitis B virus (HBV) infection (5 cases of acute hepatitis B and 6 of sub-clinical infection) were detected among 65 members of our university's American football team during a period of 19 months. All tested positive for antibody to the hepatitis B surface antigen (HB(s)Ag) or core antigen (HB(c)Ag). The incidence of HBV infection among team members (20.4%) was significantly higher (P<. 001) than among students who tested positive for antibody to HB(s)Ag throughout the university (1.8%). We also detected a single carrier of hepatitis B antigen (HB(e)Ag) on the team. Analysis of HB(s)Ag subtypes in 3 of 5 players with acute hepatitis B indicated that their subtype (adr) was identical to that of the HB(e)Ag carrier. All players with acute hepatitis B belonged to the same training group, which also included the HB(e)Ag carrier. Our analysis suggests that horizontal transmission of HBV can occur even in a sports team, probably due to contact with open wounds during training.