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Illness during the 2010 Super 14 Rugby Union tournament – a prospective study involving 22 676 player days
  1. Martin Schwellnus1,2,
  2. Wayne Derman1,2,
  3. Tony Page3,
  4. Michael Lambert1,
  5. Clint Readhead4,
  6. Craig Roberts4,5,
  7. Ryan Kohler6,
  8. Esme Jordaan7,
  9. Robert Collins8,9,
  10. Stephen Kara10,
  11. Ian Morris11,
  12. Org Strauss12,
  13. Sandra Webb13
  1. 1Department of Human Biology, University of Cape Town, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Cape Town, South Africa
  2. 2International Olympic Committee (IOC) Research Centre, Cape Town, South Africa
  3. 3Sports Medicine Department, Olympic Park Sports Medicine Centre, Melbourne, Australia
  4. 4Medical and Scientific Department, South African Rugby Union, Cape Town, South Africa
  5. 5Discipline of Sports Science, University of Kwazulu-Natal, Durban, South Africa
  6. 6Sports Medicine Department, Australian Institute of Sport, Canberra, Australia
  7. 7Biostatistics Unit, Medical Research Council, Parow, South Africa
  8. 8Sports Medicine Department, Golden Lions Rugby Union, Johannesburg, South Africa
  9. 9Section of Sports Medicine, Sports Concussion South Africa and University of Pretoria, Pretoria, South Africa
  10. 10Sports Medicine Department, Blues Super Rugby Franchise, Auckland, New Zealand
  11. 11Sports Medicine Department, Cheetahs, Bloemfontein, South Africa
  12. 12Sports Medicine Department, Bulls, Pretoria, South Africa
  13. 13Team Physician, Highlanders, Dunedin, New Zealand
  1. Correspondence to Martin Schwellnus, Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Newlands, Cape Town 7700, South Africa; mschwell{at}


Background Illness accounts for a significant proportion of consultations with a team physician travelling with elite athletes.

Objective To determine the incidence, type, cause and consequences of illness in Rugby Union players participating in a 16-week tournament.

Setting 8 teams participating in the 2010 Super 14 Rugby tournament

Participants A cohort of 259 elite rugby players from eight teams was recruited.

Assessmen All players were followed daily over the 16-week competition period (22 676 player days). Each day, team physicians completed an illness log with 100% compliance. Information included the daily squad size and illness details including system affected, final diagnosis, type and onset of symptoms, training/match days lost and suspected cause.

Main outcome measurement Incidence of illness (illness per 1000 player days).

Results The incidence of illness in the cohort was 20.7/1000 player days (95% CI 18.5 to 23.1) with the highest incidence of illness in the respiratory system (6.4: 95% CI 5.5 to 7.3), gastrointestinal system (5.6: 95% CI 4.9 to 6.6) and the skin and subcutaneous tissue (4.6; 95% CI 4.0 to 5.4). Infections accounted for 54.5% of all illness and 26.1% of illness resulted in time loss of ≥1 day. In over 50% of illnesses, symptoms were present for ≥1 day before being reported to the team physician.

Conclusion Infective illness involving the respiratory tract and gastrointestinal tract together with dermatological illness was common in elite rugby players participating in this international tournament. A delay in reporting of symptoms >24 h could have important clinical implications in player medical care.

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  • Competing interests None.

  • Ethics approval Research Ethics Committee, Faculty of Health Sciences, University of Cape Town.

  • Provenance and peer review Not commissioned; externally peer reviewed.