Cutaneous Allergic Reactions Induced by Sporting Activities

Cyanobacteria are common inhabitants of freshwater lakes and reservoirs throughout the world. Under favourable conditions, certain cyanobacteria can dominate the phytoplankton within a waterbody and form nuisance blooms. Case reports and anecdotal references dating from 1949 describe a range of illnesses associated with recreational exposure to cyanobacteria: hay fever-like symptoms, pruritic skin rashes and gastro-intestinal symptoms are most frequently reported. Some papers give convincing descriptions of allergic reactions while others describe more serious acute illnesses, with symptoms such as severe headache, pneumonia, fever, myalgia, vertigo and blistering in the mouth. A coroner in the United States found that a teenage boy died as a result of accidentally ingesting a neurotoxic cyanotoxin from a golf course pond. This death is the first recorded human fatality attributed to recreational exposure to cyanobacteria, although uncertainties surround the forensic identification of the suspected cyanotoxin in this case.We systematically reviewed the literature on recreational exposure to freshwater cyanobacteria. Epidemiological data are limited, with six studies conducted since 1990. Statistically significant increases in symptoms were reported in individuals exposed to cyanobacteria compared to unexposed counterparts in two Australian cohort studies, though minor morbidity appeared to be the main finding. The four other small studies (three from the UK, one Australian) did not report any significant association. However, the potential for serious injury or death remains, as freshwater cyanobacteria under bloom conditions are capable of producing potent toxins that cause specific and severe dysfunction to hepatic or central nervous systems. The exposure route for these toxins is oral, from ingestion of recreational water, and possibly by inhalation.A range of freshwater microbial agents may cause acute conditions that present with features that resemble illnesses attributed to contact with cyanobacteria and, conversely, acute illness resulting from exposure to cyanobacteria or cyanotoxins in recreational waters could be misdiagnosed. Accurately assessing exposure to cyanobacteria in recreational waters is difficult and unreliable at present, as specific biomarkers are unavailable. However, diagnosis of

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“…• Non-allergic urticaria: physical stimuli such as heat, cold and exercise can induce itching and hives in susceptible individuals [ 99 , 104 ].…”

Section: Introductionmentioning

confidence: 99%

Recreational and occupational field exposure to freshwater cyanobacteria – a review of anecdotal and case reports, epidemiological studies and the challenges for epidemiologic assessment

et al. 2006

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“…Potentially contagious rashes such as herpes simplex, molluscum contagiosum, fungal infections, scabies and louse infestations should be evaluated and treated before the athlete continues contact with other athletes. 1,[34][35][36] …”

Section: Skinmentioning

confidence: 99%

Pre-Participation Evaluation

Rizzo¹

2007

Clinical Sports Medicine

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“…S ir , Discomfort caused by sports and recreational activities interferes considerably with quality of life and leads to consultation of physicians 1 . A 24‐year‐old student reported transient swelling and erythema of both arms with a feeling of tenseness and slight pruritus immediately when bicycling on rough ground (Fig.…”

Section: Summary Of Previously Reported Cases With Vibratory Angio‐omentioning

confidence: 99%