An eruption across the state has hit four schools in four communities, postponing both football games and soccer matches. Medical experts wonder if new strain is the cause, how many will be affected.
The first outbreak seemingly came out of nowhere in late August: Fifteen football players from Don Bosco Prep in Ramsey had come down with coxsackievirus, also known as hand-foot-and-mouth disease, forcing the cancellation of the team’s final scrimmage.
Thirteen days later, a similar eruption of HFMD struck 16 miles away at Pequannock High School, postponing the football team’s season-opener.
And now this week comes news of the the latest developments: More sudden outbreaks of HFMD among soccer players at Kinnelon High and Hunterdon Central High, schools located 55 miles apart in different counties. The discoveries bring the total of HFMD cases to four schools in four communities in less than three weeks.
RELATED: Kinnelon postpones games after HFMD outbreak
The emergence of the highly contagious virus has medical experts questioning why the outbreaks are happening and wondering how many more school districts will become infected. Meanwhile, Michael Prybicien, an athletic trainer with Sports Safety International, called the outbreaks “unprecedented.”
“It’s getting a little crazy,” Prybicien said. “I haven’t heard of multiple schools in New Jersey getting this specific virus. This virus is one that hasn’t spread through locker rooms or schools in the past.”
HFMD causes painful sores inside the mouth as well as a skin rash on a person’s hands or feet, and it can also lead to high fevers and body aches, according to the Center for Disease Control and Prevention. The virus can be spread through contact or the air from coughing or sneezing, and it’s most commonly diagnosed in younger children.
Although the virus can cause significant discomfort, it doesn’t pose serious risks if properly treated with rest, fluids and Tylenol, according to doctors. Typically, the illness subsides in one to two weeks.
Medical experts said Thursday it is unusual for the illness to be so widespread in different places among teenagers or athletes. Jack Kripsak, a sports medicine and family practice physician and also the chair of the state athletic association’s medical advisory board, said “this is the first time ever” he’s seen an HFMD outbreak of this magnitude.
“The only thing I can speculate is that there’s a new strain of this virus in the air and people are coming down with it,” Kripsak said. “It has to be something that people haven’t been exposed to before. It has to be a new strain. Otherwise, why would this be happening? We’ve never had it before. No one’s ever seen this before.”
RELATED: HFMD outbreak strikes at Pequannock High
After the earlier discoveries of HFMD at Don Bosco and Pequannock, Kinnelon postponed its boys and girls soccer games Wednesday following an outbreak at the school. Then on Thursday Kripsak, Hunterdon Central’s school doctor, said there have been two confirmed cases of HFMD with the school’s boys soccer team and another suspected case on the girls team. Hunterdon Central athletic director Mike Raymond said Thursday no games have been cancelled or postponed.
Kripsak also said North Hunterdon High has athletes reporting HFMD symptoms, but the cases have not been confirmed as the virus.
He speculated the outbreaks could be similar to the constantly evolving seasonal flu virus.
“No one’s done any testing to find out exactly what this strain of virus is,” Kripsak said. “While rare, you can get this disease a second and third time based on the strain, just like you can get a flu virus because the strain of the influenza virus is different most years, that’s why the flu vaccine is different every year. There’s just got to be a different strain of this coxsackievirus in the environment that no one’s ever been exposed to before.”
At the high school sports level, athletic trainers and doctors are trying to wrap their arms around the eruption. Eric Schwartz, President of the Athletic Trainers’ Society of New Jersey, said more common outbreaks have been associated with skin diseases such as impetigo, ring worn, herpes or methicillin-resistant staphylococcus aureus (MRSA).
“We’ve seen situations pertaining to wrestling outbreaks, where it’s an indoor arena and you’ve had those types of outbreaks,” Schwartz said. “But foot and mouth not so much.”
The skin disease outbreaks are usually restricted to infected gyms, mats and surfaces. Meanwhile, HFMD is transmitted more like the cold or flu — through personal contact, touching the same surfaces as an infected person or just from being close to someone with the illness.
RELATED: Don Bosco Prep cancels football scrimmage after outbreak
Nicole Mulvaney Kirgan, a communications officer from the New Jersey Department of Health, said in a statement released to NJ Advance Media that HFMD is “common in summer and early fall.”
“It is a contagious disease that is spread among people, particularly when going back to school,” the statement continued. “It is not unexpected to see this in school settings. Outbreaks frequently occur among groups of children.”
The disease could be spreading more through sports because of the frequent touching from bumping, jostling or slapping hands.
“There’s more contact,” Kripsak said. “If it’s in the classroom you might not be touching all your classmates, but if you’re out on the field of play you’re going to be touching your teammates during practice and kids on other schools.”
Kripsak and Schwartz said the best way to contain the virus is to eliminate towel and water bottle sharing and thoroughly clean and disinfect athletic equipment and locker rooms. They also said schools should make sure to wash uniforms and towels and scrub water coolers.
Kripsak said the greatest HFMD risk is to pregnant women, adding people should see their doctor if they have chest pains or a persistent or worsening headache.
The question remains: How many more people will contract the virus?
Kripsak and others said it’s hard to predict.
“Definitely it’s unusual,” Kripsak said. “If more of this happens someone’s going to have to step up and send a notice out to all the local physicians and the state that we’re having this outbreak. We need help in identifying what’s going on.”
Matthew Stanmyre may be reached at mstanmyre@njadvancemedia.com. Follow him on Twitter @MattStanmyre. Find NJ.com on Facebook.
