Team water bottles stacked around the benches are such a common sight that most of us give them little thought. However, the evidence is overwhelming that this is a hidden danger for hockey. Common sense tells us that shared water bottles significantly increase the odds that communicable illnesses will be spread among the team--even when players attempt to squirt the water into their mouths.

Colds and flu are bad enough, but meningitis is also spread this way. Here is an overview of the problem and what can be done about it. (This information was taken from a variety of web resources. While details may vary from source to source, there is considerable agreement on key issues.) Note on the meningitis vaccinations: Public health officials do not single out members of sports teams as a specific high risk group

About Meningitis

• Meningitis is an inflammation of the membrane covering the brain. There are a number of different types of the disease, both bacterial and viral. The viral form rarely causes death.
• Enteroviruses, or viral meningitis, is the most common form seen in the US and tends to cause very mild meningitis
• Somewhere between 5 and 20 percent of the population carry a meningitis bacteria or virus and show no ill effects.
• Meningitis is fatal about 10% of the time. In the last decade its frequency has been increasing. Currently, there are about 3000 occurrences a year in the US.
• The Alberta government reports meningitis most often hits children five and under and between 15 and 19, for reasons which are not clearly understood.
• More information is available at Intelihealth. Here's a clear description from an Australian web site and another from the Centers for Disease Control.

Meningitis Vaccinations (New Vaccination available as of 2005)

• A new meningitis vaccination, Meningococcal conjugate vaccine (MCV4), was approved in 2005. The CDC has a clear explanation of meningitis vaccinations and how they work. The CDC is recommending "For
  those who have never gotten MCV4 previously, a dose is recommended at high school entry." (NOTE: On Oct. 1, 2005, a New York Times article dealt with five 17-18 year olds who came down with Guillain-Barré syndrome after they received the vaccination. Two and a half million doses of MCV4 have been distributed. At the time of the article, it was unclear if the cases were related to MCV4.)
• MCV4 is available in Wyoming through Public Health for about $70 a shot.
• "New Meningitis Vaccine Offers Greater Protection" Health article from the Palm Beach Post.
• "Together Educating About Meningitis" Stories from teens who have survived meningitis -- often only after amputations. The site also includes a fact page about the disease and vaccinations and notes "For those who have not previously been vaccinated, CDC also recommends immunization for young adults before entering high school or at about age 15 (whichever comes first) and for college freshmen living in dormitories Additionally, CDC states all other adolescents and college students wishing to reduce their risk may elect to be immunized.The American Academy of Pediatrics and American Academy of Family Physicians have released similar recommendations targeting adolescents and college students.

News stories

• (Note: News stories are often deleted from newspapers web sites, so broken links to the original articles are not uncommon.)
• "Defining a New Normal" Hockey player adapts to loss of limbs following an attack of bacterial meningitis. From Youth Matters.
• "Prep notebook: Brother's memory kept alive at Both ell" Seattle Times article on the meningitis related death of a high school football player following a football camp. (2005)
• Six Raleigh, N. C., football players contract meningitis. (2003)
• Two Pop Warner football players come down with meningitis in Arizona--shared water bottles blamed. (The Arizona Republic new story no longer online.)
• "Viral meningitis played role in student's death" --an unusual example of viral meningitis playing a role in a death. From the New Jersey Sunbeam. (2005)
• Steven Duarte of Massachusetts. sets up a foundation to provide water coolers and cups to school organizations who need them after his 17 year old daughter contracted meningitis and died. "I have become obsessed when I see sports teams using water bottles and players sharing drinks," he said.
• The Winchester, VA paper, in reporting a 6th case of meningitis, noted that "five of the six cases were school-aged children involved in team sports." (2003)
• Update from the Virginian Pilot on a 2002 incident in which a Virginia Tech athlete lost parts of all four limbs due to meningitis.(2005)
• "Georgia Tech quarterback Reggie Ball, who missed Saturday's win over Connecticut, has been diagnosed with viral meningitis." -- 2005 story from The Sports Network.

Representative Recommendations.

• The Canadian Hockey Association Team Hygiene Recommendations including making sure each player has a labeled water bottle.
• The Texas Medical Center News, in reporting on a 2001 outbreak of Meningitis, recommends that "All sports participants should have their own bottles or cups for water."
• The Lethebridge Hockey Association has excellent recommendations on how to prevent problems:
  • keep personal water bottles with name and number on bottle and lid for each player
  • Squirt the water into the mouth.
  • Leave the bottle spout open during the game
  • Don't top off a bottle with water from other bottles
  • Carry the bottle in a zip lock when it is carried in an equipment bag. Change the bag after each game.
• The Meningitis Research Foundation of Canada recommends " School athletic, coaching personnel, and athletes should make every effort to ensure that they do not share the following items with other team members: water bottles, [or] mouth guards . . . ."
• The Canadian Hockey Association recommends "Players should have their own drinking or squeeze bottles to prevent transmissions of viruses and bacteria" in their Hockey Canada Safety Program.
• "Outbreaks of aseptic meningitis-like illnesses have occurred in high school football players for reasons that may include the close contact among players and the overlap of football season with the peak enterovirus season." -- "Aseptic Meningitis: A Seasonal Concern", from The Physician and Sports Medicine. (1997)