Incidence Of Illness Among Team USA Paralympic Athletes Competing In The Tokyo 2020 Paralympic Games

Previous literature has examined the incidence of illnesses occurring during both Summer and Winter Paralympic Games; however, determination of illness rates among a single country’s Paralympic athlete delegation remains largely nonexistent. PURPOSE: This study evaluated the incidence and characteristics of illnesses experienced by Team USA Paralympic athletes competing in the Tokyo 2020 Summer Paralympic Games. METHODS: Medical encounters documented during the Tokyo 2020 Summer Paralympic Games (August 14 - September 6, 2021) were included in this analysis. Medical encounters were reviewed to: a) identify new illnesses that were diagnosed during the selected time frame, and b) to ensure accuracy of the illness diagnosis based on the medical note. Illnesses were categorized using the Orchard Sports Injury and Illness Classification System. Details of the athlete (sex) and illness (type) were examined and incidence rates (IR) with 95% confidence intervals per 1,000 athlete days (AD) were calculated. RESULTS: 241 athletes (122 female and 119 male) comprised the Team USA Paralympic Games delegation. Throughout the Tokyo 2020 Paralympic Games, a total of 25 medical illnesses were documented, resulting in an IR of 6.3 [95% CI; 3.9, 8.8] per 1,000 AD. The IR for female athletes (72% of all illnesses) was 4.6 [2.6, 7.0] per 1,000 AD, whereas the IR for males was 1.8 (95% CI; 0.5, 3.1) per 1,000 AD. The most common illnesses were infectious (n = 10 [40%]; IR, 2.5 [1.0, 4.1] per 1,000 AD), respiratory (n = 4 [16%]; IR, 1.0 [0.0, 2.0] per 1,000 AD), and dermatologic (n = 3 [12%]; IR, 0.8 [-0.1, 1.6] per 1,000 AD) conditions. CONCLUSION: The incidence of illness among Team USA Paralympic athletes during the Tokyo 2020 Paralympic Games was lower than multi-delegation reports from previous Games. One potential reason for the lower incidence is the strict infection prevention measures put in place to combat the SARS-Cov-2 virus. Female athletes accounted for the majority of cases, and infectious etiologies were most common. Understanding illness epidemiology at elite sports events can assist sports medicine staff in developing and implementing effective strategies to reduce the incidence of illness at these events.