Next Question: Can You Catch AIDS Playing Basketball

February 09, 1992|By JONATHAN BOR

Today, with opening tip-off of the National Basketball Association All-Star Game, the age of AIDS gets just a little older.

It seems like yesterday when frightened people were asking the rudimentary questions: Could you catch the AIDS virus from a sneeze, handshake or embrace? (No, no and no). How about sex and drugs? (A powerful yes on both accounts).

Now, almost overnight, the hottest question is whether you can catch the disease by going one-on-one with Magic Johnson. This intellectual leap is either a measure of our growing sophistication or of our continuing hysteria. Perhaps it's both.

The question, of course, emerged when the Magic announced his intentions to play in the All-Star Game -- and next summer, in the Olympics -- despite the the fact that he retired from the game last November upon learning that he was infected with the AIDS virus.

Magic's gumption brings delight to sports fans who miss his incomparable mix of sportsmanship, power and grace on the basketball court. But many people have questioned whether he might be placing other players at risk.

Australia's Olympic basketball team, for one, questioned whether they should compete against a United States team that includes a player known to be infected with HIV, the virus that causes AIDS.

In the past week, radio talk shows that normally entertain such questions as whether to trade Billy Ripken were flooded with medical talk. What if Magic has a bloody collision with another player while going up for a layup? If both players bled, and their blood mingled, couldn't the opposing player catch the virus?

And isn't it possible that Magic could compromise his own immune system simply by putting his body under the stress of basketball?

Here, class, is how two leading AIDS experts at the Johns Hopkins Medical Institutions answer these questions. They are Dr. John Bartlett, chief of infectious diseases, and Dr. Alfred J. Saah, director of infectious disease epidemiology at the School of Hygiene and Public Health.

First, does Magic pose any risk to other players?

While they can't rule out absolutely all risk, both said it's so remote as to be immeasurable. Obviously, no one has ever studied the risk. You'd need thousands of basketball games, several players known to carry the virus and thousands of collisions to reach any conclusions.

The closest analogy they could find is the health care setting, where doctors and nurses commonly get stuck with hypodermic needles carrying blood from HIV-infected patients. This problem has been studied thoroughly: The odds of contracting the virus from such a needle-stick is approximately 5 in 1,000.

But the needle is tailor-made for transmission. It delivers the virus deep within the skin, right to the blood stream. "You actually jam the blood into your finger," Dr. Bartlett said.

But on the basketball court, the doctors said, you'd need an unlikely combination of events for the virus to pass from one player to another: two players colliding, their blood mixing, and blood from one player not just lying on his opponent's skin, but getting absorbed into the bloodstream of the other.

"You come down with a risk that's so low that the risk of getting struck by lightning is higher," said Dr. Saah, part of a Johns Hopkins group commissioned by the NBA players association to educate the teams about AIDS. He's in Orlando this weekend educating league management about the disease.

Incidentally, between 80 and 100 people each year are killed by lightning -- sobering statistics that, nonetheless, have not generated a national debate about the wisdom of playing golf with a chance of rain in the forecast.

"To me, it's beyond my level of worrying about it. I'm more concerned about getting mugged, being in a car accident."

Even he acknowledged that the concerns are natural. After all, a recent survey in Los Angeles found that 48 percent of private internists refuse patients who are infected with the AIDS virus -- some, because they fear getting infected.

While they have no inside knowledge about Magic's condition, they said fans should not be concerned that he may be "stressing out" his immune system. Dr. Bartlett said he has patients who safely jog long distances, while Dr. Saah cited bodybuilders who continue to pump iron years after testing positive.

"These guys can work out until they don't feel like it anymore," Dr. Saah said. How long? "It can be as long as the incubation period." This is the length of time it takes for a patient's infection to develop into a full-blown case of AIDS.

So far, half of all people who contract the virus go 10 years or more before coming down with the first serious infection that signals AIDS. That doesn't mean they'll spend a decade feeling good enough to pound a hardwood court with nine men of almost unimaginable strength and ability.

Even this is too much to demand of Magic. But don't we owe it to him -- and to ourselves -- to let him try?

G; Jonathan Bor is a medical writer for The Baltimore Sun.

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