Elite Athlete Availability: A public health approach to outbreak investigation and management of infectious disease in elite athletes

Elite athletes are a small unique sub-group of the broader population having commonalities in their physiologic and physical attributes and talents setting them apart from non-athletes. Their bodies are subject to years of training stress and managing their health and fitness for peak performance and at times balancing the trade-off of health relative to optimal performance fitness leading into major competitions. While it is a reasonable assumption that exercise benefits athlete’s health, it is important to note exercise and health do not form a linear relationship. It has been proposed that while recreational and sub elite athletes have a “J” curve with a large increase risk of illness with high training loads, elite athletes are likely to have an “S” curve with lower illness rates at higher training loads (Schwellnus et al., 2016) implying a unique physiological state.