Why Was Lara Passed Fit to Play?
Wed, Sep 18, '02
The confirmation out of Sri Lanka that Brian Lara is infected
with hepatitis is worrisome, not just
because of the health implications for him, but also about the
level of care that players should expect when involved in overseas
tours. As an MD and a cricket fan (and WI supporter) I am concerned
for a number of reasons.
I have a high personal regard for this greatest of batsmen. My son
Andrew and I having spent some wonderful moments with Brian over
the last few years, since he, along with his team, graced us with
his presence in Toronto, a few years ago. His commitment to West
Indies cricket and his passion for the game remains supreme,
despite the strain of repeated appearances and the responsibility
on him to perform over and over, and over again.
The last thing that this man would do, therefore, is to opt out
(even in circumstances such as yesterday's game where the outcome
probably will not matter) because he "wasn't feeling well". But
it's in the nature of this man to play, and to play hard, even when
there is only the faintest of chances
of qualifying. Tuesday night he scored a pivotal century, yet
again, when others were unable to deliver.
Yet, it appears he was passed fit to play (by whom, I ask?) when,
by all reports, there would likely have been recognisable signs of
a potentially serious illness, namely infectious Hepatitis.
What is infectious hepatitis? It is a viral illness that affects
(primarily) the liver (Latin: hepar) and is otherwise known as
hepatitis A, or "epidemic jaundice". It is almost always a
relatively mild illness and the symptoms do tend to settle once the
cardinal sign of jaundice appears. This usually occurs between 2
and 6 weeks after acquiring the infection (and that is usually by
handling contaminated food etc. as the virus tends to inhabit the
gut initially and from there can be passed on).
Prior to the jaundice appearing, patients tend to suffer a variety
of gut symptoms of varying severity, and often flu-like symptoms.
An important Public Health concern, incidentally, is the tracing of
contacts to ascertain the integrity of the food supply etc. The
other forms of hepatitis (namely B and C need not
concern us as they will not apply here).
Whilst typically a mild illness, that is by no means always the
case, and the disease must never be underestimated, especially in
it's early stages.
Healthy fit young people get infectious hepatitis, and happily
complete recovery is usually the rule inside of about 3 months, on
average. There is of course a lot of individual variation. There is
a need to rest and recuperate, and to avoid strenuous activity, as
the disease becomes manifest and as recovery occurs. It's this last
issue that concerns me the most.
The diagnosis was confirmed by the WICB, it seems, in a public
announcement. Presumably that was after the game when a competent
MD noted the jaundice (and other tell tale signs that we need not
dwell upon). It seems therefore fair to suppose that Lara had some
signs and symptoms prior to the game that were either overlooked or
not acted upon.
Hopefully, and in the interests of present and future players'
health and safety, we will learn the precise sequence of events. If
this great sportsman was put at personal risk because of the lack
of a simple medical assessment, then steps must be introduced at
once to prevent any repetition.
I trust that even if the diagnosis of infectious hepatitis is
confirmed (in a day or two usually), then he will make a complete
recovery, as is the normal outcome. He needs to rest and recover
fully before getting mentally and physically prepared for the
trials and tribulations that World Cup 2003 will bring.
He cannot play competitive cricket for another 3 months or so. He
needs to be fit again to lead from the front, by example, and if I
know anything of this man, then that will be precisely what he will
do.
God speed, Brian Charles Lara. Get well again, soon. We need you,
yet again.
(Dr Mike McLean is a West Indies cricket fan based in Toronto,
Canada).
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