Please watch the following video about Sickle Cell Trait:

CATAWBA COLLEGE ATHLETIC TRAINING DEPARTMENT

Sickle Cell Trait Testing

About Sickle Cell Trait -

- Sickle cell trait is an inherited condition of the oxygen-carrying , , in the red blood cells. - Sickle cell trait is a common condition (> three million Americans) - Although Sickle cell trait is most predominant in those of African, Mediterranean, Middle Eastern, Indian, , and South and Central American ancestry, persons of all races, sex and ancestry may test positive for sickle cell trait. - Sickle cell trait is usually benign, but can be life-threatening, especially during intense, sustained exercise, hypoxia (lack of oxygen) in the muscles may cause sickling of red blood cells (red blood cells changing from a normal disc shape to a crescent or “sickle” shape), which can accumulate in the bloodstream and “logjam” blood vessels, leading to which is a collapse from the rapid breakdown of muscles starved of blood. For more information on Sickle Cell:

http://web1.ncaa.org/web_files/health_safety/SickleCellTraitforSA.pdf

Sickle Cell Trait Testing –

- The NCAA mandates that all NCAA student-athletes have knowledge of their sickle cell trait status before the student-athlete participates in any intercollegiate athletics event, including strength and conditioning sessions, practices, competitions, etc. - The Catawba College Department of Intercollegiate Athletics offers sickle cell trait screening in the form of a blood test to all student-athletes for a nominal fee through the on-campus Student Health Services. - Testing will be conducted at the Catawba College Student Health Center and through a local designated laboratory facility and results will be reported to the student-athlete, Student Health Center, the Athletic Training Staff and the team physicians. - If you have already been tested for sickle cell trait, please provide a copy of the written results to the Athletic Training Department.

Sickle Cell Testing Compliance All Catawba Freshmen and Transfer Student-Athletes must show proof of mandatory Sickle Cell Testing by attaching a copy of a diagnostic lab report! Acceptable laboratory reports include Hemoglobin Solubility Test, Hemoglobin Electrophoresis, or High Performance Liquid Chromatography, (HPLC). A copy of the Sickle Cell Test done at birth is also acceptable to meet this requirement.

What You Should Know About

What Is Sickle Cell Disease? Sickle cell disease (SCD) is a group of inherited disorders. •• Healthy red blood cells are round and they move through small blood vessels carrying oxygen to all parts of the body. •• In SCD, the red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle”. •• Sickle cells die early, which causes a constant shortage of red blood cells. •• Sickle cells can get stuck in small blood vessels and block the flow of blood and oxygen to organs in the body. These blockages cause repeated episodes of severe pain, organ damage, serious infections, or even . What Causes Sickle Cell Disease? SCD is inherited in the same way that people get the color of their eyes, skin, and hair. •• A person with SCD is born with it. •• People cannot catch SCD from being around a person who has it. Who Is Affected By Sickle Cell Disease? •• It is estimated that SCD affects 90,000 to 100,000 people in the United States, mainly Blacks or . •• The disease occurs among about 1 of every 500 Black or African- American births and among about 1 out of every 36,000 Hispanic- American births. •• SCD affects millions of people throughout the world and is particularly common among those whose ancestors come from sub- Saharan ; regions in the Western Hemisphere (, the Caribbean, and ); Saudi Arabia; ; and Mediterranean countries such as , , and .

What Health Problems Does Sickle Cell Disease Cause? Following are some of the most common complications of SCD: “Pain Episode” or “Crisis”: Sickle cells don’t move easily through small blood vessels and can get stuck and clog blood flow. This causes pain that can start suddenly, be mild to severe, and last for any length of time. Infection: People with SCD, especially infants and children, are more likely to experience harmful infections such as flu, meningitis, and hepatitis. Hand-Foot Syndrome: Swelling in the hands and feet, often along with a fever, is caused by the sickle cells getting stuck in the blood vessels and blocking the blood from flowing freely through the hands and feet. Eye Disease: SCD can affect the blood vessels in the eye and lead to long term damage. (ACS): Blockage of the flow of blood to the lungs can cause acute chest syndrome. ACS is similar to pneumonia; symptoms include chest pain, coughing, difficulty breathing, and fever. It can be life threatening and should be treated in a hospital. Stroke: Sickle cells can clog blood flow to the brain and cause a stroke. A stroke can result in lifelong disabilities and learning problems. National Center on Birth Defects and Developmental Disorders Division of Blood Disorders

CS216728 What steps can you take to prevent •• Muscle cramps; exercise-related illness? •• Rapid breathing Athletes with SCT should take the same precautions without wheezing; that can prevent exercise-related illness as athletes •• Feeling who do not have SCT. To prevent exercise-related overheated; illness, you should •• Inability to cool, •• Obtain a physical examination before reduced sweating beginning an exercise program; at rest; and •• Make a plan with a coach/fitness trainer before •• Prolonged beginning an exercise program; exhaustion or •• Begin conditioning exercise gradually; fatigue. •• Set your own pace; What should you do if you experience •• Stay any of these signs or symptoms while hydrated exercising? by drinking plenty of If you display any of the signs or symptoms of water; distress above, you should

•• Refrain •• Immediately stop exercising; from consuming •• Report the symptoms immediately to the high coach, athletic trainer, or person overseeing caffeine your training; energy drinks •• Rest and re-hydrate; and other •• Move out of the heat, cool down with wet stimulants; towels or ice; and •• Seek •• Seek prompt medical care if symptoms worsen care or or do not improve with rest. assistance immediately if showing signs/symptoms of exercise-related illness; For more information, visit: •• Be aware of and adjust gradually to a change http://www.cdc.gov/ncbddd/sicklecell/traits.html in altitude as this may increase the risk of dehydration; and http://www.hematology.org/Patients/Anemia/ •• Limit exercise when sick. Sickle-Cell-Trait.aspx

What are the signs or symptoms of http://www.sicklecelldisease.org/index. exercise-related illness or complications? cfm?page=about-scd Some signs of exercise-related illness include http://www.sicklecelldisease.org/index. cfm?page=sickle-cell-trait-athletics •• Muscle burning or tenderness; •• Muscle weakness or pain;

CS258998A How Is Sickle Cell Disease Treated? The goals of treating SCD are to relieve pain and to prevent infections, eye damage, and . •• There is no single best treatment for all people with SCD. Treatment options are different for each person depending on the symptoms. Treatments can include receiving blood transfusions, maintaining a high fluid intake (drinking 8 to 10 glasses of water each day), receiving IV (intravenous) therapy (fluids given into a vein) and medications to help with pain. •• For severe SCD, a medicine call hydroxyurea might be recommended. Research suggests that hydroxyurea can reduce the number of painful episodes and the recurrence of ACS. It also can reduce hospital stays and the need for blood transfusions among adults who have SCD. Is There A Cure For Sickle Cell Disease? To date, the only cure for SCD is a bone marrow or stem cell transplant. •• A bone marrow or stem cell transplant is a procedure that takes healthy stem cells from a donor and puts them into someone whose bone marrow is not working properly. These healthy stem cells cause the bone marrow to make new healthy cells. •• Bone marrow or stem cell transplants are very risky, and can have serious side effects, including death. For the transplant to work, the bone marrow must be a close match.

For more information visit: www.cdc.gov/sicklecell What You Should Know About Sickle Cell Trait

What Is Sickle Cell Trait? What Are The Chances Sickle cell trait (SCT) is not a mild form of sickle cell disease. That A Baby Will Have Having SCT simply means that a person carries a single for sickle cell disease (SCD) and can pass this gene along to Sickle Cell Trait or their children. People with SCT usually do not have any of the Sickle Cell Disease? symptoms of SCD and live a normal life. Hemoglobin is found in red blood cells and it gives blood its color. It carries oxygen to all parts of the body. Hemoglobin is made from two similar , one called alpha-globin and one called beta-globin, that “stick together.” Both proteins must be present and function normally for the hemoglobin to carry out its job in the body. People with SCT have red blood cells that have normal hemoglobin and abnormal hemoglobin. are the instructions that control how red blood cells make alpha- and beta-globin proteins. All people have two genes for making beta-globin. They get one beta-globin gene from each parent. SCT occurs when a person inherits a gene for sickle beta- globin from one parent and a gene for normal beta-globin from the other parent. This means the person won’t have sickle cell disease, but will be a trait “carrier” and can pass it on to their children.

What Is Sickle Cell Disease? SCD is a genetic condition that is present at birth. In SCD, the red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle.” The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel The most important through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious problems. It is thing to know about inherited when a child receives two sickle beta-globin genes— one from each parent. Therefore, a child can only have SCD having SCT is that when both of his/her parents have at least one abnormal you could have a beta-globin gene. baby with SCD if Who Is Affected By Sickle Cell Trait? your partner also SCT is more common among people whose ancestors come from Africa, the Mediterranean region, Middle East, and South Asia, but has an abnormal anyone can have SCT. hemoglobin gene. •• 1 in 12 blacks or African Americans in the United States has SCT.

CS252247-A If both parents have SCT, each child that they have together has a •• 1 in 2 (50%) chance of having SCT. Children with SCT will not have symptoms of SCD, but they can pass SCT on to their children. •• 1 in 4 (25%) chance of having sickle cell , one of several types of SCD. Sickle cell anemia is a serious medical condition. •• 1 in 4 (25%) chance that they will not have SCD or SCT. If one parent has SCT and the other parent has another abnormal hemoglobin gene (like trait or beta- trait), each of their children has a •• 1 in 2 (50%) chance of having SCT. •• 1 in 4 (25%) chance of having SCD (not sickle cell anemia). These other types of SCD can be more or less severe depending on the specific abnormal hemoglobin gene. •• 1 in 4 (25%) chance that they will not have SCD or SCT. How Will A Person Know If only one parent has SCT, each of their children has a If He Or She Has Sickle •• 1 in 2 (50%) chance of having SCT. Cell Trait? •• 1 in 2 (50%) chance that they will not have SCT. To find out if you have What Health Problems Might Occur in People SCT, your doctor needs to with Sickle Cell Trait? order a blood test. If you Most people with SCT do not have any health problems caused find out you and/or your by sickle cell trait. However, there are a few, rare health problems that may potentially be related to SCT. For example, if people with loved one has SCT, talk to SCT have pain when traveling to or exercising at high altitudes, your healthcare provider they should tell their healthcare provider. People with SCT and and/or a genetic counselor eye trauma should seek out medical attention and inform the about what that means. It physician about the trait status. People with SCT should drink plenty of water during exercise. People with SCT should contact is important that you know and inform their doctor if they notice blood in their urine. To find what SCT is and how it can out more about SCT and to get specific answers to your questions, affect you and your family. call your healthcare provider.

For more information visit: www.cdc.gov/sicklecell

Page 2 of 2 Athletes: Don’t Get Sidelined by Sickle Cell Trait! Play it Safe with These Helpful Tips!

Participating in regular physical activity is one of the most important things you can do for your health. This is true for everyone, including those with Sickle Cell Trait (SCT). You just have to be aware of the warning signs and complications of exercise-related illness, listen to your body, and take steps to protect yourself. Below are answers to some commonly asked questions about SCT, participation in sports, exercise related illness, and what to do to stay safe and healthy while engaging in physical activity.

Should people with SCT be allowed to play sports? Absolutely! People with SCT can safely participate in all sports provided they take a few general precautions, such as

•• Drinking enough water; •• Taking breaks when needed; and •• Not overdoing it, especially when starting a new exercise program.

While most people with SCT participate in sports without problems, there have been occasional serious complications and even deaths associated with dehydration, overheating, and other avoidable situations. All athletes should be aware of the warning signs of exercise-related illness and know what to do if they experience any of these signs or symptoms.

Are there conditions that increase the risk of exercise-related illness among people with SCT?

Scientific information specific to SCT is currently limited. However, the conditions that increase the risk of exercise-related illness for athletes with SCT appear to be the same as those that increase the risk for athletes who do not have SCT and include

•• Significant and sudden increase in exercise intensity; •• Failure to adjust gradually to new environmental conditions like higher altitude, increased heat, or higher humidity; •• Exercising when ill or dehydrated (lack of fluids); and •• Drug, alcohol or stimulant use.

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