A person may become infected by:
(1) direct skin contact with another athlete
(2) inhalation of infectious agents
(3) blood exposure (including use of injected performance enhancing drugs)
(4) fecal-oral exposure in water or food
(5) environmental water exposure (streams, lakes, etc)
(6) sport-related water exposure (swimming pool, shower)
(7) biting insects (vector transmission)
(8) animal exposure
(9) contaminated sports equipment
(10) an unprotected sexual encounter
Factors affecting transmission:
(1) how communicable the disease is
(2) the magnitude of the exposure
(3) defects in host defenses (immunodeficiency, etc)
(4) breaks in protective barriers (skin, mucosa, etc)
(5) protective measures such as vaccination
