Team illness prevention strategy (TIPS) is associated with a 59% reduction in acute illness during the Super Rugby tournament: a control-intervention study over 7 seasons involving 126 850 player days

Br J Sports Med. 2020 Feb;54(4):245-249. doi: 10.1136/bjsports-2019-100775. Epub 2019 Aug 1.


Objectives: To determine whether a team illness prevention strategy (TIPS) would reduce the incidence of acute illness during the Super Rugby tournament.

Methods: We studied 1340 male professional rugby union player seasons from six South African teams that participated in the Super Rugby tournament (2010-2016). Medical staff recorded all illnesses daily (126 850 player days) in a 3-year control (C: 2010-2012; 47 553 player days) and a 4-year intervention (I: 2013-2016; 79 297 player days) period. A five-element TIPS was implemented in the I period, following agreement by consensus. Incidence rate (IR: per 1000 player days; 95% CI) of all acute illnesses, illness by main organ system, infectious illness and illness burden (days lost due to illness per 1000 player days) were compared between C and I period.

Results: The IR of acute illness was significantly lower in the I (5.5: 4.7 to 6.4) versus the C period (13.2: 9.7 to 18.0) (p<0.001). The IR of respiratory (C=8.6: 6.3 to 11.7; I=3.8: 3.3 to 4.3) (p<0.0001), digestive (C=2.5: 1.8 to 3.6; I=1.1: 0.8 to 1.4) (p<0.001), skin and subcutaneous tissue illness (C=0.7: 0.4 to 1.4; I=0.3: 0.2 to 0.5) (p=0.0238), all infections (C=8.4: 5.9 to 11.9; I=4.3: 3.7 to 4.9) (p<0.001) and illness burden (C=9.2: 6.8 to 12.5; I=5.7: 4.1 to 7.8) (p=0.0314) were significantly lower in the I versus the C period.

Conclusion: A TIPS during the Super Rugby tournament was associated with a lower incidence of all acute illnesses (59%), infectious illness (49%) and illness burden (39%). Our findings may have important clinical implications for other travelling team sport settings.

Keywords: illness; rugby.

Publication types

  • Observational Study

MeSH terms

  • Acute Disease / epidemiology*
  • Anniversaries and Special Events
  • Competitive Behavior*
  • Cost of Illness
  • Football*
  • Humans
  • Incidence
  • Male
  • Primary Prevention / organization & administration*
  • South Africa / epidemiology