As he pondered how to handle a health crisis facing his baseball team, manager Ned Yost reached out this last weekend to his mother. Several Royals also contacted their families, all asking some version of a question they had not pondered since childhood: Mom, did I ever have the chickenpox?
The answer became imperative, at the behest of the Kansas City medical staff, as the team dealt with an outbreak as they completed a series against the Tampa Bay Rays at Tropicana Field in St. Petersburg, Fla. Outfielder Alex Rios and All-Star reliever Kelvin Herrera both have been infected with the virus and could miss at least two weeks of action, as The Star first reported on Tuesday.
An examination on Monday of both players confirmed the diagnosis. Each man has been quarantined at his home in the area. The team spent the weekend conducting “damage control,” in the words of trainer Nick Kenney, making sure the rest of their players and staffers are inoculated against the virus.
“We’re on alert,” Kenney said. “We’ve got our guys knowing that they’ve got to pay attention to what they’re seeing. And if you do see anything, we need to see it and we need to inspect it.”
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The Royals believe the infections are limited to Herrera and Rios. The most at-risk players are those from countries in Latin America, where the chances of childhood inoculation are lower, experts say. Though the scenario sounds more amusing than worrisome — a World Series contender stricken by a children’s illness — the reality is far more insidious, given the severity of the virus when adults catch it.
Even in the hothouse of a big-league clubhouse, where players mingle in close quarters for upwards of nine months, the situation is unusual. Members of the Kansas City front office and big-league staff greeted the news with incredulity. General manager Dayton Moore told Kenney he had never seen anything like this in two decades as a baseball executive; Kenney responded he had never seen it in his two decades as an athletic trainer.
“My initial reaction was ‘It’s 2015,’” Moore said. “I was surprised that we’d be having the chickenpox. I’m sure it’s more common than I’m aware of as far as adults getting chickenpox. But it was more frustration than anything else.”
The uncertainty with Rios has already affected the team’s roster. Unable to guarantee his return this season, the Royals acquired Atlanta Braves outfielder Jonny Gomes on Monday night for a minor-league infielder. The club hopes the fresh arms allowed by September roster expansion can compensate for Herrera’s absence.
“I’ve never had anybody that had the chickenpox,” Yost said. “Much better than Aug. 28 than Sept. 25.”
The chickenpox virus spreads through the air or through bodily contact. The symptoms are well-known to parents, as itchy blisters overrun the skin and the body grapples with fatigue and fever. Chickenpox manifests in the same way for grown-ups, only patients suffer more and face complications like pneumonia and brain infections, experts say.
“For adults who get chickenpox, it tends to be much more severe,” said Rafael Harpaz, a medical epidemiologist from the Centers for Disease Control and Prevention.
Harpaz indicated the rate for hospitalization due to the infection is much higher once the patients reach adolescence.
“A child might have a couple hundred lesions,” Harpaz said. “An adult might have over 500. The likelihood that they’ll end up getting pneumonia is much higher. That’s pretty rare in children. So there’s a number of complications that are more common in adults than in children.”
The organization hopes that later this week, when Rios and Herrera are less contagious, Kenney can visit them at their homes and aid their recovery. During the past two days, Kenney and his staff inspected the medical history of each player, making sure they had either been contracted the virus as a child or received a vaccination.
For those who had recently been vaccinated and might still be at risk, the medical staff decided to repeat the process to be sure. Citing HIPAA protection, Kenney declined to reveal which players underwent that treatment. Alcides Escobar recently received a vaccination as he applied for citizenship in the United States.
The process filtered down to the minor leagues. Over the weekend, as Alex Gordon completed a rehabilitation assignment with Class AAA Omaha, he was asked by the team’s trainer if he ever had the chickenpox. Gomes heard a similar question after the Royals traded for him on Monday. “I think I’ve had all my rabies shots,” Gomes said.
Even with the infections limited to only two players, the Royals must stay vigilant, experts say. After exposure to the virus, victims can still take up to three weeks to display symptoms.
“If you’re exposed on day zero, the realistic expectation is the earliest you’ll get the disease is day seven,” said Aaron Glatt, a physician specializing in infectious diseases and a spokesman for the Infectious Diseases Society of America. “So they actually need to look for symptoms from day seven after exposure to day 21 after exposure. That’s when the disease manifests after you get it.”
The Royals believe Rios was the first player infected. When he arrived at Tropicana Field on Saturday, he displayed “these little, tiny, blistered bumps on his chest and on his back,” Kenney said. According to Kenney, the Rays internist diagnosed Rios with the chickenpox and Yost scratched him from that day’s lineup.
The team decided to send Rios home, but felt uncomfortable putting him on a commercial flight. So it chartered a private jet to fly Rios to Kansas City.
Shortly after Rios’ plane took off on Sunday, Herrera reported similar symptoms upon his arrival to the clubhouse. The training staff quarantined him, too. Herrera flew home with the team, but only after the Royals vetted the flight crew to be sure no one was in danger of infection.
The team’s general theory is Rios caught the infection from a child. Several members of the team have brought their children on the road with them during the summer. Moore indicated the Royals would not alter this policy, even after this episode.
“It’s an unfortunate situation,” Moore said. “Hopefully, we’ll get through it.”
Doctors did not introduce a chickenpox vaccination until 1996, but in general, experts say when after a person contracts it once, the infection does not return. Most Americans experience this as children.
Harpaz, the expert from the CDC, suggested that “for reasons that are not well-understood,” people raised in Caribbean climates are often more susceptible to the chickenpox as adults in America. Rios grew up in Puerto Rico. Herrera grew up in the Dominican Republic.
“One of the main theories is that the virus just doesn’t last as long in tropical conditions, so the likelihood of you catching it is enough reduced to make it that less contagious,” Harpaz said.
During physicals in spring training, the Royals solicit information from the players regarding vaccinations. The organization trusts that the information it receives is reliable.
“What could happen here is that guys who’ve had vaccinations, but maybe they didn’t follow through with the full vaccination,” Kenney said. “Or maybe, through their medical records, they thought they were vaccinated for something, when they actually weren’t.”
At times on Tuesday, Royals officials could only shake their heads. The situation surprised them, perplexed them and ultimately frustrated them. They will be without their starting right fielder and one of their best relievers for most of September, and perhaps longer.
Even as Kansas City hopes to move past the initial outbreak, they must keep their eyes open for new infections. After two quiet days, the club opted for a hopeful stance.
“Every day that passes by, you feel a little more secure that we’re going to be OK,” Moore said.