Tackling Sickle Cell

In February, a perfectly healthy Bennie Frank Abram III collapsed on the practice field during preseason football training at the University of Mississippi.

The 20-year-old defensive back was rushed to Baptist Memorial Hospital in Oxford, where he was pronounced dead four hours later.

Experts have long known that anyone with two copies of the sickle-cell gene develops the painful blood disorder, which can be fatal.

What wasn't widely recognized until recently is that people, like Abram, with one sickle-cell gene, can be die from the disease while engaging in strenuous physical activity.

Recent casualties among college athletes have forced the reevaluation. Since 2000, 16 NCAA Division I football players have suffered non-traumatic deaths. And nine of those carried the single sickle-cell trait, which contributed to their deaths, according to the National Athletic Trainers Association.

Reflecting the shift, the NCAA last month mandated sickle-cell-trait testing for all entering Division I athletes in the 2010 season so they can be identified and watched carefully during periods of high heat and exertion.

"NCAA did a great job in ruling this, because people were suddenly collapsing and dying," said Eric Laudano, the University of Pennsylvania's head athletic trainer. "We see them when they first collapse and later find out that they have the trait."

"Most of these deaths could have been prevented just by knowing if they have the trait."

Those with sickle-cell disease make red blood cells that are normally round but can change to a sickle shape under stress. These cells then deliver less oxygen to the body, break apart, and clog more easily. Patients experience painful "crises" that can involve intense pain and organ failure and lead to long hospital stays.

To get sickle-cell disease, people must get two copies of the gene, one from each parent. If they receive only one copy, they are called carriers.

African Americans are disproportionately afflicted by the disease. One out of 12 African Americans has the trait, but it's not limited to those individuals.

An estimated two million Americans are carriers, according to the Sickle Cell Disease Association of America. This includes 1 of 2,000 Americans of Mediterranean descent (including Italians and Greeks) and 1 of 10,000 Caucasians.

While the single trait was long thought to be benign, complications have been mentioned for years in medical literature.