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Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000
Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted...
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| Published in: | Emerging infectious diseases 2003-06, Vol.9 (6), p.702-707 |
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| container_title | Emerging infectious diseases |
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| creator | Sejvar, James Bancroft, Elizabeth Winthrop, Kevin Bettinger, Julie Bajani, Mary Bragg, Sandra Shutt, Kathleen Kaiser, Robyn Marano, Nina Popovic, Tanja Tappero, Jordan Ashford, David Mascola, Laurene Vugia, Duc Perkins, Bradley Rosenstein, Nancy |
| description | Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis. |
| doi_str_mv | 10.3201/eid0906.020751 |
| format | article |
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We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis.</description><identifier>ISSN: 1080-6040</identifier><identifier>EISSN: 1080-6059</identifier><identifier>DOI: 10.3201/eid0906.020751</identifier><identifier>PMID: 12781010</identifier><language>eng</language><publisher>United States: U.S. National Center for Infectious Diseases</publisher><subject>Adult ; adventure travel immunoassay ; Borneo ; Case studies ; Disease Outbreaks ; DNA, Bacterial - analysis ; doxycycline ; febrile illness ; Female ; Fever - epidemiology ; Fever - microbiology ; Fresh Water - microbiology ; Humans ; Leptospira - genetics ; Leptospira - isolation & purification ; Leptospirosis ; Leptospirosis - diagnosis ; Leptospirosis - epidemiology ; Malaysia ; Malaysia - epidemiology ; Male ; Middle Aged ; Risk Factors ; Sports ; Travel ; Water Microbiology</subject><ispartof>Emerging infectious diseases, 2003-06, Vol.9 (6), p.702-707</ispartof><rights>COPYRIGHT 2003 U.S. National Center for Infectious Diseases</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-1223c764745ab14821de879aea3ccb1baff82b961e94e978e115f6c562ba34823</citedby><cites>FETCH-LOGICAL-c725t-1223c764745ab14821de879aea3ccb1baff82b961e94e978e115f6c562ba34823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000150/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000150/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12781010$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sejvar, James</creatorcontrib><creatorcontrib>Bancroft, Elizabeth</creatorcontrib><creatorcontrib>Winthrop, Kevin</creatorcontrib><creatorcontrib>Bettinger, Julie</creatorcontrib><creatorcontrib>Bajani, Mary</creatorcontrib><creatorcontrib>Bragg, Sandra</creatorcontrib><creatorcontrib>Shutt, Kathleen</creatorcontrib><creatorcontrib>Kaiser, Robyn</creatorcontrib><creatorcontrib>Marano, Nina</creatorcontrib><creatorcontrib>Popovic, Tanja</creatorcontrib><creatorcontrib>Tappero, Jordan</creatorcontrib><creatorcontrib>Ashford, David</creatorcontrib><creatorcontrib>Mascola, Laurene</creatorcontrib><creatorcontrib>Vugia, Duc</creatorcontrib><creatorcontrib>Perkins, Bradley</creatorcontrib><creatorcontrib>Rosenstein, Nancy</creatorcontrib><creatorcontrib>Eco-Challenge Investigation Team</creatorcontrib><creatorcontrib>the Eco-Challenge Investigation Team</creatorcontrib><title>Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000</title><title>Emerging infectious diseases</title><addtitle>Emerg Infect Dis</addtitle><description>Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. 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We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis.</abstract><cop>United States</cop><pub>U.S. National Center for Infectious Diseases</pub><pmid>12781010</pmid><doi>10.3201/eid0906.020751</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Emerging infectious diseases, 2003-06, Vol.9 (6), p.702-707 |
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| subjects | Adult adventure travel immunoassay Borneo Case studies Disease Outbreaks DNA, Bacterial - analysis doxycycline febrile illness Female Fever - epidemiology Fever - microbiology Fresh Water - microbiology Humans Leptospira - genetics Leptospira - isolation & purification Leptospirosis Leptospirosis - diagnosis Leptospirosis - epidemiology Malaysia Malaysia - epidemiology Male Middle Aged Risk Factors Sports Travel Water Microbiology |
| title | Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000 |
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