1887
  1. Home
  2. Eurosurveillance
  3. Volume 24, Issue 40, 03/Oct/2019
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

In the Netherlands, obstacle, mud and survival runs are increasingly popular. Although outbreaks of gastroenteritis have been reported following these events, associated health risks have not been systematically assessed.

Aim

To investigate the incidence of acute gastrointestinal infections (AGI), skin infections (SI) and respiratory infections (RI) among obstacle run participants, as well as risk factors.

Methods

Between April and October 2017, we conducted a retrospective cohort study among 2,900 participants of 17 obstacle runs in the Netherlands. Demographic, symptomatic and behavioural data were collected from participants via an online questionnaire 1 week after participation in an obstacle run. Stool specimens were obtained from respondents for microbiological tests. Adjusted relative risks (aRR) and 95% confidence intervals (CI) using multilevel binomial regression analysis were calculated.

Results

Of 2,646 respondents (median age: 33 years; 53% male), 76 had AGI after the obstacle run; ingesting mud was associated with AGI (aRR: 1.7; 95% CI: 1.2–4.9) and 38 respondents had AGI during or in the week before the obstacle run. Overall, 103 respondents reported SI and 163 RI. Rinsing off in a hot tub was associated with SI (aRR: 2.2; 95% CI: 1.7–2.8). Of 111 stool specimens, 13 tested positive for six different pathogens. No clusters were found.

Conclusion

The reported incidence of AGI, SI and RI was low. Risk of these infections could be decreased by informing participants on preventive measures, e.g. showering vs rinsing in the hot tub, avoiding ingesting mud and not participating with symptoms of AGI.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2019.24.40.1900088
2019-10-03
2024-12-21
/content/10.2807/1560-7917.ES.2019.24.40.1900088
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/24/40/eurosurv-24-40-3.html?itemId=/content/10.2807/1560-7917.ES.2019.24.40.1900088&mimeType=html&fmt=ahah

References

  1. Obstakels.com. Wat is een obstacle run. Facts feiten. [What is an obstacle run. Facts]. Lieshout: Obstakels.com. [Accessed: 4 Sept 2019]. Dutch. Available from: https://obstakels.com/wat-is-een-obstacle-run/facts-feiten/<ref/
  2. Strong Viking. Legal. Policies and conditions. Website. [Accessed: 4 Sept 2019]. Dutch. Available from: https://strongviking.com/nl/condities/
  3. Obstakels.com. Obstacle Run Kalender. [Obstacle run calendar]. Lieshout: Obstakels.com. [Accessed: 29 Dec 2017]. Dutch. Available from: https://obstakels.com/kalender/
  4. Terrain Race. What is an obstacle course race? Website. [Accessed: 4 Sept 2019]. Available from: https://terrainrace.com/terrain-obstacle-course/
  5. Obstakels.com. Wat is nou een survivalrun? [What is a survival run?]. Lieshout: Obstakels.com. [Accessed 13 Aug 2018]. Dutch. Available from: https://obstakels.com/2015/11/24/wat-is-nou-een-survivalrun/
  6. All Terrain. What is a survival run? Website. [Accessed: 4 Sept 2019]. Available from: https://allterrain.nl/what-is-a-survivalrun/
  7. Griffiths SL, Salmon RL, Mason BW, Elliott C, Thomas DRH, Davies C. Using the internet for rapid investigation of an outbreak of diarrhoeal illness in mountain bikers. Epidemiol Infect. 2010;138(12):1704-11.  https://doi.org/10.1017/S0950268810001561  PMID: 20587125 
  8. Hall V, Taye A, Walsh B, Maguire H, Dave J, Wright A, et al. A large outbreak of gastrointestinal illness at an open-water swimming event in the River Thames, London. Epidemiol Infect. 2017;145(6):1246-55.  https://doi.org/10.1017/S0950268816003393  PMID: 28162113 
  9. Joosten R, Sonder G, Parkkali S, Brandwagt D, Fanoy E, Mughini-Gras L, et al. Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study. PLoS One. 2017;12(4):e0174732.  https://doi.org/10.1371/journal.pone.0174732  PMID: 28369101 
  10. Mexia R, Vold L, Heier BT, Nygård K. Gastrointestinal disease outbreaks in cycling events: are preventive measures effective? Epidemiol Infect. 2013;141(3):517-23.  https://doi.org/10.1017/S0950268812000817  PMID: 22591923 
  11. Six C, Aboukais S, Giron S, D’Oliveira JC, Peloux-Petiot F, Franke F, et al. Outbreak of diarrhoeal illness in participants in an obstacle adventure race, Alpes-Maritimes, France, June 2015. Euro Surveill. 2016;21(23):30253.  https://doi.org/10.2807/1560-7917.ES.2016.21.23.30253  PMID: 27311488 
  12. Stuart TL, Sandhu J, Stirling R, Corder J, Ellis A, Misa P, et al. Campylobacteriosis outbreak associated with ingestion of mud during a mountain bike race. Epidemiol Infect. 2010;138(12):1695-703.  https://doi.org/10.1017/S095026881000049X  PMID: 20334726 
  13. Zeigler M, Claar C, Rice D, Davis J, Frazier T, Turner A, et al. , Centers for Disease Control and Prevention (CDC). Outbreak of campylobacteriosis associated with a long-distance obstacle adventure race--Nevada, October 2012. MMWR Morb Mortal Wkly Rep. 2014;63(17):375-8. PMID: 24785983 
  14. Hintaran AD, Kliffen SJ, Lodder W, Pijnacker R, Brandwagt D, van der Bij AK, et al. Infection risks of city canal swimming events in the Netherlands in 2016. PLoS One. 2018;13(7):e0200616.  https://doi.org/10.1371/journal.pone.0200616  PMID: 30052633 
  15. Zijlstra M, Hulsker CCC, Fanoy EB, Pijnacker R, Kraaijeveld A, Koene MGJ, et al. [Tularaemia in a boy following participation in a mud race]. Ned Tijdschr Geneeskd. 2017;160(0):D1180. PMID: 28466800 
  16. Uiterwijk M, De Rosa M, Friesema I, Valkenburgh S, Roest H, van Pelt W. Staat van Zoönosen 2015. [State of Zoonoses 2015]. Bilthoven: National Institute for Public Health and the Environment (RIVM); 2016. Dutch.
  17. De Schrijver K, Berghs R, Van Esbroeck M, Vlieghe E, Flipse W. Leptospirose bij deelnemers aan een obstakelloop in Nijlen in 2015. [Leptospirosis among participants in an obstacle course in Nijlen in 2015]. Vlaams infectieziektebulletin. 2017;2017(4):6-11.
  18. National Institute for Public Health and the Environment (RIVM). Gastroenteritis and food poisoning (foodborne). Bilthoven: RIVM; [Accessed 12 Sep 2019]. Dutch. Available from: https://lci.rivm.nl/draaiboeken/gastro-enteritis-en-voedselvergiftigingen
  19. National Institute for Public Health and the Environment (RIVM). Article 26 notifications Wpg settings. Bilthoven: RIVM; [Accessed 12 Sep 2019]. Dutch. Available from: https://lci.rivm.nl/draaiboeken/artikel-26-meldingen-wpg-instellingen
  20. Collector Innovative Surveys. Vragenlijsten [questionnaires]. Survalyzer AG [Accessed in 2017]. Dutch Available from: https://login.premiumuser.datacoll.nl/
  21. Hooiveld M, Donkers GA, Korevaar JC. Wekelijkse surveillance cijfers. Nivel Zorgregistraties eerste lijn. [Weekly surveillance figures. Nivel Primary Care Registration]. Utrecht: Nivel; 2018. Dutch. Available from: www.nivel.nl/surveillance.
  22. Bellido-Blasco JB, Arnedo-Pena A, Cordero-Cutillas E, Canós-Cabedo M, Herrero-Carot C, Safont-Adsuara L. The protective effect of alcoholic beverages on the occurrence of a Salmonella food-borne outbreak. Epidemiology. 2002;13(2):228-30.  https://doi.org/10.1097/00001648-200203000-00020  PMID: 11880766 
  23. Correia AM, Gonçalves G, Gomes A, Oliveira B, Gonçalves J, Miranda M, et al. The protective effect of alcoholic beverages in a foodborne outbreak of Salmonella Enteritidis PT1 in northern Portugal. Euro Surveill. 2003;7(13):2195.
  24. Desenclos JA, Klontz KC, Wilder MH, Gunn RA. The protective effect of alcohol on the occurrence of epidemic oyster-borne hepatitis A. Epidemiology. 1992;3(4):371-4.  https://doi.org/10.1097/00001648-199207000-00013  PMID: 1637901 
  25. Romeo J, Wärnberg J, Nova E, Díaz LE, Gómez-Martinez S, Marcos A. Moderate alcohol consumption and the immune system: a review. Br J Nutr. 2007;98(S1) Suppl 1;S111-5.  https://doi.org/10.1017/S0007114507838049  PMID: 17922947 
  26. World Health Organization (WHO). WHO guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care is Safer Care. Geneva: WHO; 2009. Available from: https://www.ncbi.nlm.nih.gov/books/NBK144004/
  27. Boerma T, Hosseinpoor AR, Verdes E, Chatterji S. A global assessment of the gender gap in self-reported health with survey data from 59 countries. BMC Public Health. 2016;16(1):675.  https://doi.org/10.1186/s12889-016-3352-y  PMID: 27475755 
Risk factors for developing acute gastrointestinal, skin or respiratory infections following obstacle and mud run participation, the Netherlands, 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Elisabeth+M+den+Boogert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">den Boogert Elisabeth M</a>, <a href="/search?value1=Danielle+M+Oorsprong&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Oorsprong Danielle M</a>, <a href="/search?value1=Ewout+B+Fanoy&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fanoy Ewout B</a>, <a href="/search?value1=Alexander+CAP+Leenders&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Leenders Alexander CAP</a>, <a href="/search?value1=Alma+Tostmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tostmann Alma</a>, <a href="/search?value1=Adriana+SG+van+Dam&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Dam Adriana SG</a></span>. Risk factors for developing acute gastrointestinal, skin or respiratory infections following obstacle and mud run participation, the Netherlands, 2017. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(40):pii=1900088. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.40.1900088" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.40.1900088</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 25 Jan 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 13 Jun 2019 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.40.1900088
/content/10.2807/1560-7917.ES.2019.24.40.1900088
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error