A couple of weeks ago I agreed to run a Tough Mudder with a couple of hockey buddies. The one I said I’d do is in Charlotte this fall, and I’m reconsidering. CDC’s MMWR (my favorite Thursday read) has details of an outbreak of Campylobacter associated with a 2012 Nevada mud run. According to Zeigler and colleagues, the epidemiological data suggested that the inadvertent swallowing of surface water in one of the obstacles was a risk factor.

A case-control study using data provided by patients and healthy persons who also had participated in the race showed a statistically significant association between inadvertent swallowing of muddy surface water during the race and Campylobacter infection (odds ratio = 19.4; p<0.001). Public health agencies and adventure race organizers should consider informing race attendees of the hazards of inadvertent ingestion of surface water.

High-intensity and competitive muddy obstacle adventure course races have surged in popularity across the United States, drawing an estimated 1.5 million participants in 2012 (2). These military-style adventure races attract high numbers of active-duty military personnel, along with young, active, extremely fit civilians. Persons typically are advised of the risks of participating and required to sign a liability waiver. Races are commonly held on farmlands where animal feces increase the risk for zoonotic disease transmission. Primary and emergency care providers, as well as public health professionals, should be aware that obstacle adventure race events could pose a heightened risk for outbreaks from inadvertent ingestion of contaminated water or mud and might consider outreach to educate participants on the health risks from oral contact with contaminated surface water or mud.

Participation in obstacle adventure races is relatively common among men and women of the U.S. military. These events typically are held in rural areas and often include man-made slurry fields (a mixture of soil or clay and water) as race “challenges.” In areas commonly frequented by animals (5), topsoil used in the creation of slurry fields can be contaminated with feces from domestic fowl (6) or ruminants (7) or wild animals. Competitors who run or ride through such areas might unintentionally swallow sufficient numbers of organisms to cause clinical disease. Fewer than 500 Campylobacter organisms are needed to cause illness (1). The race described in this report was held on a cattle ranch, and participants reported seeing cattle and swine on or near the course on race day. Obstacle adventure race planners should consider building slurry field challenges where animal fecal contamination is not likely.

First a manager at a Charlotte Papa John’s was diagnosed with hepatitis A resulting in hundreds of IgG shots and now a Raleigh-area outlet has been questioned about storing and transporting raw dough unsafely. One situation is a real public health risk, the other elicits some yuck-factor response.

When he saw the same thing again and again, he notified the restaurant. The first time, a manager said, “have it thrown away immediately.” The second time, they told him they’d address the issue.

When it happened a third time, Barnhill brought his photos and video to 5 On Your Side.

Then the exposed dough balls were placed in the back of an employee’s car.

“That’s a problem,” said [health inspector] Thomas Jumalon, upon viewing Barnhill’s video.

“Had this happened during an inspection, if that product had had any rainwater, anything like that, we would advise them to toss it,” he said.

Jumalon had some points of assurance for diners.

He pointed out that pizza dough cooks at 500 degrees for 20 minutes – enough to kill just about anything that could be on it – and that food is exposed to the outdoors whenever you dine outside. He also said transporting food in a personal car is no different than using a company vehicle.

Maybe some physical hazard risks, but not the kind of stuff that leads to foodborne illness.

Over the past couple of days I drove the family from sunny and somewhat warm Raleigh, NC to the frigid tundra of Southern Ontario. I knew things would be bad when it started snowing as we passed through Maryland – in mid-April.

One of the consequences of a long cold winter is an extended norovirus season (the virus is more stable in cold weather). 

Even in Florida.

According to local10, a Broward County, FL school is dealing with a norovirus outbreak – and some folks seem to think drinking from water fountains is a risk factor.

A contagious stomach flu-like virus is making an unusually high number of students at Boulevard Heights Elementary School in Hollywood sick.

The employee was diagnosed on Monday or Tuesday of this week.

“The Mecklenburg County Health Department is working with the State Health Department and our Public Information Office on coordinating messages about what residents who ate food from the restaurant should do,” the email states.

If you ate at the restaurant between March 28 and April 7, officials say you should get a hepatitis vaccination. The vaccine is effective if you were exposed within the last 14 days and could prevent you from getting sick.
 
If you ate food from this location between March 24 and March 27, officials say the vaccination would no longer be effective. In this case, you should be aware of the symptoms and notify your physician if you see them.

There will be a vaccination clinic for people at the Cabarrus County Health Department and Mecklenburg County Health Department on Friday from 4 pm to 8 pm.