Tough mudders and cyclists, beware the agri-land: Outbreaks amongst participants in Norway, Scotland

NRK reports that some 50 of 300 participants became sick with Campylobacter in a cycling event in Norway.

Competitors at the start of the 2015 Tough Mudder Scotland at Drumlanrig Castle, Dumfries and Galloway

Earlier, several people were stricken by E. coli O157 in a tough mudder event which was held at Drumlanrig Castle in Scotland on June 17 and 18.

These outbreaks follow previous, numerous outbreaks involved with playing in mud.

In Norway, the reason why the cyclists have become so bad is because animal wreckage resolved after a heavy rainfall and remained in the road. This has again sprung up on the cyclists.

“Especially if the stool is fresh and there are large amounts of water, it can sprinkle on drinking bottles and hands so you get it when you drink,” said Tor Halvor Bjørnstad-Tuveng, to NRK (something may be lost in translation).

“We have been in dialogue with the management of the race, and we have some concrete measures that we will look at. We have been very unlucky with the rides of the year, but we must definitely look at what we can do to prevent it happening again, “says Bjørnstad-Tuveng.

Per Stubban was one of those who had to go to the hospital for intravenous nutrition.

“Now I’m on my way, but there have been some tough days. Next time I will not use a handheld drink bottle, but a drinking bag, and if there is as much rain as it was now, I would probably be skeptical to start, “he said.

Participants in an endurance event at a Scottish castle have been warned to look out for symptoms of E. coli O157 after it was identified among those who took part.

NHS Dumfries and Galloway said “a small number of cases” of the bacteria have been found in those involved in the Tough Mudder event at Drumlanrig Castle last month.

It has advised anyone associated with the event who experiences symptoms to seek medical advice.

A spokesman for the health board said: “NHS Dumfries and Galloway can confirm that we are aware of a small number of cases of E.coli O157 across Scotland that appear to be associated with participation in the Tough Mudder event which was held at Drumlanrig Castle on June 17 and 18.

“Any activity undertaken on agricultural land inevitably involves a small risk of gastrointestinal infection.”

A spokesman for the event said: “The safety of Tough Mudder participants, spectators, volunteers and staff is our number one priority.

Uh-huh.

Norovirus strikes hundreds at obstacle race in France

In June 2015, near Nice in the Alpes-Maritimes department, an acute gastroenteritis (AG) outbreak occurred among participants of an obstacle race. An investigation in 2 phases was conducted to identify the source of infection and document the extent of the outbreak.

tough_mudder_16-340x227During phase 1, a message on Facebook asked the racers to report by email any symptoms. In phase 2, a retrospective study was conducted through an interactive questionnaire for all participants. Cross-sectional descriptive studies were conducted, completed by an analytical study of the potential risks factors. Microbiological and environmental investigations were conducted in order to identify the responsible agent. An analysis of antidiarrhoeal drugs reimbursements was conducted with data from the French national health insurance to confirm the epidemiological investigation.

During phase 1, on 8229 registered participants, at least 1001 adults reported an AG, which was resolved in 48H.

In phase 2, the risks factors of AG identified were due to: younger participants, first hour of departure time and ingestion of mud. Twenty stool specimens traced were negative for bacteriological research. Only 4 stool specimens were sent to the CNR of enteric viruses. They were all positive for Norovirus genogroup1 and genotype 2 (GI.2), strain of human origin.

Indicator bacteria were negative in the drinking water and positive in the muddy water. Outbreak origin was due to human transmission: a norovirus possibly introduced by stools or vomiting from one or more persons infected, transmitted through contaminated muddy water.

For the future, recommendations for the organisation of such events should be proposed. The risks related to these races should be assessed to guide health authorities and to guide organizers in their awareness of potential risks factors.

Investigation of an outbreak of acute gastroenteritis among participants of an Obstacle Adventure Race Alpes-Maritimes

S Giron, C Six

http://invs.santepubliquefrance.fr/Publications-et-outils/Rapports-et-syntheses/Maladies-infectieuses/2016/Investigation-d-une-epidemie-de-gastro-enterites-virales-survenues-apres-une-course-a-obstacles

The risks of running through mud

Being in France, I’m reminded that on June 20, 2015, about 1,000 of the almost 8,400 runners who took part in Mud Day activities in Nice on the French Riviera were stricken with gastroenteritis.

TMSplash-300x224And now, the paper.

An acute gastroenteritis (AG) outbreak occurred among participants in an obstacle race in France in the summer of 2015.

An investigation in two phases was conducted to identify the source of infection and document the extent of the outbreak.

First, a message on a social media website asked racers to report any symptoms by email to the Regional Health Agency of Provence-Alpes-Côte d’Azur. Second, a retrospective cross-sectional study was conducted through an interactive questionnaire for all participants, followed by an analytical study of potential risks factors.

Of 8,229 persons registered, 1,264 adults reported AG resolved within 48 hours. Of adults who reported AG, 866 met the case definition. Age group, departure time and ingestion of mud were associated with AG. Twenty stool specimens tested negative for bacteria. All four stool samples tested for viruses were positive for Norovirus genogroup I and genotype 2. No indicator bacteria for faecal contamination were found in drinking water but muddy water of ponds tested positive.

The outbreak was possibly caused by human-to-human transmission of a norovirus introduced by one or more persons and transmitted through contaminated mud. Risks related to similar races should be assessed and recommendations be proposed to raise awareness among health authorities and organisers.

Outbreak of diarrhoeal illness in participants in an obstacle adventure race, Alpes-Maritimes, France, June 2015

Eurosurveillance, Volume 21, Issue 23

Six C, Aboukais S, Giron S, D’Oliveira J, Peloux-Petiot F, Franke F, Terrien H, Dassonville F, Deniau J, Ambert-Balay K, Chesnot T, Ruimy R, Pélandakis M, Basset P, Munoz Rivero M, Malfait P.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22499

1,000 runners fall sick after mud race in France

There’s this fetish for running through mud.

TMSplashI don’t get it.

I’d rather play hockey and have someone shot a puck at my head at 90 mph.

Of the almost 8,400 runners who took part in Mud Day activities on 20 June in Nice on the French Riviera, about 1,000 have been stricken with gastroenteritis. Probably Campylobacter or Salmonella.

Michigan Tough Mudder race organizers share info about avoiding illnesses

Over the past 6 months I’ve been running a few times a week as a way to get some decent exercise while I try to get to a more healthy weight.

Not an activity that I liked until I was about 30, I do most of my running on treadmills while I watch sports and listen to podcasts. There are a few guys on my hockey team who have taken up endurance mud running as a way to work off the chicken sandwiches and beer we consume every Monday night. A couple of them ran the Tough Mudder in South Carolina a couple of years ago and are trying to talk me into joining them in the spring. Not sure I’m into it.TMSplash

From the organizer’s website, “Tough Mudder events are hardcore 10-12 mile obstacle courses designed by British Special Forces to test your all around strength, stamina, mental grit, and camaraderie. Triathlons, marathons, and other lame-ass mud runs are more stressful than fun. Not Tough Mudder. As hardcore as our courses are, we meet you at the finish line with a beer, a laugh, and a rockin’ live band.”

The site lists a set of obstacles with names like Arctic Enema, Dirty Ballerina and Kiss of Mud.

The races have a history of testing more than physical and mental toughness – they have been linked to multiple pathogen outbreaks.

A 2012 Tough Mudder in Scotland was linked to at least three cases of E. coli O157.  Last year a Michigan event recent was linked to norovirus.

According to Mlive, the organizers of this weekend’s Michigan event are addressing pathogen concerns.

Tough Mudder officials want to remind anyone planning to compete or attend this year’s event to practice good hygiene before and after attending.

“Illnesses of this nature are extremely rare. More than 1.5 million Mudders have run a Tough Mudder course; this issue is highly isolated,” said Ben Johnson, a spokesperson for Tough Mudder, via email. “However, safety is our No. 1 priority, and we encourage all participants, spectators, and volunteers to take the following preventative measures:

– It is important to not attend the event if you are feeling ill. We can provide a transfer to a future event.

– Practice good hygiene before and after the event:

Stay home for at least 48 hours after symptoms disappear.

Use chlorine-bleach based household cleaners to disinfect contaminated surfaces.

Free transfers to a future event is a good step – maybe that will result in sick folks skipping it until they’re done shedding pathogens.

Tough Mudder race linked to pathogens, again

There are a few guys on my hockey team who have taken up endurance mud running as a way to work off the chicken sandwiches and beer we consume every Monday night. A couple of them ran the Tough Mudder in South Carolina last year and are planning on doing it again this year in the Charlotte area.TMSplash

From the organizer’s website, “Tough Mudder events are hardcore 10-12 mile obstacle courses designed by British Special Forces to test your all around strength, stamina, mental grit, and camaraderie. Triathlons, marathons, and other lame-ass mud runs are more stressful than fun. Not Tough Mudder. As hardcore as our courses are, we meet you at the finish line with a beer, a laugh, and a rockin’ live band.”

The site lists a set of obstacles with names like Arctic Enema, Dirty Ballerina and Kiss of Mud.

Last year, a Tough Mudder in Scotland was linked to at least three cases of E. coli O157.

According to WILX 10 in Lansing, MI a recent Mudder race has been linked to norovirus.

The Tough Mudder event is leaving people with a lot more than sore muscles.

At least a dozen people and probably many more who attended the competition at Michigan International Speedway last weekend are reporting symptoms of norovirus and upper respiratory issues.

The Michigan Department of Community Health is handling the case with the Lenawee County Health Department.

Maybe it was the Arctic Enema? UK Tough Mudder race linked to at least three E. coli O157 cases

In preparation for a legendary Raleigh event, the Krispy Kreme Challenge, I started running last fall. The challenge is to run 2.5 miles, eat a dozen donuts, and then run an another 2.5 miles. All under an hour. I finished in 1hr 6min (and I didn’t barf). I ran with a few guys from my hockey team – and now a couple of them are moving on to another endurance event, The Tough Mudder in South Carolina.

From the organizer’s website, "Tough Mudder events are hardcore 10-12 mile obstacle courses designed by British Special Forces to test your all around strength, stamina, mental grit, and camaraderie.

Triathlons, marathons, and other lame-ass mud runs are more stressful than fun. Not Tough Mudder. As hardcore as our courses are, we meet you at the finish line with a beer, a laugh, and a rockin’ live band."

The site lists a set of obstacles with names like Arctic Enema, Dirty Ballerina and Kiss of Mud.

According to BBC, a Tough Mudder event last month in Scotland was linked to at least three cases of E. coli O157.

The trio developed symptoms in the days following the Tough Mudder event, which attracted almost 6,000 competitors to Drumlanrig Castle on 14 and 15 July.

Many of the assault course-style obstacles on the 12-mile run involved immersion in, or contact with, mud.

Health Protection Scotland (HPS) said that, even more than three weeks after the event, further cases could not be ruled out.

HPS added: "If local authorities are made aware that such events are being planned, they would normally advise the organisers on any potential risks, which might for instance include the risk of mud being contaminated with animal faeces or slurry.

"This underlines the importance of event organisers liaising with local authorities during the planning stage, not least to consider what information participants need in order to enjoy ‘extreme’ activities as safely as possible."