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Surveillance and outbreak report Open Access
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Abstract

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.

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/content/10.2807/1560-7917.ES.2016.21.23.30253
2016-06-09
2017-10-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.23.30253
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References

  1. National Association of State Public Health Veterinarians Animal Contact Compendium Committee 2013. Compendium of measures to prevent disease associated with animals in public settings, 2013. J Am Vet Med Assoc. 2013;243(9):1270-88.  https://doi.org/10.2460/javma.243.9.1270  PMID: 24134577 
  2. 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 
  3. 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 
  4. Gulsin GS, Stirling Laing RB. Non-food environmental exposure to Escherichia coli O157:H7 – the risks of cycling on muddy pathways. J Infect Prev. 2015;16(2):88.  https://doi.org/10.1177/1757177414563871 
  5. Griffiths SL, Salmon RL, Mason BW, Elliott C, Thomas DR, 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 
  6. 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 
  7. Crampin M, Willshaw G, Hancock R, Djuretic T, Elstob C, Rouse A, et al. Outbreak of Escherichia coli O157 infection associated with a music festival. Eur J Clin Microbiol Infect Dis. 1999;18(4):286-8.  https://doi.org/10.1007/s100960050278  PMID: 10385018 
  8. Pagès F, Larrieu S, Simoes J, Rodicq M, Kurtkowiak B, Domonte F, et al. Epidémie de leptospirose suite à un triathlon, mars 2013, La Réunion. [Leptospirosis outbreak following a triathlon, March 2013, Reunion]. BVS 2014:24:11-13. http://www.invs.sante.fr/fr/Publications-et-outils/Bulletin-de-veille-sanitaire/Tous-les-numeros/Ocean-indien-Reunion-Mayotte/Bulletin-de-veille-sanitaire-ocean-Indien.-N-24-Octobre-2014
  9. Vally H, Whittle A, Cameron S, Dowse GK, Watson T. Outbreak of Aeromonas hydrophila wound infections associated with mud football. Clin Infect Dis. 2004;38(8):1084-9.  https://doi.org/10.1086/382876  PMID: 15095211 
  10. Kemble SK, Lynfield R, DeVries AS, Drehner DM, Pomputius WF 3rd, Beach MJ, et al. Fatal Naegleria fowleri infection acquired in Minnesota: possible expanded range of a deadly thermophilic organism. Clin Infect Dis. 2012;54(6):805-9.  https://doi.org/10.1093/cid/cir961  PMID: 22238170 
  11. Vinjé J. Advances in laboratory methods for detection and typing of norovirus. J Clin Microbiol. 2015;53(2):373-81.  https://doi.org/10.1128/JCM.01535-14  PMID: 24989606 
  12. Yoder JS, Hlavsa MC, Roberts VA, Ayana R, Anderson AR, Orr M, et al. Surveillance for waterborne disease and outbreaks associated with recreational water use and other aquatic facility-associated health events—United States, 2007-2008. MMWR Surveill Summ. 2011;60(12):1-32. PMID: 21937976 
  13. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Updated norovirus outbreak management and disease prevention guidelines. MMWR Recomm Rep. 2011;60(RR-3) RR03;1-18.
  14. Van Cauteren D, De Valk H, Vaux S, Le Strat Y, Vaillant V. Burden of acute gastroenteritis and healthcare-seeking behaviour in France: a population-based study. Epidemiol Infect. 2012;140(4):697-705.  https://doi.org/10.1017/S0950268811000999  PMID: 21676346 
  15. Van Cauteren D, Turbelin C, Fonteneau L, Hanslik T, De Valk H, Blanchon T. Physician practices in requesting stool samples for patients with acute gastroenteritis, France, August 2013-July 2014. Epidemiol Infect. 2015;143(12):2532-8.  https://doi.org/10.1017/S0950268814003884  PMID: 25592030 
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