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Gastrointestinal disease outbreaks in cycling events: are preventive measures effective?

  • R. MEXIA (a1) (a2), L. VOLD (a2), B. T. HEIER (a2) and K. NYGÅRD (a2)

Summary

In 2009, following a bike race, a gastrointestinal illness outbreak affected many participants. A cohort study showed an attack rate of 16·3% with the main risk factor being mud splashes to the face. Considering these findings, in 2010 recommendations to participants in the bike race were issued and environmental control measures were implemented. In 2010, a retrospective cohort study using web-based questionnaires was conducted to measure the use of preventive measures and to assess risk factors associated with gastrointestinal illness. A 69% response rate was achieved and 11721 records analysed, with 572 (attack rate 4·9%) matching the case definition, i.e. participants reporting diarrhoea within 10 days of race. There was a clear increase in the use of mudguards (96·7% reported access to/receiving information on preventive measures) and a significant decrease in gastrointestinal illness. This may indicate that the measures have been effective and should be considered, both in terms of environmental control measures as well as individual measures.

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Copyright

Corresponding author

*Author for correspondence: Dr R. Mexia, Folkehelseinstituttet, SMAO, Postboks 4404 Nydalen, 0403 Oslo, Norway. (Email: ricmexia@gmail.com)

References

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1.Kapperud, G, et al. Two outbreaks of campylobacteriosis after bicycle races – are mud splashes the source? [in Norwegian]. MSIS-Rapport. Meldigssystem for Smittsomme Sykdommer 2000; 28:08: 1.
2.Stuart, TL, et al. Campylobacteriosis outbreak associated with ingestion of mud during a mountain bike race. Epidemiology and Infection 2010; 138: 16951703.
3.Cramping, M, et al. Outbreak of Escherichia coli O157 Infection Associated with a Music Festival. European Journal of Clinical Microbiology & Infectious Diseases 1999; 18: 286288.
4.Hofshagen, M, Heier, BT, Hauge, K.Report on zoonoses in Norway 2009 [in Norwegian]. National Veterinary Institute, July 2010 (http://www.vetinst.no/nor/Forskning/Publikasjoner/Zoonoserapporten/Zoonoserapporten-2009). Accessed 25 May 2011.
5.Griffiths, SL, et al. Using the internet for rapid investigation of an outbreak of diarrhoeal illness in mountain bikers. Epidemiology and Infection 2010; 138: 17041711.

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