Skip to main content Accessibility help
×
Home

Using the internet for rapid investigation of an outbreak of diarrhoeal illness in mountain bikers

  • S. L. GRIFFITHS (a1), R. L. SALMON (a1), B. W. MASON (a1), C. ELLIOTT (a1), D. Rh. THOMAS (a1) and C. DAVIES (a2)...

Summary

In summer 2008, we investigated an outbreak of diarrhoeal illness in participants of a mountain-bike event in Wales (UK) which had been affected by heavy rain. We conducted a retrospective cohort study to investigate the cause using an internet-based questionnaire. Fifty-three percent of those contacted responded, and 161 (46·5%) out of the 347 responders, reported gastrointestinal symptoms. Median day of onset was 3 days following the event. Ten riders reported receiving a laboratory-confirmed diagnosis of Campylobacter. Multivariate logistic regression analysis identified the inadvertent ingestion of mud (OR 2·5, 95% CI 1·5–4·2, P<0·001) and eating ‘other’ food during the event (OR 2·1, 95% CI 1·2–3·6, P=0·01) as significant risk factors for illness. We concluded that the outbreak was caused by Campylobacter, spread to the riders by the inadvertent ingestion of mud which had been contaminated with sheep faeces from the rural course. Mountain-bike race organizers should consider microbiological hazards when risk-assessing potential race courses. The internet is an efficient tool for the investigation of outbreaks in computer-literate populations.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Using the internet for rapid investigation of an outbreak of diarrhoeal illness in mountain bikers
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Using the internet for rapid investigation of an outbreak of diarrhoeal illness in mountain bikers
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Using the internet for rapid investigation of an outbreak of diarrhoeal illness in mountain bikers
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: Dr S. L. Griffiths, Public Health Wales, 36 Orchard Street, Swansea, SA1 5AQ, Wales, UK. (Email: sian.griffiths6@wales.nhs.uk)

References

Hide All
1.Turbeville, SD, Cowan, LD, Greenfield, RA. Infectious disease outbreaks in competitive sports. American Journal of Sports Medicine 2006; 34: 18601865.
2.Young, CC, et al. Infectious disease and the extreme sport athlete. Clinics in Sports Medicine 2007; 26: 473487.
3.Morgan, J, et al. Outbreak of leptospirosis among triathlon participants and community residents in Springfield, Illinois, 1998. Clinical Infectious Diseases 2002; 34: 15931599.
4.Sejvar, J, et al. Leptospirosis in ‘Eco-challenge’ athletes, Malaysian Borneo, 2000. Emerging Infectious Diseases 2003; 9: 702707.
5.Stuart, TL, et al. Campylobacteriosis outbreak associated with ingestion of mud during a mountain bike race. Epidemiology and Infection. Published online: 25 March 2010. doi:10.1017/S095026881000049X.
6.Forestry Commission for Wales. Mountain bike trails, 2009 (http://www.forestry.gov.uk/forestry/INFD-6RLFD3). Accessed 14 April 2010.
7.Cascade Content Management System. Version 3. Cardiff: Health Solutions Wales, 2009.
8.StataCorp. Stata Statistical Software. Release 10. College Station, TX: StataCorp LP, 2007.
9.National Public Health Service for Wales. The investigation of an outbreak of diarrhoeal illness in participants of the Builth Wells Mountain Bike Marathon. Swansea: NPHS, 2008. (http://www.wales.nhs.uk/sitesplus/888/news/14690). Accessed 6 April 2010.
10.Howie, H, et al. Investigation of an outbreak of Escherichia coli O157 infection caused by environmental exposure at a scout camp. Epidemiology and Infection 2003; 131: 10631069.
11.Crampin, M, et al. Outbreak of Escherichia coli O157 infection associated with a music festival. European Journal of Clinical Microbiology and Infectious Diseases 1999; 18: 286288.
12.Ghosh, TS, et al. Internet- versus telephone-based local outbreak investigations. Emerging Infectious Diseases 2008; 14: 975977.
13.de Jong, B, Ancker, C. Web-based questionnaires – a tool used in a Campylobacter outbreak investigation in Stockholm, Sweden, October 2007. Eurosurveillance 2008; 13: 4.
14.Srikantiah, P, et al. Web-based investigation of multistate Salmonellosis outbreak. Emerging Infectious Diseases 2005; 11: 610612.
15.Passaro, DJ, Scott, M, Dworkin, MS. Email surveys assist investigation and response: a university conjunctivitis outbreak. Epidemiology and Infection 2004; 132: 761764.
16.Kuusi, M, et al. Internet use and epidemiologic investigation of gastroenteritis outbreak. Emerging Infectious Diseases 2004; 10: 447450.
17.Raupach, JCA, Hundy, RL. An outbreak of Campylobacter jejuni infection among conference delegates. Communicable Diseases Intelligence 2003; 27: 380383.
18.Castrodale, L, et al. Using email to investigate outbreaks. Western Journal of Medicine 2002; 176: 181183.
19.Rhodes, SD, Bowie, DA, Hergenrather, KC. Collecting behavioural data using the world wide web: considerations for researchers. Journal of Epidemiology and Community Health 2003; 57: 6873.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed