TY - JOUR AU - Sejvar, James AU - Bancroft, Elizabeth AU - Winthrop, Kevin AU - Bettinger, Julie AU - Bajani, Mary AU - Bragg, Sandra AU - Shutt, Kathleen AU - Kaiser, Robyn AU - Marano, Nina AU - Popovic, Tanja AU - Tappero, Jordan AU - Ashford, David AU - Mascola, Laurene AU - Vugia, Duc AU - Perkins, Bradley AU - Rosenstein, Nancy T1 - Leptospirosis in “Eco-Challenge” Athletes, Malaysian Borneo, 2000 T2 - Emerging Infectious Disease journal PY - 2003 VL - 9 IS - 6 SP - 702 SN - 1080-6059 AB - Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in “Eco-Challenge” multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis. KW - leptospirosis KW - febrile illness KW - adventure travel immunoassay KW - doxycycline KW - research KW - Borneo KW - Malaysia DO - 10.3201/eid0906.020751 UR - https://wwwnc.cdc.gov/eid/article/9/6/02-0751_article ER - End of Reference