Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000

James Sejvar, Elizabeth Bancroft, Kevin Winthrop, Julie Bettinger, Mary Bajani, Sandra Bragg, Kathleen Shutt, Robyn Kaiser, Nina Marano, Tanja Popovic, Jordan Tappero, David Ashford, Laurene Mascola, Duc Vugia, Bradley Perkins, Nancy Rosenstein

Research output: Contribution to journalArticlepeer-review

224 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)702-707
Number of pages6
JournalEmerging infectious diseases
Issue number6
StatePublished - Jun 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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