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Up to 41 may have been infected in race

Investigators contact all participants in a Hillsborough adventure race after six come down with a rare disease. They find more sick.

By LISA GREENE
Published December 15, 2005

Elite athlete Josh Crosby was at the doctor for the third time in weeks, being told he couldn't possibly have leptospirosis.

No, no, the specialist said. I've only seen one case in 30 years.

Minutes later, the positive test results arrived.

That made Crosby, of Los Angeles, one of at least 41 suspected or confirmed cases of the unusual bacterial infection contracted during a 24-hour, 100-mile adventure race last month through Hillsborough County Wilderness Park, health officials said.

That's a big number for a potentially fatal disease usually diagnosed only 50 to 100 times a year in the continental United States.

Investigators from the local Health Department to the federal Centers for Disease Control and Prevention teamed up to contact the 201 participants from around the country, all competitors in the national championships for the U.S. Adventure Racing Association.

Hillsborough County Wilderness Park is a system of parks in northern Hillsborough County. The race course included Flatwoods, Morris Bridge, Trout Creek and Sargeant parks.

At least six cases have been confirmed so far, with 35 others suspected, Dr. Tom Clark, medical epidemiologist with the CDC, said Wednesday.

"Something tipped the balance," Clark said. "They were exposed to areas that (people) hadn't been exposed to before. Or heavy rains washed all the bacteria into one common area ... or just that they were there for 24 hours."

People get the disease from bacteria, most often by coming in contact with water contaminated with urine of an infected animal.

Two athletes described arduous races Wednesday.

They swam through alligator-infested waters at night and hiked through swamps of waist-deep water. Many of the infected racers wore shorts, and as they sprinted past jagged saw palmettos, their legs became laced with blood. Crosby said his looked like he had "been attacked by a rabid cat." Then those open wounds soaked for hours in swamp water.

All that was the easy part.

"Everybody thinks the race was tough," Crosby said. "The sickness was worse."

The athletes' experience was so extreme that Clark and local health officials don't see much threat to the public.

Officials haven't closed off any areas of the park system, said county parks spokesman John Brill, because nobody has been able to pin down where the athletes were infected.

Crosby, 31, went home to L.A. pleased with the third-place finish of the team he captains, Team Revo 2.

Days later, he started feeling sick. He spent several days with a 103-degree fever, muscle aches and headaches. Over the Thanksgiving holiday, he slept 12 hours a day. On the worst night, his vision blurred. Even now, Crosby said, he's just starting to get his stamina back.

Crosby got tested for the disease after another runner, New York securities project manager Chris Rice, became so sick he was hospitalized for six days.

The disease can be treated with antibiotics, but left untreated it can cause kidney damage, liver failure or death.

Rice, 32, was one of the first to get sick, about 10 days after the race. His fever soared to 104 degrees. His head and back throbbed. One of his eyes turned beet-red. On his second trip to the emergency room, he asked an infectious disease specialist if it could be leptospirosis. Rice remembered hearing about an outbreak among athletes in the 2000 "Eco-Challenge" race in Borneo.

Once his diagnosis was confirmed, the CDC began to investigate. Working with Hillsborough County and state health officials, they contacted all the participants. They asked them about symptoms and the race experience.

Of the 188 people who have responded, Clark said, 41 have listed symptoms that indicate they could have the disease. Health officials are waiting for blood test results, but Clark expects most of the tests to be positive.

Many different animals carry the disease. Early blood tests indicate the most likely carriers were wild pigs, Clark said.

The athletes' answers to investigators' questions made Clark realize just how tough the race was. One question asked how much time racers spent in the water. One answered: "I was wet the whole time."

Despite the outbreak, Crosby and Rice said they will keep racing. Crosby plans trips next year to races in Australia, Europe and Canada.

"This race was a great race, and it's just one of those kind of random things," he said.

Rice still plans to race, but he was shaken by having his two sons see him in the hospital. He plans to avoid wet races in warm climates.

And next time, he'll wear long pants.

CAUSED BY: Leptospira bacteria.

HOW PEOPLE GET IT: Most often, contact with water contaminated by urine of infected animals. Can also be spread through contaminated food or soil. It's not known to spread from person to person.

WHERE IT COMES FROM: The disease infects many wild animals, as well as cattle, horses, dogs and rodents. It's more common in warmer climates.

SYMPTOMS: Some people don't become sick. Others get headaches, fever, muscle aches, vomiting, jaundice and sometimes a rash. Without treatment, people can experience kidney damage, liver failure, meningitis or breathing problems, and they may die.

TREATMENT: Antibiotics

Source: Centers for Disease Control and Prevention

[Last modified December 15, 2005, 00:34:03]