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News From the Centers for Disease Control and Prevention
October 4, 2000

Outbreak of Acute Febrile Illness Among Participants in EcoChallenge Sabah 2000—Malaysia, 2000

JAMA. 2000;284(13):1646. doi:10.1001/jama.284.13.1646-JWR1004-5-1

MMWR. 2000;49:816-817

On September 7, 2000, CDC was notified by Idaho Department of Health about a case of acute febrile illness in a 35-year-old man; the illness was characterized by acute onset of high fever, chills, headache, and myalgias. The patient had participated in the EcoChallenge Sabah 2000 Expedition Race, a multisport event held during August 20-September 3, at various sites in Sabah in Malaysian Borneo.

This report presents preliminary findings of an ongoing investigation to identify cases of acute febrile illness among athletes who participated in the EcoChallenge Race in Borneo during August 2000. Preliminary laboratory test results indicate the probable cause of illness to be leptospirosis, a spirochete infection. The event involved jungle trekking, open water swimming, river and ocean paddling, mountain biking, canyoneering, scuba diving, and spelunking. Participating were 76 four-person teams from 26 countries, including 37 teams from the United States. Subsequently, nine other EcoChallenge participants who became ill were identified in California (five in San Diego County, two in Orange County, and two in Los Angeles). To identify additional athletes with febrile illness, an EcoChallenge participant list was obtained from race organizers, and a telephone survey was administered by CDC with the assistance of several state public health departments. As of September 13, 82 (53%) of 155 U.S.–based athletes have been contacted; 37 (45%) reported having fever and 12 (15%) were hospitalized. No deaths have been reported.