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Health advisory: Outbreak of aeromonas skin infections associated with athletic event in Sonoma County

August 28, 2023

On August 24, 2023, Sonoma County issued a Health Alert and Media Advisory regarding a Tough Mudder Endurance event that took place on August 19-20, 2023 in Sonoma, CA. Multiple event participants reportedly developed symptoms of rash, sometimes accompanied by fever, myalgias, nausea/vomiting or respiratory symptoms, often 24 hours after exposure to mud at the event. Culture results implicate a pan-sensitive Aeromonas species. Aeromonas species are Gram-negative rods that can cause a range of serious infections. Prompt evaluation of any symptomatic patients is strongly recommended, and empiric antibiotic treatment, until culture results are obtained, should be strongly considered.

To report cases to the County of Santa Clara Public Health Department, complete and submit a CMR reporting as "Unusual/Other" with a note that the patient participated in the Tough Mudder event. Fax the completed form to (408) 885-3709 or email [email protected] within 1 business day.


Actions Requested of Healthcare Providers:

  • Promptly evaluate persons experiencing symptoms who were at the Tough Mudder event on August 19-20, 2023 in Sonoma, CA.
  • Cultures are recommended if possible, and empiric treatment for both Gram-negative Aeromonas species and Gram-positive bacteria should be strongly considered. Use antimicrobial susceptibility testing to guide completion of treatment.
  • Complete and submit CMR reporting as "Unusual/Other" with a note the patient participated in the Tough Mudder event. Fax the completed CMR to (408) 885-3709 or email [email protected] within 1 business day.
  • For clinical guidance, please email [email protected] or call (408) 885-4214 during business hours; after hours you may page the Health Officer on call via (408) 998-3438.
     

Actions Requested of Laboratories:

  • Report any positive cultures of Aeromonas spp. since August 20, 2023 to the County of Santa Clara Public Health Department via Electronic Laboratory Reporting (ELR).
  • If unable to submit via ELR, please fax culture results to (408) 885-3709 or email to [email protected].


References:

  1. Sonoma County issues Health Advisory for Tough Mudder race participants. Sonoma County Department of Health Services. 2023.
  2. Outbreak of Aeromonas Skin Infections Associated with an Adventure Race, Sonoma, California. California Department of Public Health. 2023.
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