title: Recent acute prerace systemic illness in runners increases the risk of not finishing the race: SAFER study V.
abstract: OBJECTIVE
  There are limited data on the negative effects of exercise in athletes with acute infective illness. The aim of this study was to determine whether a recently diagnosed prerace acute illness in runners affects the ability to finish a race.
  
  
  METHODS
  Runners were prospectively evaluated in the 3 days before the race for acute infective illness and then received participation advice using clinical criteria based on systemic or localised symptoms/signs. We compared the did-not-start and the did-not-finish frequencies of ill runners (Ill=172: localised=58.7%; systemic=41.3%) with that of a control group of runners (Con=53 734).
  
  
  RESULTS
  Runners with a systemic illness were 10.4% more likely not to start compared with controls (29.6% vs 19.2%) (p=0.0073). The risk difference of not starting the race in runners who were advised not to run the race compared with controls was 37.3% (56.5% vs 19.2%, p<0.0001). Compared with controls, runners with illness had a significantly (p<0.05) greater risk (any illness (5.2% vs 1.6%), systemic illness (8.0% vs 1.6%), illness <24 hours before the race (11.1% vs 1.6%)) and relative risk (prevalence risk ratio) (any illness=3.4, systemic illness=4.9, systemic illness <24 hours before the race=7.0) of not finishing the race.
  
  
  CONCLUSIONS
  Runners with prerace acute systemic illness, and particularly those diagnosed <24 hours before race day, are less likely to finish the race, indicating a reduction in race performance.
authors.affiliation: Department of Human Biology, UCT Research Unit for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Leigh
authors.initials: L
authors.lastname: Gordon
authors.affiliation: Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa.|IOC Research Centre, Pretoria, South Africa.
authors.forename: Martin
authors.initials: M
authors.lastname: Schwellnus
authors.affiliation: Biostatistics Unit, Medical Research Council, Parow, South Africa.
authors.forename: Sonja
authors.initials: S
authors.lastname: Swanevelder
authors.affiliation: Biostatistics Unit, Medical Research Council, Parow, South Africa.
authors.forename: Esme
authors.initials: E
authors.lastname: Jordaan
authors.affiliation: Institute of Sport and Exercise Medicine, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Wayne
authors.initials: W
authors.lastname: Derman
mesh_terms: D000208:Acute Disease / Q000453:epidemiology*; D056352:Athletes; D054874:Athletic Performance; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012306:Risk; D012420:Running
keywords: adherence; complications; exercise; illness; infections; neck check; return-to-play