Can Running Marathons Make You Sick?

Can running a marathon make you sick? As a health inspector, it’s something I think about every time I run an event. I think about the types of germs I’ll interact with during the event, how those germs will move in that environment and whether it all will pose a health risk to me. Here is a story of how it could happen at a marathon and what you can do to keep yourself safe. 

Our story begins at the All American Marathon. Following her pre-race ritual, Runner X arrives at the starting corral about 30 minutes before the start. Her stomach has been cramping for the past few hours. Could it be pre-race jitters or the pasta dinner the night before? What she doesn’t realize at the time is that she is experiencing the first symptoms of a norovirus infection (aka “stomach flu”). But, she had been training for this event for months and she wasn’t going to let an upset stomach keep her from running this marathon.

She keeps the body under control until about mile 10, when the stomach cramps get intense. The course map indicated that there would be porta potties at the mile 13 water station, so if she decides to pick up the pace to get there before the worst happens. She gets lucky, the bladder holds till she arrives at the porta pottie and there is no line. It’s a bad bout of diarrhea. Mixed with lots of gas, it explodes unto the toilet seat and all over her butt. She does her best to clean herself up, but some poop manages to make it on her hand. She doesn’t notice it, unlatches the lock and moves the door handle with her virus-contaminated, poopy hand. Before leaving the area, she notices a bowl of pretzels. They might settle her stomach so she decides to take some. While attempting to grab a couple, she spreads her virus-contaminated poop unto the pretzels remaining in the bowl. She then continues on down the road. 

Nature calls for Volunteer Y, who happens to be working the mile thirteen water station. He grabs the latch and locks the door before doing his business. Some microscopic drops of Runner X’s virus-contaminated poop make it onto his hands. Unfortunately, there was no way to get a handwash sink out here, so he goes back to the station and uses some hand sanitizer. The problem is the hand sanitizer neither removes nor kills the norovirus. A large blob of runners are coming into the station, so Volunteer Y grabs some drink cups and stations himself for distribution. He holds cups from their tops between his fingers. In fact, his fingers almost touch the liquid inside. That way, he can hold lots of cups and the runners can easily grab them as they pass through the station. What he doesn’t know is that he has just contaminated the drinks and now the runners will be drinking the virus. By the end of the day, Volunteer X gives out several hundred drink cups to runners. A hundred more runners will touch the handle on the porta-pottie and then get the poop onto their drinks or fuel with their contaminated hands. A few dozen more eat the contaminated pretzels. All end up exposed to Runner X’s virus. Within 72 hours, several hundred people have developed severe diarrhea symptoms.

Given that this story could happen at any marathon, what can a runner do to keep themselves from getting sick?

• First of all and most importantly, if you have any illness with diarrhea or vomit symptoms, DON’T RUN THE EVENT OR VOLUNTEER TO WORK. Stay home. Yes, your poop or vomit (even microscopic drops of it) could literally make hundreds of people sick. Do you want the responsibility for all their vomit/diarrhea on your hands?

• Water stations should have a handwash station. Here is an easy way to make one. Get a cooler that has the type of nozzle that allows water to flow without you touching it. Clearly mark it for “Handwashing Only” and keep it in an area separate from the liquids for the race cups. Keep pump liquid soap, paper towels and a trash can handy. You don’t want your volunteers touching any of the hand wash station after their hands are clean.

• Consider using gloves to handle the cups and snacks. Consider using a gloved hand to give the snack to runners so they don’t contaminate your snack supply. I was pleasantly surprised to see volunteers using gloves at all the water/snack stations during the 2010 Oklahoma City Marathon. (You didn’t have to wear the moon suits however…thanks for putting my safety first).  

• Handle cups from the bottom and encourage runners to take them off a table to minimize person-to-person contact. If you have to hold the cup for the runner, avoid putting your fingers (even gloved ones) inside the cup or on the cup lip. 

There is no way to be 100% safe, but take a health inspector's advice. Just following these few simple guidelines will go a long ways toward keeping the germs from making you or others sick.