Tough Mudder races are collaborative obstacle courses in the mud.Photo:Tayfun Coskun/Anadolu Agency via Getty Images

Tayfun Coskun/Anadolu Agency via Getty Images
Several people in California’s Sonoma County have fallen ill after competing in a Tough Mudder race — a collaborative obstacle course challenge in muddy terrain — on August 19 and 20 at the Sonoma Raceway.
Their symptoms were so severe, ranging from skin rashes to vomiting, that it prompted the county health department to issue an advisory.
“The Tough Mudder race involved extensive skin exposure to mud. Most affected persons have pustular rash [rashes with pus-filled blisters], fever, myalgias [muscle pain], and headache,” the advisory from theSonoma County Department of Health Servicessaid.
However, the advisory continued that the symptoms could have a wide range of causes — some potentially deadly.
Tough Mudder participants get covered in mud during the endurance event.Tayfun Coskun/Anadolu Agency via Getty Images

Never miss a story — sign up forPEOPLE’s free daily newsletterto stay up-to-date on the best of what PEOPLE has to offer, from juicy celebrity news to compelling human interest stories.
“These symptoms could be indicative of a minor illness called Swimmers’ Itch, but they can also indicate a staph infection or other more serious bacterial infection such as Aeromonas.”
Staph infections, however, can turn deadly, theMayo Clinic says.While symptoms vary, staph usually presents with pus-filled boils, impetigo (a painful rash), and cellulitis.
If the staph bacteria enters the bloodstream, it can cause a deep infection known as bacteremia, which can impact internal organs, and muscles.
While staph is generally treated with antibiotics, theMayo Clinicpoints out that antibiotic-resistant strains of staph may require intravenous antibiotics.
The CDC saysCalifornia is the first stateto mandate reporting of Aeromonas infections.
The Sonoma County health department also advised: “If you participated in the race and have a rash with fever or other symptoms, please see your medical provider or, if you do not have a medical provider, your local emergency department. You may wish to take this Advisory with you. Incubation period is 12 to 48 hours.”
A representative for Tough Mudder said in a statement to PEOPLE that all participants and spectators from the event have been contacted and urged to seek medical attention if they are experiencing any symptoms. Additionally, they are working closely with the County of Sonoma Health Services to investigate the matter.
“As it has been for the thousands of races we have put on for millions of racers across the globe, the health and safety of the Tough Mudder community is always our top priority,” the statement said. “All necessary protocols were followed in preparation for, and during, the event. Our thoughts are with those affected and we are actively investigating to understand exactly what occurred.”
ATikTok videoof the event showed participants assisting one another as they scaled a steep, muddy incline, and climbing in and out of murky water-filled ditches.
Andanother TikTokerwho participated in the Tough Mudder challenge shared a video of rash-covered knees, writing, “little did we know that chills, fever, body aches (headache) and infection would follow.”
“We hosed off, changed clothes then showered well after,” Lindsay Sirmon wrote in theTikTok caption. “After drs. visits, we are on antibiotics and topicals.”
But as Sirmon pointed out, “I mean, it is in the mud, I get that.”
source: people.com