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Updated: Apr 24, 2026

A Preclinical Model of Exertional Heat Stroke in Mice
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Infection as an Exertional Heat Illness Risk Factor: A Prospective Cohort Study.

Hayley C Tyson1, Michael J Zurawlew1, Megan R Robinson1

  • 1School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UNITED KINGDOM.

Medicine and Science in Sports and Exercise
|April 23, 2026
PubMed
Summary
This summary is machine-generated.

Respiratory infections significantly increase the risk of severe exertional heat illness (EHI) in military recruits. Avoid strenuous activity during respiratory illness to prevent severe EHI.

Keywords:
HEAT INJURYHEAT STRESSHEATSTROKERESPIRATORY INFECTION

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Area of Science:

  • Military Medicine
  • Environmental Physiology
  • Infectious Disease Epidemiology

Background:

  • Strenuous physical activity poses a risk of fatal exertional heat illness (EHI).
  • The link between respiratory infection and EHI risk is unclear, with limited objective data.
  • This study aimed to objectively investigate the association between respiratory infection and EHI.

Purpose of the Study:

  • To determine if respiratory infection increases the risk of exertional heat illness (EHI).
  • To quantify the association between respiratory infection symptoms and EHI severity.
  • To explore physiological markers associated with respiratory infection and EHI.

Main Methods:

  • A prospective cohort study of 807 UK infantry recruits undertaking a loaded march.
  • Respiratory infection symptoms assessed using the Jackson Common Cold Questionnaire and clinical pathology.
  • Exertional heat illness (EHI) classified as mild or severe; logistic regression used for analysis.

Main Results:

  • Severe EHI risk increased four-fold with respiratory infection symptoms prior to and during the march (OR=4.09).
  • Respiratory infection was linked to increased pathogen expression, systemic inflammation (CRP), and higher pre-march body temperature.
  • No association found between respiratory infection symptoms and mild EHI susceptibility.

Conclusions:

  • Ongoing respiratory infection is associated with a significantly higher likelihood of severe exertional heat illness (EHI).
  • Individuals engaging in strenuous activities, such as athletes and military personnel, should avoid such exertion when experiencing respiratory infection symptoms.