Aileen M. Marty, M.D.
Director, FIU Health Travel Medicine Program

The World Cup 2014 poses specific health risks to travelers because of who will attend and where and when it will be held.

The Three Ws

Who: 3.7 million visitors and participants from all over the world. The World Health Organization (WHO) classifies this as a Mass Gathering because of the great number and diversity of people attending or participating.

Where: Brazil. The World Cup will feature events in 12 cities throughout Brazil from Manaus in the North, where there will be tropical conditions, to Curitiba and Porto Alegre in the South, where the weather will be cool. The great variation in climate in the different cities where the games will be played create a significant risk for the transmission of imported or endemic infectious diseases, especially diseases that are easily transmitted as a result of people gathering in close contact. PAHO, the Pan American Health Organization (a regional arm of WHO), and the Centers for Disease Control (CDC) note that these conditions increase the risk for seasonal influenza. PAHO is already reporting significant influenza activity in Brazil, mostly H3N2 flu viruses (http://ais.paho.org/phip/viz/ed_flu.asp), but also H1N1 virus that causes swine flu.

When: June 12- July 13. This falls during the winter season in the Southern Hemisphere, when influenza risk is highest for Brazil.

CDC Urges World Cup Travelers to get Flu Vaccine

The CDC is recommending that travelers to the World Cup in Brazil, who have not yet gotten a flu vaccine during the 2013-14 season, get vaccinated now. The flu vaccine is the single best way to protect against influenza. You should get vaccinated at least two weeks before traveling since it takes about two weeks for protective antibodies to develop.  Vaccination is particularly important for people at high risk of developing serious complications from flu including children under five years of age, pregnant women, adults 65 and older, and people with immunologic problems and chronic medical conditions like asthma, diabetes and heart disease.

Other Risks:

The WHO warns that in addition to influenza, the close proximity of multiple asymptomatic but infected people in one country increases the risk of transmission of diseases such as tuberculosis, as well as tropical diseases endemic to Brazil, such as malaria, dengue, leishmaniasis, yellow fever, hantavirus, leptospirosis, and Chagas disease, among others.  Dengue poses a significant risk in all states, including the host cities. Vaccination against yellow fever is recommended except for travelers who will only visit coastal areas. If you are visiting high-risk areas for malaria, you may need anti-malaria pills. Chikunguya fever may also be a threat for Brazil.

Don’t just Blame it on Rio

As a long-time advisor to the WHO on Mass Gatherings, I know how much work goes into ensuring these events take place in a positive atmosphere, but nothing can take the place of personal prevention and precaution. If you’re a fan planning to attend the World Cup, you should first visit a travel-medicine clinic and obtain vaccinations, preventative medications, and other medical advice depending on where you plan to go. Make sure World Cup fever is the only one you catch and bring back home with you.

May 30, 2014