Hundreds of thousands of people will travel to Rio de Janeiro this August to watch the finest athletes on the planet compete in the 2016 summer Olympics. But anticipation and worry is growing that Olympic athletes and those attending the competition may be risking infection with Zika.
The mosquito-borne virus most often causes only mild Zika virus symptoms — but not always. Zika is now known to also result in the devastating birth defect known as microcephaly and Guillain-Barré syndrome, a rare and sometimes fatal neurological disorder.
The virus has moved quickly through a large part of Central and South America. Brazil has been smackdab at the center of the outbreak, and Rio has been especially hard hit by the disease. So if you’ve already made plans and bought tickets to head to that city in a few months for the Olympics, or if you are considering whether to book reservations, you may be wondering if it’s time to rethink your trip.
If you are woman who is expecting, the answer is clear: Don’t go. The Centers for Disease Control and Prevention (CDC) and other health agencies urge women who are pregnant or might become pregnant to stay away from any location where Zika infections have been reported, and that includes Rio. (If any trip to an area where the virus is active is absolutely necessary, talk to your doctor first and strictly follow steps to prevent mosquito bites during your travels.)
However, for everyone else there’s not a definite answer yet about how potentially dangerous the threat in Rio could be in August. In fact, there are some outright disagreements in the public health community about whether making the trek to the Olympics is fairly safe — or foolhardy.
Amir Attaran, D.Phil, a biologist and professor both in the School of Public Health and the School of Law at the University of Ottawa, is calling for the 2016 Olympic games to be postponed or moved from Rio to another location where the virus is not so widespread.
In a commentary published in the Harvard Public Health Review, Attaran pointed out there are around 26,000 suspected cases of Zika in Rio, the highest infection rate of any state in Brazil. And he warned visitors to the Olympics could contract the virus, return home, and accelerate its spread across the globe.
“While Brazil’s Zika inevitably will spread globally — given enough time, viruses always do — it helps nobody to speed that up,” he wrote. "In particular, it cannot possibly help when an estimated 500,000 foreign tourists flock into Rio for the Games, potentially becoming infected, and return to their homes where both local Aedes mosquitoes and sexual transmission can establish new outbreaks. All it takes is one infected traveler and a few viral introductions of that kind, in a few countries, or maybe continents, would make a full-blown global health disaster.”
Now 125 public health experts, doctors and bioethicists from more than a dozen countries are following Attaran’s lead and publicly calling for the summer Olympics to be moved from Rio.
“We agree with the U.S. Centers for Disease Control recommendation that workers should ‘Consider delaying travel to areas with active Zika virus transmission’,” the group wrote in a letter to the World Health Organization (WHO). “If that advice were followed uniformly, no athlete would have to choose between risking disease and participating in a competition that many have trained for their whole lives.”
“To prejudge that ‘there’s not going to be a lot of problems,’ before reviewing this evidence [on the virus' effects] is extremely inappropriate of WHO, and suggests that a change in leadership may be required to restore WHO’s credibility.”
The WHO sounded an alarm months ago about the potential seriousness of Zika, declaring the epidemic a health emergency. However, WHO and the Pan American Health Organization (PAHO) have issued a statement that does not call for moving or canceling the upcoming summer Olympics.
The organizations explained they are working with the government of Brazil to reduce the mosquito population and lower the risk of infection in that country. They are also encouraging athletes and those attending the summer Olympics to protect themselves proactively from the virus by learning how to avoid mosquito bites and, because the virus is now know to be spread sexually, by practicing safer sex.
But this may not be the final word on the Zika virus and the Olympics from WHO and PAHO. The organizations stated they will continue to monitor the risks in Brazil and provide updates on outbreaks and developments in prevention intervention between now and August and beyond on the WHO website.
"I do share the concern of some athletes and travelers,” WHO Director Margaret Chan said at a recent press briefing. “It is very much an individual decision. The role of WHO is to provide them with support so they can make the right decision."
Hope Solo, goalkeeper for the U.S. Olympic women’s soccer team, told reporters at a press conference she’s not sure she’ll compete in Rio. "All I can do is speak for myself,” she said. “If the Olympics were today, I would not go. I believe we have some time to get our doubts and questions answered."
Several Olympic teams have already come up with protective measures for athletes to help lower the odds they will contract the Zika virus. Australia is providing their Olympians with anti-viral condoms to promote safer sex, and South Korea is issuing special mosquito-repellent uniforms to that country’s Olympic athletes. Frank Busch, the U.S. Olympic swimming national director, has notified all national swim team athletes and coaches that a pre-Olympic training camp will not be held in Puerto Rico in July because of concerns about the virus epidemic there. Instead, Olympic team swimmers will train in Atlanta.
The United States Olympic Committee (USOC) has not issued its own statement for athletes and staff about Zika, other than agreeing with recommendations issued by the CDC and WHO. A report that some Olympic officials told sports federation athletes and Olympic staff members they should consider not participating in the Olympics if they are concerned about their health was called inaccurate by USOC spokesman Patrick Sandusky.
"Team USA looks forward to the Games and we did not, would not and will not prevent athletes from competing for their country should they qualify," Sandusky said.
A Brazilian research team predicts the Rio Olympics will result in only 15 Zika infections among foreign visitors, according to Reuters. The study follows another group of Brazilian scientists who project the Olympics will result in no more than 16 new cases. Neither study, however, assessed the risk of just one traveler carrying the virus back home to their own country, a fear of those calling for the Olympics to be moved.
So what’s the bottom line about whether the Zika epidemic should keep you from heading to Rio if you have your heart set on seeing the Olympics in person? The decision has to be made by you and your doctor, factoring in any health conditions you may already have and your willingness to take all precautions possible to avoid infection with the Zika virus.
The WHO urges anyone planning a trip to Rio for the Olympics to follow this advice:
For regularly updated information about travel to areas where Zika infections are being reported, visit the CDC’s Zika Travel Advisory page.
June 07, 2016
Christopher Nystuen, MD, MBA