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Zika gets all the headlines, but visitors of the 2016 Olympic
and Paralympics Games face bigger worries from the relative
mundanities of upset stomachs, traffic accidents, and muggings,
public health experts warn.
As many as 500,000 tourists from 206 countries will travel to
Rio for the games, which begin with opening ceremonies on the
evening of August 5. Brazil is the epicenter of the Zika
outbreak that has spread to 50 nations or territories in the
last year. But in reality, Zika should be low on the list of
“During the Games, mosquito-borne Zika virus transmission is
expected to be low,” a CDC analysis
has concluded. That’s largely because the Olympics and
Paralympics will be held in August and September, winter months
in Brazil when cool and dry weather typically reduces mosquito
A Yale School of Public Health study
released this week, for example, found that even if Olympic
tourists lived under the same conditions as local Rio
residents, without air conditioners and screened hotel windows,
only about 80 would catch Zika, and just 16 would feel any
Once the Games are over, only four countries — Chad, Djibouti,
Eritrea, and Yemen, which are sending about 60 people in all —
face a higher-than-normal risk of Zika spreading to their
country because of the Olympics, the CDC said. That’s because
hardly anyone from those four countries travels to Brazil, so
the Games will slightly increase the odds that an infected
traveler returns home with the disease to spread to heretofore
uninfected mosquitoes. For everyone else, it’s a wash.
In February the World Health Organization declared a
public health emergency over the spread of Zika in Brazil.
Health authorities were particularly worried about the
thousands of severe brain birth defects linked to the
mosquito-borne virus, and the rarer cases in adults of
post-infection paralysis caused by Guillain-Barre syndrome.
After the WHO’s declaration, Brazil’s sports minister George
Hilton issued a statement saying that cancelling the Olympics
because of Zika was “not in discussion.” Yet calls for the
cancellation of the Games have continued, for example from the
Harvard Public Health Review and a May letter signed by 238
health experts. A few athletes,
mainly golfers, have dropped out of the Games because of
But they’re not being very rational, experts say.
“The bigger drama is over water quality,” Neil Silverman, an
obstetrician at the Ronald Reagan UCLA Medical Center, told
BuzzFeed News, who now regularly advises patients on travel to
Brazil. “That doesn’t mean the risk of Zika isn’t there. But
from a public health perspective, it doesn’t look like there is
a big risk of more people being infected because of the
“Rio thy sea, endless beaches. Rio you were made for me,” sang
Brazilian musician Tom Jobim in Samba do
Avião, celebrating the “marvelous
city.” If you’re headed to the Olympics, in all likelihood,
you’ll have a wonderful, healthy time in Rio de Janeiro,
reveling in the city’s beautiful beaches, stunning mountains,
and carnival atmosphere.
But if you’re intent on worrying about something, here’s what’s
more concerning than Zika.
Rio’s Guanabara Bay is so polluted that Olympics organizers
plan to have helicopters scanning the water for
Raw sewage spilling into the bay means “some athletes, using
these sites at times of poor water quality, may suffer from
illnesses such as stomach upsets and respiratory tract
according to the WHO.
Even for tourists who never go into the water, traveler’s
illness has that name for a reason, Silverman said. “Diarrhea
is so common in travel that I just always tell people to
prepare for it.”
Hepatitis A is also something people can catch from tainted
food or water, and Brazil “is prone to outbreaks,” according to
the WHO. Although it is too late to get the vaccine (which
comes as two shots, spaced three months apart) in time for the
Games, Silverman said, even the first shot can give some
protection a few weeks ahead of time.
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WHO’s William Perea said sunburn or sunstroke is the number one
health risk for tourists at the Games, speaking at
a July briefing. “Particularly for people standing outside
for long periods of time,” he added, you’ll want SPF 15 or
higher sunscreen applied every two hours to ward off the
sun, and a water bottle to ward off dehydration.
Summer in the northern hemisphere is winter flu season in
Brazil, Lin Chen of Harvard Medical School told BuzzFeed News.
“That means people should be washing their hands a lot.”
In a helpful round-up of
health risks to Olympics visitors released this month, WHO
starts by suggesting travelers have vaccinations for
diphtheria, Haemophilus influenzae type b, hepatitis B,
measles, mumps, pertussis, polio, rubella and tetanus.
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The WHO listed dengue and chikungunya viruses ahead of Zika in
its warning, just a few of the viruses that afflict travelers
to Brazil. “There are many others that are much more important
than Zika,” said the WHO’s Perea.
Dengue, carried by the same mosquito as Zika, is often seen as
a proxy for how the latter virus would spread, which is slowly:
The winter plunge in dengue cases started in Rio in the last
dropping from 8,700 cases in April to less than 700 in
Few Dengue cases have been identified in the city lately —
15 people out of a city of millions, in the last week of
June. And Zika cases are reported with similar frequency,
the latest report from the state government.
A 2014 study
of nearly 1,600 ill travelers found that hookworms, fly, and
flea infestation was the leading health complaint of travelers
to Brazil from 1997 to 2013, followed by diarrhea, and then
fevers from dengue or malaria.
The CDC also advises skipping swimming in
freshwater lakes in Brazil for this reason, due to the
threat of schistosomiasis. It’s caused by parasitic worms,
found in freshwater snails, that infect some 200 million people
That same 2014 study found 28 cases of HIV acquired by
travelers to Brazil, which points to the risks of sexually
transmitted diseases (including
Zika), Chen noted. The CDC
advises travelers to Brazil to abstain from sex or to use
condoms during vaginal, oral, or anal sex, something that
should continue for eight weeks after getting home, even
without any symptoms.
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Leaving illness aside, crime is also a worry in Rio: “Assaults
are common on beaches or in parks after dark,” according to the
US Department of State. “Even while driving, motorists can
be vulnerable to armed bandits on motorcycles who prey on
potential victims waiting at traffic lights or in traffic.”
Rather than driving yourself, the State Department suggests
people take a licensed taxi or Uber driver.
Or maybe stick to walking. “Traffic accidents and injuries,
mostly caused by motor vehicle crashes, are the leading causes
of death among travelers under the age of 55 years,” according
to the WHO.
Pedestrians need to be wary of Brazilian drivers at crosswalks.
Travelers themselves are a worry for Brazil, and for other
tourists. The Pan American Health Organization this week
reminded Olympics visitors to get their vaccinations for
measles, mumps, and rubella, concerned they might carry those
diseases to Brazil.
The mass gathering that looks most similar to the Olympics,
Chen said, with large international collections of tourists
coming together, is
the Hajj, the religious pilgrimage to Mecca, in Saudi
Arabia. Coughing and flu regularly
crops up among the two million people who make the
pilgrimage there every year. She also advises a lot of
handwashing, particularly before eating.
“Illness goes both ways,” Chen said. “Travelers can bring
diseases, and travelers can bring back diseases home. People
need to be careful.”