Canadians who attend the World Cup and Olympics in Brazil over the next two years may return home with more than just fond memories of the momentous sporting events, a new multi-national study suggests.
Data on past visitors to the South American country suggest the flood of foreign sports enthusiasts will bring back cases of malaria, dengue fever, nasty skin conditions and other maladies from a region that is home to an array of unpleasant infectious disease.
“Many [international] sporting events are held in Europe or in a place that is relatively developed,” said Dr. Jay Keystone, a Toronto-based travel-medicine expert who co-authored the report. “Although Brazil is developed, we’re now talking about people going into endemic areas with diseases that are potentially life threatening.”
Thousands of Canadians head yearly to destinations like southeast Asia and India that have similar infectious-disease profiles. But fans who fly to Brazil over the next two months for the Cup or in 2016 for the Olympics may not be the kind of cautious travellers who would automatically think to guard against malarial mosquitos, tainted water and other threats, he noted.
The good news is that the infection risks are largely preventable if fans get vaccinated where appropriate and take other simple precautions, he said. That might even include packing condoms for potential encounters in a country of “beautiful people” and relatively widespread HIV.
“You’re not going to New York. You have to think of health issues,” said Dr. Keystone.
Representatives of the Brazil embassy in Ottawa could not be reached for comment on the research.
The World Cup, to start next month, and the 2016 Summer Olympics are each expected to attract about 600,000 international visitors, notes the study just published in the journal Clinical Infectious Diseases.
Some concerns have already been raised about the high rate of violent crime, and the potential for political unrest.
The authors stress that Brazil has made great progress in the last three decades in providing safe water, sanitary facilities and health care — reducing deaths from communicable illness — but say malaria and yellow fever remain endemic in parts of the country, while dengue fever has caused massive outbreaks recently.
To gauge what kind of disease threats foreigners face, researchers headed by Mary Wilson of Harvard University’s School of Public Health looked at data from the GeoSentinel Surveillance Network, a sampling of travel-medicine clinics on six continents.
About 40% of the patients returning from Brazil over a 16-year period had skin conditions, the most common being cutaneous larva migrans, where tiny round worms penetrate the upper layer of skin and sometimes begin to move slowly under the surface, causing severe itchiness.
Next most common was diarrhea triggered by various pathogens, and then fever-causing illnesses like dengue and malaria.
Dengue, which is spread by mosquitos and usually causes little more than severe flu-like symptoms, is present throughout Brazil, especially in cities. Malaria is endemic in the northwest, covering two cities that will host World Cup matches.
Yellow fever, passed on by the same type of mosquito as dengue and killing about 7% of patients, may be the most serious infectious threat, though none of the Brazil travellers seen in the sentinel clinics had it. It is not considered a risk in the country’s main coastal cities, but the study authors urge vaccination for yellow fever in areas further inland, which take in five World Cup and two Olympic sites.Fans planning to attend either event should first drop in to a travel-medicine clinic and obtain vaccinations or anti-malarial drugs, depending on where they plan to go, said Dr. Keystone. Once on the ground, they should be careful to use mosquito repellant, spurn tap water and limit eating of street-stall food, he said.
With such precautions, the vast majority will stay healthy, said the physician, who heartily recommends the cultural benefits of visiting less-developed parts of the world.
In fact, to put the infection threat in context, he said the most common way that foreign travelers die — accounting for 40% of fatalities — is in motor-vehicle accidents. Perhaps the most important health-protecting measure fans can take in Brazil is avoiding travelling by rural road at night, said Dr. Keystone.