The World Cup presents a unique challenge for public health officials. Dozens of teams from around the world, as well as millions of their devoted fans – will descend on major American cities in the coming weeks.
It is the largest tournament in FIFA history, with 39 teams holding training camps in the United States. The first match in this country will take place on June 12 in California, and the last more than a month later, on July 19, in New Jersey.
The scale is not comparable to that of the Super Bowl or even the Olympic Games, which are generally limited to a single city and over a shorter period of time. Football fans tend to travel en masse with their teams from city to city for matches.
Inevitably, some will arrive ill or become ill during their journey.
Despite the ongoing outbreak in the Democratic Republic of Congo and increased monitoring of passengers arriving from affected areas, experts say the chances of Ebola spreading during World Cup matches or broadcast nights are extremely slim. Ebola transmission is not respiratory; it is transmitted by direct contact with the bodily fluids of an infected person. Healthcare personnel and caregivers are at greatest risk of exposure.
A virus more likely to spread is extremely contagious measleswhich causes several significant epidemics in the United States
“I wouldn’t be surprised if we saw a measles outbreak linked to the World Cup,” said Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health. “Crowds are an ideal place for the measles virus to spread. »
It takes up to 14 days for the measles rash to appear, making an outbreak possible before the tournament ends. Since the incubation period can last up to three weeks, foreign fans could potentially be exposed while in the United States and bring the virus back to their home country.
Some matches will be played in Mexico and Canada, which are also dealing with thousands of measles cases. THE Pan American Health Organization is urging health officials in host cities to step up surveillance for measles outbreaks even before the games begin.
Dr. Marcus Plescia, director of the health board in Fulton County, Ga., which includes Atlanta, said his staff members had been preparing for months, ensuring they had an adequate supply of vaccines and immunoglobulin injectionswhich may be administered in some cases after exposure. “I specifically asked our staff to have a plan to combat measles in the event of an outbreak,” he said.
The team looked at a multitude of scenarios: what happens if a visitor tests positive for measles, for example? How could or would health officials keep this traveler and their friends and family isolated in hotel rooms, especially if they are not U.S. citizens?
“Measles is tricky,” Plescia said. “It’s possible that people will come here for the World Cup and be exposed, but they may not return to their home country until they get sick.”
Other potential spread of diseaseFlu and Covid levels are in a summer lull in the United States. But it’s winter in some parts of the southern hemisphere. “There is a good chance that people infected with the flu will come from this area and we will face respiratory infections that we are not used to seeing in the summer,” Pekosz said.
What if these travelers brought a disease that American doctors rarely see, like malaria or dengue fever? “It may take a little longer to diagnose people” with these illnesses, Pekosz said. “Treatments are therefore not implemented as quickly as they would be if a person were in their home country. »
Nasty stomach bugs such as norovirus and rotavirus which can be spread through contaminated or spoiled food.
“Public health agencies in cities hosting World Cup matches are responsible for ensuring that all food served is done so safely,” Plescia said. His team is responsible for daily inspections of temporary vendors and food trucks parked at festivals and other community events. “That’s actually the biggest win for us.”
The Centers for Disease Control and Prevention is finalizing a dashboard for local and state public health officials, with more than 30 staff tasked with monitoring wastewater levels and helping local public health authorities track. About 170 more people are on standby if states need help with an outbreak or other major health concerns related to gaming.
Separately, last week, Georgetown University and MedStar Health in Washington, D.C., launched a Health Security Operations Center to collect and analyze health data related to World Cup matches nationwide, including sewage detections, electronic health record data stripped of personal information, and real-time information from emergency personnel.
“If suddenly you have a bunch of people showing up in the emergency room with nausea, vomiting and diarrhea, you’ll look to see if you can coordinate that with wastewater data demonstrating, for example, a norovirus outbreak,” said Dr. Ethan Booker, chief medical officer of telehealth at MedStar Health and vice president of care innovation at the MedStar Institute for Innovation.
Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University, said the team would also monitor mobility data — observing crowds of fans moving from city to city — and offer regular situation reports and a daily briefing. Both will be available to the public.
Booker said any preparations for potential problems should reassure the public.
“I want people to come to the United States, have fun, support their teams and feel that sense of community,” he said. “If we do our job well, people don’t see it, and it would look like a success.” »
