The World Cup presents a unique challenge for public health authorities. In the coming weeks, dozens of teams from around the world, along with millions of their devoted fans, will descend on major US cities.<\/p>\n
This is the largest tournament in FIFA history, with 39 teams setting up training camps in the United States. The first match in the country will take place on June 12 in California, and the last one will be held more than a month later, on July 19, in New Jersey.<\/p>\n
The scale of these competitions is incomparable to the Super Bowl or even the Olympic Games, which are typically held in a single city and over a shorter period of time. Football fans typically travel en masse with their teams from city to city for matches.<\/p>\n
Inevitably, some will arrive sick or become ill along the way.<\/p>\n
Despite the ongoing outbreak in the Democratic Republic of Congo and enhanced screening of arriving passengers from affected areas, experts say the likelihood of the Ebola virus spreading at World Cup matches or while watching live broadcasts is extremely low. Ebola is not transmitted through the air, but through direct contact with the bodily fluids of an infected person. Healthcare workers and caregivers are at the highest risk of infection.<\/p>\n
A more common virus is the highly contagious measles, which causes several large outbreaks across the United States.<\/p>\n
\u00ab"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 ideal places for the measles virus to spread.".<\/p>\n
The measles rash can take up to 14 days to appear, so an outbreak before the tournament is over is entirely possible. Since the incubation period can last up to three weeks, foreign fans could potentially become infected while in the United States and bring the virus back to their home countries.<\/p>\n
Some matches will be held in Mexico and Canada, where thousands of measles cases have also been reported. The Pan American Health Organization is urging health officials in host cities to strengthen surveillance for measles outbreaks before the games begin.<\/p>\n
Dr. Marcus Plesia, director of the Fulton County Board of Health in Georgia, which includes Atlanta, said his staff has been preparing for months, ensuring an adequate supply of vaccines and immunoglobulin injections, which in some cases can be administered after exposure. "I've specifically asked our staff to develop a contingency plan for a measles outbreak," he said.<\/p>\n
The team considered a variety of scenarios: what if, for example, a traveler were diagnosed with measles? How would health officials ensure that the traveler, their friends, and relatives were isolated in hotel rooms, especially if they were not U.S. citizens?<\/p>\n
\u00ab"Measles is a complex issue," Plesia said. "People might come here for the World Cup and get infected, but they might not be able to return to their home countries before they get sick.".<\/p>\n
In the United States, the summer has seen a lull in the spread of influenza and COVID-19. However, in some parts of the Southern Hemisphere, winter is now underway. "There's a fairly high probability that people infected with influenza could travel from that region, and that we'll see respiratory infections we're not used to seeing in the summer," Pekosz said.<\/p>\n
What if these travelers bring with them a disease rarely encountered by American doctors, such as malaria or dengue fever? "These illnesses may take a little longer to diagnose," Pekosz said. "So treatment may not begin as quickly as if the person were in their home country.".<\/p>\n
Even more dangerous infectious diseases are nasty stomach infections such as norovirus and rotavirus, which can be spread through contaminated or spoiled food.<\/p>\n
\u00ab"Health organizations in the cities hosting World Cup matches are responsible for ensuring the safety of all food served," said Plesia. His team inspects temporary vendors and food trucks located at festivals and other public events daily. "This is perhaps our biggest challenge.".<\/p>\n
The Centers for Disease Control and Prevention is finalizing a dashboard for local and regional health officials. More than 30 staff members will be monitoring wastewater levels and assisting local health officials with these metrics. Another 170 or so staff members are on standby in case states require assistance with an outbreak or other serious health issue related to the games.<\/p>\n
Last week, Georgetown University and MedStar Health in Washington, D.C., separately launched the Health Security Operations Center to collect and analyze health data related to World Cup matches across the country, including wastewater contamination detections, electronic health record data with personal information removed, and real-time information from emergency responders.<\/p>\n
\u00ab"If suddenly a group of people came into the emergency department with nausea, vomiting, and diarrhea, you would try to correlate that with wastewater testing data that indicated, say, a norovirus outbreak," said Dr. Ethan Booker, chief medical officer for telemedicine at MedStar Health and vice president of healthcare innovation at the MedStar Innovation Institute.<\/p>\n
Rebecca Katz, director of Georgetown University's Center for Global Health Science and Security, said the team will also track mobility data\u2014monitoring the movement of crowds of fans from one city to another\u2014and provide regular situation reports and a daily briefing. Both reports and briefings will be publicly available.<\/p>\n
Booker said all preparations for potential problems should instill confidence in the public.<\/p>\n
\u00ab"I want people to come to the U.S., have a great time, support their teams, and feel that sense of community," he said. "If we do a good job, people won't notice, and it will look like success.".<\/p>\n
This article was originally published on NBCNews.com.<\/p>","protected":false},"excerpt":{"rendered":"
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