Saturday, May 24, 2014

That Aside, Have A Good Time!

"Many [international] sporting events are held in Europe or in a place that is relatively developed."
"Although Brazil is developed, we're now talking about people going into endemic areas with diseases that are potentially life-threatening."
"You're not going to New York. You have to think of health issues."
Dr. Jay Keystone, travel-medicine expert, Toronto
The official match ball for the 2014 World Cup in Brazil. PHOTO: REUTERS 
 
Dr. Keystone is speaking with the authority of one who knows, with data on past visitors to Brazil giving more than adequate warning that the flood of World Cup enthusiasts who will enter the country will bring back with them more than fond memories of the sporting events they witnessed. According to a new multi-national study. In the past, such travellers have brought back with them cases of malaria, dengue fever, wretched skin conditions and allied maladies from a geography with its unfortunate share of infectious disease.

In Canada alone, travelling Canadians bring back with them annually similar maladies from their jaunts in southeast Asia and India, with infectious-disease reputations similar to that of Brazil. Fans who migrate to Brazil over the next two months for the World Cup, or later on into 2016 for the Olympics, would do well to give deep thought to guarding themselves against malarial mosquitoes, tainted water, and allied threats to human health.

While Brazil itself is mobilizing 157,000 soldiers and police to ensure against violence breaking out in its capital an various sport venues, and security is of immense importance during the event, those travelling from abroad, anticipating fun and games, entertainment and the time of their lives, may find themselves facing the health challenges of their lives if they're not sufficiently attuned to the potential health dangers they will face on their arrival.

Within Brazil, mass demonstrations, strikes and protests have brought out as many as a million people, angry and outraged that their government is hosting such world events.The protests have become violent at times. "Our feeling is that (the protests) will be smaller than the ones last June [over the Confederations Cup, a dress rehearsal for the World Cup]. But, sincerely speaking, we are prepared for any situation", journalists were told by Justice Minister Jose Eduardo Cardozo.

The protesters are angry over the more than $11 billion being spent to host the World Cup in a country with glaring social and wealth inequality and pressing needs in education, unaddressed issues in health care, housing and transport. Brazil boasts one of the world's worst crime rates. And, as the World Cup event comes ever nearer, there is a threat of a nationwide strike by federal police. At a time when 3-million Brazilians and 600,000 foreign tourists will be attending the events.

Infection rates are largely preventable if people exercise due diligence and become vaccinated where appropriate, advised Dr. Keystone. Slated to begin next month, concerns have been raised about the high rate of violent crime, the potential for political unrest, and the prevalence of malaria and yellow fever endemic to parts of the country. Dengue fever has caused massive outbreaks recently. While about 40% of people returning from Brazil over a 16-year-period were bedevilled by skin conditions.

A man shops for World Cup regalia at a store in San Paulo, Brazil. Fans planning to attend should use mosquito repellent, spurn tap water and avoid street-stall food.
AP Photo/Andre Penner   A man shops for World Cup regalia at a store in San Paulo, Brazil. 
 
The recently published study on the issues involved of which Dr. Keystone played a part, appearing in the journal Clinical Infectious Diseases, launched research headed by Mary Wilson of Harvard University's School of Public Health, examining data from the GeoSentinel Surveillance Network which samples travel-medicine clinics on six continents.

The most common skin condition brought back from Brazil is cutaneous larva migrans; tiny roundworms penetrating the upper layer of the epidermis, occasionally moving under the surface. Next was diarrhea, triggered by various pathogens, and following that in incidence was fever-causing illnesses like dengue and malaria. Dengue, spread by mosquitoes is present throughout Brazil.

Yellow fever, with the same type of mosquitoes as dengue being responsible for infection, kills about 7% of patients, yet presenting less of a threat in Brazil's main coastal cities, but rather inland. But Malaria and Dengue are present in two cities hosting World Cup matches. And Yellow fever venues take in five World Cup and two Olympic sites.

Dr. Keystone advises that fans whose plans are to attend either of these events should visit a travel-medicine clinic to obtain vaccinations or anti-malarial drugs. Once within Brazil, travellers should be alert to the use of mosquito repellent, pass on drinking tap water and appealing as it might seem, give an additional pass to consuming street-stall food.

And then, he added the most common way to heaven for foreign travellers -- 40% of fatalities -- is represented in motor-vehicle accidents. Avoid travelling on rural roads during the nighttime.

Brazil

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