ECDC assesses public health risk for Olympic Games in Brazil
The agency advised travellers to take standard hygiene measures to decrease the risk of gastrointestinal illness such as use of bottled drinks and mineral water and factory-produced ice cubes, eating thoroughly cooked meat and fish, serving mixed meals such as feijoada (a typical Brazilian dish) or lasagne at temperatures above 60°C and salads at below 5°C, and sanitising all fruits and vegetables before eating them.
It added people should consider the general hygiene conditions when having common local products, such as freshly-made fruit juices, coconut water, drinks and cocktails.
ECDC said the overall risk of importing food- or waterborne disease from Europe to Brazil was ‘very low’.
No outbreaks were reported during the last Olympic Games in London in 2012, except for a few gastrointestinal and respiratory infections. There were also no public health events of potential international concern during the FIFA World Cup hosted by Brazil in 2014.
During this World Cup, ECDC enhanced epidemic intelligence activities and recorded three reports of food and waterborne illnesses.
International mass gatherings pose a risk for communicable disease outbreaks and rapid spread around the world, said ECDC.
Average foodborne outbreaks per year
Although there have been advances in food and water hygiene in Brazil during 2000 to 2013, the Brazilian Ministry of Health reports an average of 665 foodborne outbreaks per year.
Causative agents of these infections were, in order of frequency, Salmonella spp., Staphylococcus aureus, E. coli and Bacillus cereus. The settings most often associated were private residences, followed by food outlets and pastry shops.
Health risks with mass gatherings
Documented infectious disease threats associated with mass gatherings in the EU or other international settings include E. coli O157 cases at a music festival in the UK in 1997, Legionnaires’ disease cases during the football Euro Cup in France 1998, a norovirus outbreak during the 2006 FIFA World Cup in Germany and a salmonellosis outbreak following a street festival in Newcastle with more than 400 associated cases in 2013.
In the last two decades, the cause of diarrhoeal diseases in the general population shifted from bacterial infections through the faecal-oral transmission to viral infections through person-to-person transmission.
WHO classifies Brazil as a country with intermediate endemicity of hepatitis A and prone to such outbreaks. The majority of European countries are classified as very low or low.
Almost all EU/EEA countries are participating in Rio 2016 and a large number of EU travellers will visit the country.
They take place during the southern hemisphere winter, and climate/weather conditions will vary significantly, ranging from the tropical warmth in the northern and north-eastern regions to chilly weather in the southern region.
The 2016 Summer Olympics are from 3–21 August and more than 10,500 athletes from 205 countries will participate.
The 2016 Paralympics will take place from 7–18 September, involving 4,350 athletes from 176 countries.
ECDC will conduct enhanced epidemic intelligence surveillance for communicable diseases from 1 to 28 August.
