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Zika Virus And How Sports Spread Disease

Major sporting events helped spread Zika Virus and it isn't the first time this has happened

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Seems bad — Getty Images
Feb 05, 2016 at 12:43 PM ET

Are you throwing a Super Bowl Party? Yes? Well, congratulations, you could end up killing your grandmother.

According to a study recently published in the American Journal of Health Economics, Super Bowl parties increase local flu deaths. By analyzing county-level data on influenza mortality from 1974 to 2009, researchers found that having the home team in the running for the Ol’ Lombardi Trophy caused an 18 percent increase in deaths from the flu in persons over 65.

Interestingly, the study found no such surge in flu mortality in the host cities themselves. The reason, they think, might be that the Super Bowl is often held in warmer cities, limiting flu transmission.

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It’s a case where climate and weather appear to work together in favor of those trying to stay healthy. But as we’re seeing with the Zika virus, we humans are not always so lucky.

Researchers believe that Zika came to Brazil during the 2014 World Cup, hitching a ride to the South American country with visitors from French Polynesia, an area where an outbreak of the disease had recently occurred. A growing body of evidence links the virus to severe birth defects like microcephaly and, despite the relatively mild course of the disease in the majority of cases, Zika appears to pose a significant threat to the currently gestating generation.

In response, the WHO has declared a Global Health Emergency, something they have only done three other times: first for an emerging influenza pandemic in 2009, then when polio threatened to surge, and most recently for Ebola. Zika has already spread to 20 other countries and territories in the Americas, including the United States, which has seen its first case of sexual transmission of the virus.

Women in the affected areas have been cautioned against pregnancy until more is known—and can be done—about the outbreak. The picture is grim, but these are the early days; not a lot is known about the virus and the details of its apparent causal link to birth defects. What we do know is that it’s well-suited for a home in Brazil and elsewhere: Zika is spread by Aedes mosquitoes, handy little disease vectors that coexist with millions of Americans in the bottom half of the country.

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So what does this mean for the Zika outbreak and the pending 2016 Olympics in Rio de Janeiro? It’s not like the WHO is absent the protocols and suggestions necessary to monitor and address disease transmission at mass gatherings, global sporting events included.

Defined as “events attended by sufficient number of people to strain the planning and response resources of a community, state or nation,” there are a series of considerations that must be made when responding to an outbreak within the context of big-ass crowds.

Planning these events properly requires the ability to detect and monitor event-related cases of the disease in question, protocols for reducing the spread of said disease, the capacity to manage and treat those that fall ill, and the ability to disseminate helpful public health messages to the population, locals and visitors combined.

It’s also critical to consider the local level of disease activity, the relative vulnerability of those affected, and, importantly, the relationship of the event duration with regard to the incubation period of the disease. If the disease takes longer to present itself than the event itself, then event-related cases are going to show up in a much more widespread fashion, with participants bringing the pathogen back to their home country, further muddying the already complex waters of a disease outbreak.

It’s possible to do this kind of surveillance well. For the 2006 World Cup in Germany, the host country bolstered its capacity for reporting and reacting to cases of infectious disease by increasing the frequency that municipalities reported cases to the state from every three days to daily; they also boosted communication among all members of the disease surveillance system.

By doing this, Germany identified and reacted to a norovirus outbreak in the International Broadcast Center during the games, and were able to epidemiologically link the outbreak to four cases directly related to the World Cup. They saw that it was happening in real-time and were able to move on that information.

But what about Rio? It’s a city already mired in economic woes, not the least of which stem from their desire to host a global athletic competition. Does Rio have the surveillance capacity and healthcare infrastructure to meet this outbreak head-on? On top of that, the three to twelve day incubation period of Zika and its propensity to cause only mild disease in most means that those at greatest risk—pregnant or soon-to-be pregnant women—won’t benefit from people getting sick and staying home. Which is, by the way, the best way to keep diseases from spreading at mass gatherings.

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With so much uncertainty and rightful fear surrounding the Zika virus, can we really all abide by the world gathering en masse in the heart of a foreboding outbreak? While Zika itself is not yet well understood enough for us to start cracking each others’ heads open and feast on the goo inside, there is a particularly terrifying historical example of what happens when an outbreak is taken lightly and is introduced into a mass gathering.

In late September of 1918, the city of Philadelphia hosted a crowd of 200,000 people for a Liberty Loan Drive parade to raise both funds and morale for the war effort. At the time, there was a nasty disease ravaging the troops—some of whom were camped nearby—killing these men in their prime and leaving their corpses a cyanotic navy.

Despite this, officials—optimistically or otherwise—assured the public that the illness would not spread beyond the military. Indeed, even though these venerated decision-makers received a July bulletin from the city’s Bureau of Public Health warning of the disease, city officials declined to even make the condition a reportable disease. It wasn’t going to be so bad, surely.

They were wrong.

Instead, Philadephia ran a huge goddamn parade right through the early days of the deadly Spanish Flu pandemic. Within days of the celebration, over 600 new cases of influenza were reported; soon after, the official admission came: conditions were indeed epidemic. A month later, cases numbered in the hundreds of thousands. By the end of the pandemic, Spanish Influenza would kill around 50 million people, worldwide.

The similarities between disease transmission at a big, rah-rah military pep rally and at, say, a major sporting event are obvious. Maybe cancel that trip to Rio.