Travelers to the FIFA world cup 2014 in Brazil: Health risks related to mass gatherings/sports events and implications for the Summer Olympic Games in Rio de Janeiro in 2016

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Summary

Background

Health threats during mass gatherings, such as the FIFA world cup 2014 differ from traditional health risks. The influence of event type, demographics of attendees and environmental conditions are still not fully understood.

Methods

An observational, prospective case–control survey conducted at the Frankfurt international airport in Germany on 544 travelers to the FIFA world cup 2014 and 432 regular travelers to Brazil departing after the end of the world cup.

Results

Travelers to the FIFA world cup 2014 were predominantly male whereas the gender distribution in the control group was more balanced. The majority in both groups obtained insect bites and sunburns as environmental risk factors. Every third traveler suffered from diarrheal complaints in both groups, whereas the proportion of travelers with flu-like symptoms was higher in the case group. Travelers to the FIFA world cup 2014 indicated alcohol intake and sexual contacts outside of a relationship more frequently than travelers in the control group.

Conclusions

The additional health risks of travelers to sporting events as the FIFA world cup 2014 should be addressed in addition to traditional health threats in pre-travel counseling for the Summer Olympic Games 2016 in Brazil.

Section snippets

Background

According to the World Health Organization (WHO), an event is classified as a mass gathering (MG) “if the number of people attending is sufficient to strain the planning and response resources of the community, state or nation hosting the event” [1]. Types of MGs are international sporting events, religious festivals, trade meetings, political events or cultural festivals [2].

For many major MGs, attendees are coming from all over the world. This potentially causes an increased risk for

Study design and study population

In this observational, prospective case–control airport-survey study, travelers to the FIFA world cup 2014 in Brazil that planned to attend one or more football matches in a stadium, were recruited between May and July 2014 at the Frankfurt international airport in Germany. As controls, other travelers to Brazil were enrolled from August to September 2014 right after the end of the FIFA world cup 2014. With permission of the airport as well as the involved airlines, consecutive passengers to

Results

544 travelers to the FIFA world cup 2014 in Brazil were recruited (cases) as well as 432 other travelers to Brazil departing after the end of the world cup (controls). Of these, 344 (63.24%) and 348 (80.56%) travelers, respectively provided followed-up information after their return. Participants who completed the follow-up were slightly younger compared with those who did not complete the follow-up in both groups (33 vs. 35 and 33.5 vs. 35 years, respectively). Apart from this, travelers with

Discussion

Travelers to the FIFA world cup 2014 clearly differed from regular travelers to Brazil with respect to demographic characteristics as well as health risks.

Whereas almost 88% of travelers to the FIFA world cup 2014 were males, the gender distribution of the control group was comparable to other studies of travelers returning from Brazil [16], [19]. Furthermore, significantly less retired persons were traveling in the case group. From these data, the typical attendee of the FIFA world cup 2014 in

Conflict of interest

None.

Acknowledgments

We are grateful to the travelers participating in this study. We thank the Frankfurt international airport and the airlines Lufthansa and TAP Portugal for their support. JPC accepted a position at Takeda Pharmaceuticals International AG, Vaccine Business Unit, Zurich Switzerland.

References (42)

  • P. Schlagenhauf et al.

    Travel-associated infection presenting in Europe (2008-12): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation

    Lancet Infect Dis

    (2015)
  • K. Ezzedine et al.

    Travellers to high UV-index countries: sun-exposure behaviour in 7822 French adults

    Travel Med Infect Dis

    (2007)
  • C. Wood

    Sun and skin - is travel health advice needed?

    Travel Med Infect Dis

    (2013)
  • M.L. Barreto et al.

    Zika virus and microcephaly in Brazil: a scientific agenda

    Lancet

    (2016 Mar 5)
  • WHO

    Communicable disease alert and response for mass gatherings: key considerations

    (2008)
  • A.H. Alquthami et al.

    A systematic review of noncommunicable health issues in mass gatherings

    Prehosp Disaster Med

    (2014)
  • S. Locoh-Donou et al.

    Mass gathering medicine: event factors predicting patient presentation rates

    Intern Emerg Med

    (2016 Jan 12)
  • J. Gaines et al.

    Health and safety issues for travelers attending the world cup and summer olympic and paralympic games in Brazil, 2014 to 2016

    JAMA Intern Med

    (2014)
  • K. Shoaf et al.

    Hospital preparedness in advance of the 2014 FIFA world cup in Brazil

    Prehosp Disaster Med

    (2014)
  • J.O. Burton et al.

    Differences in medical care usage between two mass-gathering sporting events

    Prehosp Disaster Med

    (2012)
  • S.A. Turris et al.

    An analysis of mass casualty incidents in the setting of mass gatherings and special events

    Disaster Med Public Health Prep

    (2014)

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