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Special Communication |

Health and Safety Issues for Travelers Attending the World Cup and Summer Olympic and Paralympic Games in Brazil, 2014 to 2016

Joanna Gaines, PhD, MPH1; Mark J. Sotir, PhD, MPH1; Timothy J. Cunningham, ScD2; Kira A. Harvey, MPH1; C. Virginia Lee, MD, MPH1; Rhett J. Stoney, MPH1; Mark D. Gershman, MD1; Gary W. Brunette, MD, MS1; Phyllis E. Kozarsky, MD1,3
[+] Author Affiliations
1Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
2Epidemiology and Surveillance Branch, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
3Emory University School of Medicine, Atlanta, Georgia
JAMA Intern Med. 2014;174(8):1383-1390. doi:10.1001/jamainternmed.2014.2227.
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Importance  Travelers from around the globe will attend the 2014 Fédération Internationale de Football Association (FIFA) World Cup and the 2016 Olympic and Paralympic Games in Brazil. Travelers to these mass gathering events may be exposed to a range of health risks, including a variety of infectious diseases. Most travelers who become ill will present to their primary care physicians, and thus it is important that clinicians are aware of the risks their patients encountered.

Objective  To highlight health and safety concerns for people traveling to these events in Brazil so that health care practitioners can better prepare travelers before they travel and more effectively diagnose and treat travelers after they return.

Evidence Review  We reviewed both peer-reviewed and gray literature to identify health outcomes associated with travel to Brazil and mass gatherings. Thirteen specific infectious diseases are described in terms of signs, symptoms, and treatment. Relevant safety and security concerns are also discussed.

Findings  Travelers to Brazil for mass gathering events face unique health risks associated with their travel.

Conclusions and Relevance  Travelers should consult a health care practitioner 4 to 6 weeks before travel to Brazil and seek up-to-date information regarding their specific itineraries. For the most up-to-date information, health care practitioners can visit the Centers for Disease Control and Prevention (CDC) Travelers’ Health website (http://wwwnc.cdc.gov/travel) or review CDC’s Yellow Book online (http://wwwnc.cdc.gov/travel/page/yellowbook-home-2014).

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Figure 1.
Venue Maps

A, Fédération Internationale de Football Association (FIFA) World Cup host cities with areas with malaria transmission and where yellow fever vaccine is recommended, Brazil, 2014. B, Venues for 2016 Olympic and Paralympic Games.aCDC Health Information for International Travel, 2014.

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Figure 2.
Dermatologic Conditions Found in Brazil

Crater ulcers of various stages due to cutaneous leishmaniasis on the arm (A) (source: Centers for Disease Control and Prevention/Mae Melvin, MD); cutaneous larva migrans (B) (source: Jay Keystone, University of Toronto); and tungiasis (C) (source: Mohammed Asmal and Rocio M. Hurtado [this image was first published on Partners’ Infectious Disease Images website, whose content is copyrighted by Partners Healthcare System Inc and is used with permission. All rights reserved]).

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