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CDC issues Rio 2016 Zika recommendations for travelers, athletes

While stressing that the 2016 Olympic and Paralympic Games in Rio de Janeiro, Brazil, do not pose a new or unique risk for importation and sustained transmission of the Zika virus for most countries, the CDC has released a series of recommendations for international athletes and travelers who plan on attending.

Voicing support for public health interventions that increase “ongoing readiness and response capabilities” to prevent Zika transmission, the CDC has issued the following recommendations for athletes, international delegations and other visitors to Rio de Janeiro:

• Pregnant women should not travel to any area where Zika virus transmission is ongoing;
• travelers should take protective measures — including the use of insect repellent with active ingredients such as DEET, wearing long-sleeved shirts and long pants, staying in areas that are air conditioned and have window and door screens, and sleeping under a mosquito net — to prevent mosquito bites while in transit and for 3 weeks after returning to their home country;
• travelers should prevent possible sexual transmission of Zika while attending the 2016 games and after returning home by correctly using condoms every time they have sex, or otherwise abstaining from sex;
• males should use condoms for at least 8 weeks after travel or, if symptomatic for Zika infection, for 6 months from the start of symptoms;
• after returning from a country with Zika transmission, men with pregnant partners should use condoms, or otherwise not have sex, for the duration of the pregnancy; and
• partners planning to try to become pregnant after attending the Rio games should wait at least 8 weeks, and 6 months if the male had symptomatic Zika infection.

“Global travel has resulted in spread of Zika virus across much of the Western Hemisphere,” Ardath Grills, PhD, of the CDC Division of Global Migration and Quarantine, and colleagues wrote in their recommendation report, published in Morbidity and Mortality Weekly Report. “Substantial and continuous travel has occurred between most of the countries participating in the Games and the 49 countries or U.S. territories with CDC Zika Travel Notices.”

The CDC researchers also determined that, while most countries in the world do not appear to have a new or unique risk for importing and sustaining the Zika virus as a result of travel to the Rio games, four nations are of concern.

According to the CDC, they are Chad, Djibouti, Eritrea and Yemen. These countries currently have no evidence of ongoing or previous Zika virus transmission but do have the environmental and population conditions that could support ongoing transmission after introduction from a single traveler.

In addition, those four countries are unique in that, apart from expected travel to the Rio games, they do not have substantial travel to any country with local Zika virus transmission, according to the researchers.

The report notes that the four countries will be represented by a combined total of 19 athletes, plus a projected delegation of 60 people. The Brazilian Tourism Board expects anywhere from 350,000 to 500,000 total visitors for the 2016 Rio games. According to the CDC, that represents a tiny fraction — less than 0.25% — of the total estimated 2015 travel volume to Zika-affected countries.

The CDC researchers added that mosquito-borne Zika virus transmission is expected to be low during the games, as August and September are winter months in Brazil, when cooler and drier weather typically reduces mosquito populations. The 2016 Olympic Games are scheduled for Aug. 5 to 21, and the Paralympic Games will take place Sept. 7 to 18.

“This risk assessment reflects an unlikely scenario, given that it will be winter in Rio de Janeiro during the Games and mosquito-borne transmission of Zika virus is predicted to be low,” Grills and colleagues wrote. “… With the exception of these four countries, the Games do not pose a unique or substantive risk for mosquito-borne transmission of Zika virus in excess of that posed by non-Games travel.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.