Travelers to the International Federation of Association Football (FIFA) World Cup in South Africa should take special precautions to avoid disease transmission during the largest mass gathering for a single sport.According to a new study published in the June issue of the American Journal of Tropical Medicine and Hygiene, visitors traveling to South Africa will need to worry less about 'exotic' tropical diseases such as malaria, and concentrate on protecting themselves from a wide range of more common travel-related diseases, such as acute diarrheal illness, sexually transmitted diseases, febrile illnesses, insect and tick bites, and vaccine-preventable infections, especially influenza and measles. South Africa is outside of the African yellow fever zone. Nearly 350,000 visitors from throughout the globe are expected to travel to South Africa for the World Cup, which is held every four years to determine the world football (soccer) champion, and takes place June 11 - July 11, 2010. To help inform travelers heading to the World Cup about what they might expect and how they should prepare to prevent illness, researchers analyzed data collected from a global network of tropical medicine/travel clinics over a 13-year period, analyzing illnesses among individuals who traveled to South Africa. The analysis of ill patients showed that systemic febrile illness (diseases characterized by fever), dermatologic (skin) conditions, and acute diarrheal illness were most common. African Tick Bite Fever, an infection acquired from tick bites in travelers engaged in outdoor pursuits, like hiking and hunting in bush areas of the country, was the most common diagnosis in travelers returning from South Africa with fever. Interestingly, these findings contradict a widely held belief that travelers to South Africa are less likely to acquire traveler's diarrhea than individuals coming from neighboring countries. People traveling to the World Cup should take specific preventative measures and self-treatment options for traveler's diarrhea. Since 1984, 25 of the last 26 influenza seasons have coincided with the dates during which the 2010 World Cup will be played. Last year, the pandemic influenza A H1N1 virus was introduced to South Africa and is expected to cause the majority of infections again this year during the World Cup. Those individuals traveling to South Africa should be vaccinated against influenza H1N1. South Africa is also in the midst of an ongoing measles epidemic; over 9,500 cases have been confirmed since the beginning of 2009. World Cup visitors are advised to ensure that they are vaccinated against measles if not already immune. In contrast to the rest of sub-Saharan Africa (SSA), only six cases of malaria were documented among ill travelers returning to GeoSentinel clinics from South Africa. The risk for acquiring malaria in South Africa has been evaluated as low, and malaria transmission does not occur in the cities where the matches will be staged. "While we are pleased that the study findings indicate that South Africa is a relatively safe place to visit from a health perspective, the results of the study highlight the importance of individuals traveling to South Africa taking proper precautions," said Prof. Marc Mendelson, head of Division of Infectious Diseases and HIV Medicine at University of Cape Town. "While the risk of acquiring a tropical disease in urban areas of South Africa is low, we encourage all travelers to consult with their physician to ensure they have the proper immunizations and have taken the necessary self-prevention measures prior to their trip to the World Cup." "This evidence-based approach should help visitors to South Africa learn about and prepare for the various health risks associated with attending the 2010 FIFA World Cup," said Edward T. Ryan, M.D., President, American Society of Tropical Medicine and Hygiene (ASTMH). "Travel to any destination often exposes individuals to new or novel diseases or conditions not present in their home environment, but with proper precautions and preparation, travelers can safely participate in even large global gatherings." Although not specifically evaluated in the study, visitors to South Africa should also keep in mind the high prevalence of HIV in the country, and practice safe sex if they choose to engage in sexual behavior while in South Africa. Travelers planning to venture outside of the World Cup's urban venues to more rural areas for activities, such as hiking and safari, should do additional research regarding necessary health and safety precautions. Contributed by the American Society of Tropical Medicine and Hygiene.
********** Published: May 28, 2010 - Volume 9 - Issue 6