Zika Virus at 2016 Rio Olympics

Rio is hosting both the 2016 Olympics and a Zika outbreak

Olympics
Pete Saloutos/Getty Images

Rio is the host city of the 2016 Olympics. It’s also ground zero in the Zika outbreak that’s plaguing Latin America. Because Zika virus can be either deadly or severely damaging to babies in the womb, the Zika virus is of great global concern, and pregnant mothers are warned to stay away from areas where Zika is transmitted or counseled to delay conception once exposed.

Some public health experts have gone so far as to call for the Olympics to be moved from Rio to another city without Zika, like London, Beijing, or Athens.

As we all know, moving the Olympic (and Paralympic) Games didn’t happen.

Rio has grappled with Zika for many months and expended resources to eradicate Aedes aegypti. Nonetheless, this mosquito vector which most commonly spreads the Zika virus still flourishes.

Zika at the Olympics

It remains to be seen the exact impact that Zika will have on the world as well as Olympic athletes, organizers and an estimated 500,000 others who will descend on Rio. However, we can be pretty sure of one thing: Many of the 500,000 tourists and athletes from around the world will unknowingly become infected with Zika virus. They will then take the virus back to their own countries of origin and spread it among endemic Aedes mosquitoes.

The Rio Olympics hastens the inevitability that Zika will disseminate worldwide. Currently, researchers are developing a vaccine to fight Zika, and the chances that it will be developed soon are excellent.

But how soon? In the time that it takes for a vaccine to be developed, the Zika virus can lead to many more thousands of birth defects spread throughout the world.

Protection Against Zika VIrus

The best thing that people traveling to the Olympics in Rio can do is prevent themselves from getting bit by mosquitoes in the first place.

Useful means of bite prevention include use of insect repellent, wearing long sleeve shirts and pants, and hanging mosquito netting around the bed.

To better prevent bites, it’s also a good idea for travelers to understand a little bit about Aedes aegypti, the mosquito that carries Zika virus, as well as dengue and chikungunya. Aedes aegypti is an aggressive day-biter that prefers urban areas and can breed in small containers of water. Thus, if you’re traveling to Rio de Janeiro or any other place where Zika is being transmitted, it’s best to keep your living space clear of any potential breeding grounds including flower pots and ice buckets.

If possible, pregnant women—or women thinking about becoming pregnant in the near future—should avoid travel to Rio or any other area in North America, Central America or South America where the Zika virus is spread. Furthermore, it’s recommended that people use condoms and dental dams while having sex to minimize the risk of catching or transmitting the Zika virus.

People traveling to Rio should not only use condoms and dental dams while at the Olympic Games but continue to do so for at least eight weeks upon returning home. Of note, it’s unclear how long the Zika virus lasts in semen and vaginal fluids thus making transmission from man to woman possible long after initial infection.

In other words, abstinence from unprotected sex for eight weeks upon return is likely a minimum estimate, with some physicians recommending postponing pregnancy and using condoms and dental dams for even longer periods of time. Please note that if you travel to Rio or any place where the Zika virus is spreading, it's a good idea to meet with your primary care physician after you return for a check-up. In case you think you have been infected with the Zika virus, request a laboratory test. Currently, the CDC is performing blood tests to confirm suspected cases of Zika.

Parting Thoughts

People traveling to the 2016 Olympics should rightfully focus on celebrating the Olympic spirit, having fun, and cheering on athletes. However, tourists must remember that Brazil is a hotbed for Zika activity. People traveling to Rio for the 2016 Olympics should protect themselves from mosquito bites and engage in protected sex to limit the spread of this disease.

By limiting the spread of Zika, tourists can help minimize its global impact before a vaccine is found. In hindsight, the success of the Games may not only be judged in unity, good sportsmanship and medals earned but also in minimized global dissemination of the Zika virus.

More About Zika

The Zika virus is a single-stranded RNA virus, which belongs to the flavirus (viral hemorrhagic fever) family.

 Other flaviviridae are the following:

  • yellow fever
  • dengue
  • Japanese encephalitis
  • West Nile viruses.

Unlike other flaviviridae, infection with Zika virus is usually mild. Only about 20 percent of those infected develop symptoms. These symptoms include the following:

  • rash
  • conjunctivitis (“pink eye”)
  • lymphadenopathy (swollen lymph nodes)
  • joint pain
  • fever
  • muscle aches
  • headache

A few notes about latent infection with the Zika virus.

First, Zika doesn’t result in respiratory symptoms, or trouble breathing.

Second, a smaller number of people who are infected with the Zika virus later go on to develop Guillain-Barré syndrome (GBS). GBS is typically a transient neurological disorder that results in ascending weakness and trouble moving and walking.

Third, we need to see how infants born to infected mothers fare as they age to truly elucidate the neurological repercussions of Zika virus infection.

Fourth, there is no specific treatment for infection with the Zika virus. Instead, symptomatic treatment like fluids, acetaminophen (Tylenol) and rest are recommended.

Zika virus is usually spread by mosquito vectors. It can also be spread during pregnancy—from the mother to her unborn baby. Although less common, Zika virus can also be spread through sex, which is why everyone at risk for Zika transmission should wear condoms or dental dams during sex.

Whereas clinical infection with the Zika virus is typically mild in adults, it can be devastating to pregnant women and their unborn babies. Zika virus is a teratogen which can either cause miscarriage or profound birth defects.

Most notably, infection with the Zika virus has been linked to microcephaly. In microcephaly, diminished skull size leads to abnormal brain development. Zika virus is also linked to various other birth defects, like eye lesions and muscular abnormalities. These other birth defects can occur either with or without microcephaly.

Organized evidence is starting to roll in that helps prove a causal link between Zika virus and birth defects. In March 2016 study published in The New England Journal of Medicine, Brazilian researchers examined 72 pregnant women with Zika virus. The researchers performed fetal ultrasound on these women and found fetal abnormalities in 29 percent of the unborn babies. These fetal abnormalities included the following:

  • abnormal amniotic fluid volume
  • abnormal arterial or cerebral flow
  • microcephaly
  • in utero growth restriction with or without microcephaly
  • ventricular calcifications or other central nervous system (brain, eyes and spinal cord) lesions

Of note, the researchers confirmed these ultrasound findings in many of the babies at the time of delivery.

Sources:

Attarin A. Off the Podium: Why Public Health Concerns for Global Spread of Zika Virus Means That Rio de Janeiro’s 2016 Olympic Games Must Not Proceed. Harvard Public Health Review.   http://harvardpublichealthreview.org

Brasil P, Pereira JP, Gabaglia CR, et al. Zika Virus Infection in Rio de Janeiro—Preliminary Report. www.nejm.org. March 4, 2016.

Jin J. Zika Virus Disease. JAMA 2016.315:2482.

Levinson W. Minor Viral Pathogens. In: Levinson W. eds. Review of Medical Microbiology and Immunology, 13e. New York, NY: McGraw-Hill; 2014.

Zika Virus. CDC. www.cdc.gov.

Continue Reading