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Netcare Travel Clinics Media Statement New*
As soccer fever heats up just how much of a healthcare threat do fans still face?
Thursday, 24 June 2010 As the Group stages of the 2010 FIFA World CupTM draw to a close and the teams prepare themselves to battle it out for a place in the final 16 of the competition, thousands of fans are still flocking into the country. Just how much of a healthcare threat do the throngs drawn together by the event pose as soccer fever reaches fever pitch?
Dr Pete Vincent of the Netcare Travel Clinics and Medicross Family Medical and Dental Centre, Tokai says with soccer fans arriving and departing constantly close on 400 000 will have visited the country by the time the competition ends. While no major health concerns have come to light yet, the influx of people and the crowds congregating for the matches could pose anything from the more mundane to the more unusual in terms of healthcare threats.
“South Africa is doing everything to ensure that the event will go well from every aspect including health,” he points out. “This country is not considered a particularly risky destination when it comes to health, and has successfully hosted a number of major events in recent years. Nevertheless there are a lot of visitors who will be coming from many different places, in addition to which it has been very cold around the country, and even wet at some centres such as Cape Town. Crowds gathering at the games also create an opportunity for the rapid spread of certain infectious illnesses such as flu. We should therefore take a few precautions to ensure that we have a happy, healthy World Cup.”
“Right now South Africa is experiencing great extremes in the weather, from the fairly strong midday sun to the freezing cold nights. Those with pale complexions and sensitive skins that have not been exposed to the harsh African sunlight should be particularly cautious and should keep the sun block handy at all times while remaining fully hydrated. The blazing sun can be dangerous between the hours of 12h00 till 14h00 – even during the winter months. The excessive consumption of alcohol also does not blend well with the sunshine,” cautions Dr Vincent.
A recent article in the Journal of Travel Medicine entitled ‘The 2010 FIFA World Cup: Communicable Disease Risks and Advice for Visitors to South Africa’ suggests that although many of the foreign visitors may perceive South Africa as an exotic, tropical type of destination, the illnesses they are likely to come across “will differ little from those affecting mass events elsewhere”.
Dr Vincent says that large events such as the 2010 FIFA World CupTM can cause a spread in sexually transmitted diseases. Visitors to South Africa should keep in mind the high prevalence rates of HIV and other sexually transmitted diseases before engaging in high-risk sexual activities, he advises. “If you engage in sexual activities with individuals whose sexual history is not known to you, be sure to use a condom,” he advises.
Dr Vincent points out that a major healthcare concern for the event is still undoubtedly flu and more particularly the H1N1 virus, which the World Health Organisation (WHO) stills sees as an important threat. While there have been no major outbreaks of flu in South Africa, doctors are seeing some cases and, as noted previously, the cold and the crowds do afford the opportunity for a rapid spread of the virus. He notes that a fan instrument such as the much loved vuvuzela “can unfortunately blow spittle and germs from infected individuals on to other people in crowded areas and may be a health risk for infectious illnesses such as flu”. In addition, he advises spectators to blow their own vuvuzelas and not to share them with others as this could easily result in the picking up and transmitting germs.
Also worrying is that there is currently a lack of stocks in the private sector of the best weapon in our armoury against flu: the annual southern hemisphere flu vaccine, says Dr Vincent. As usual the annual southern hemisphere flu vaccine this year provided protection against three strains of the flu virus. One of them was the H1N1 virus. Unfortunately, stocks of the vaccine quickly ran short at the beginning of the season. However, while the annual southern hemisphere flu vaccine is not available, the Government has at least supplied Clicks pharmacies with 300 000 doses of the H1N1 vaccine. Those at risk of developing flu-related complications such as the elderly, individuals with asthma, and other chest problems, pregnant women and individuals whose systems have been immuno-compromised, should at least still be sure to have this administered.
The Journal of Travel Medicine suggests that the transmission of flu in stadia “should be relatively low,” although it warns that outbreaks have been reported before at outdoor mass gatherings. Dr Vincent believes, however, that the public should not be complacent about the flu threat, and particularly that posed by the H1N1 virus. He says that the H1N1 virus is still active in some areas of the world and could become a major problem again.
It has been found that many of the deaths related to the H1N1 virus have been caused by bacterial pneumonia. Those who have a high risk of exposure to the H1N1 virus should therefore seriously consider having the pneumococcal vaccine as well, says Dr Vincent. And those at risk of developing flu or cold related complications should have their pneumococcal vaccination administered with the flu vaccine as a “matter of course”, he advises.
On the subject of vuvuzelas, the major threat they pose from a health point of view is to people’s hearing. Dr Vincent says that those who are worried about the possibility of having their hearing impaired by a nearby fan, should consider taking earplugs to the games. Vuvuzelas have been shown to be a possible risk to people’s hearing, although few people who actually go to watch matches at the stadiums find them particularly hard on the ear. Also be careful also not to overdo the trumpeting. In a well-publicised case a woman recently ruptured her throat after playing a vuvuzela, although Dr Vincent suggests that such a problem is highly unusual and has not been reported by any of the other thousands of fans using the vuvuzela.
South Africa has been in the throes of a measles epidemic with more than 16 000 cases having been reported since the beginning of 2009. The country has launched a massive immunisation campaign against the disease, which seems to be helping to curb it. Those who have never had measles or measles vaccinations previously would also be wise to vaccinate against this illness, suggests Dr Vincent. Measles complications can be dangerous for both children and adults. The measles virus can remain alive for some two hours outside of the human body in sneeze droplets and on surfaces, which makes it highly contagious.
Acute diarrhoea is another potentially debilitating illness that could be easily spread during the event and something that football fans should watch out for. Diarrhoea can be avoided by watching what you eat and being sure that you practice good personal and food hygiene. A vaccine is available to help prevent the Rotavirus infection in infants. The Rotavirus is responsible for most of the serious diarrhoea cases in children.
There are other potentially dangerous infections that we can contract such as meningitis and Hepatitis A and B. Fortunately there are vaccinations available for all of the above-mentioned diseases, and they are effective if administered as prescribed, says Dr Vincent.
The risks for visitors acquiring diseases such as malaria are low as none of the stadia for the event fall within malaria areas. In addition winter is a time of low transmission – even in the malaria areas of South Africa. Nevertheless, those travelling to malaria areas such as the Kruger Park should use DEET-based mosquito repellents and enquire at their local travel clinic whether they require prophylaxis to protect them from this dangerous disease.
The Journal of Travel Medicine points out that more people need to be aware of cough etiquette and hand hygiene. One should always cover one’s mouth when coughing and direct all coughs away from other people. Hands should also be washed regularly to help ensure that germs are prevented from being spread from one person to another during physical contact. Dr Vincent points out that a few precautions taken regarding your health can save you a lot of headaches and help ensure that you have an enjoyable 2010 FIFA World CupTM. He advises those who want to stay healthy this winter to visit their nearest Netcare Travel Clinic.
The National Institute for Communicable Diseases (NICD) with the Provincial and National Departments of Health have an enhanced surveillance programme in place for the World Cup. A short guide on staying healthy in South Africa over 2010 is available from the NICD website www.nicd.ac.za.
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