Straight, No Chaser: Focus on the Rio Olympics, Zika and Worldwide Public Health

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There are no words, yet I’ll write a few. In my lifetime, I cannot recall such an egregious breach of the public health trust than what will occur at the Rio Olympics. Consider the following: among other things, public health means to contain and limit exposure to disease. The nature of why vaccinations and quarantines are imposed support such a consideration. Now, let’s look at the potential ramifications of exposing a worldwide audience to a Zika virus hotbed.

  • You may have heard the suggestions that “it’s not the height of mosquito season in Brazil, or the outbreak started and is worse outside of Rio, so it’s ok.” Not true on all counts: Rio now appears to be the hotbed of Zika activity, and other diseases transmitted by mosquito bites (most notably dengue) have surged such that cases are six-fold higher than a year ago, with over 8,000 cases already having been reported this year. Furthermore, Rio’s Zika cases are more numerous than any other Brazilian location, totaling over 26,000. All of this is in the face of the country’s intense efforts to kill mosquitos.

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  • You may have heard the suggestion that “male athletes or women not of childbearing age don’t have to worry about the pregnancy-related complications of Zika.” Really? First of all, Zika is transmitted in multiple ways, not limited to a mosquito bite. For example, sexual exposure to someone infected with Zika virus can cause the disease, even if the infected individual isn’t showing symptoms. It can be transmitted through blood transfusions and laboratory exposure. And of course, the virus is transmitted from mother to child during pregnancy. The concern isn’t just the obviously infected individual but also those who become carriers of the virus and can transmit it to others.
  • And the point of this? The Olympics is literally bringing approximately 500,000 individuals from around the world into a high-risk environment in which they can become carriers of the disease, subsequently exporting the disease around the world. This is about as irresponsible of an action as one can fathom – and to what end? What exactly are the ends here that justify these risks, primarily (but not limited) to unborn children? We know Zika infection is associated with pediatric microcephaly and brain damage, but it also has now been linked with adult conditions such as Guillain-Barré syndrome and acute disseminated encephalomyelitis, which are debilitating brain and nervous system conditions that can be fatal. Have I mentioned that in Rio, fully 29% of all women pregnant with Zika are displaying fetal abnormalities?

The World Health Organization’s silence on this matter is deplorable.

Even as this is bad enough, there’s more. Consider the water.

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  • The Marina da Gloria is the visually stunning setting where the Olympic sailing events will be held. Nearly 1,400 of the more than 10,000 athletes competing at the Games will be directly exposed to it. This water is well-known to be contaminated with feces, and pre-Olympics cleaning efforts have fallen short of targets and expectations. On this matter, the World Health Organization has chosen to speak, recommending that athletes cover cuts and grazes with waterproof plasters prior to exposure, “try” to avoid swallowing the water, wash/shower as soon as possible after exposure and, simply minimize time in the water (especially avoiding going in the water after heavy rainfall).
  • As a means of quantifying the problem, the Associated Press has reported levels of bacteria and viruses so high that inadvertently swallowing just three teaspoons of water from the bay was likely to lead to severe stomach (intestinal illnesses including but not necessarily limited to diarrheal diseases) and respiratory illnesses. The concentrations of adenoviruses (a common cause of diarrheal disease) have been reported to be thousands of times higher than the levels considered safe in the US or Europe.

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It’s easy to conclude that the calculus of the-powers-that-be has prioritized money above worldwide public health considerations and certainly above the health risks to participating athletes. This expands any existing precedent by which financial considerations have been allowed to endanger the vulnerable. If you’ve chosen to support this year’s Olympics by watching, you should consider (or at least be consciously aware of) the ramifications of your choice. If you’ve chosen to go to Rio, reconsider the logic of your decision. If you’re in any way potentially exposed to the Zika virus, please take recommended precautions.

Feel free to ask any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

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