The traveling sportsman and the infectious risks

With globalization, more and more people are moving around the world. We have gone from a tourist flow estimated at around 400 million in 1990 to 1,400,000,000 in 2018 (UNWTO).

This phenomenon also affects sportsmen. One can highlight the displacement of both individuals or limited groups who go to practice sports in countries other than their country of origin (e.g., diving activities in tropical areas) but also the presence of major sporting events with displacement of large masses of people (mass gathering) from various parts of the world with an increased risk of spreading infectious diseases. These can either be acquired in the host country or arrive from the traveler's home countries through the traveler.

We may have infectious diseases with oro-fecal transmission (e.g., shigellosis, Campylobacter infection) that, if long incubating, can cause illness after returning to the country of origin. Others are respiratory-transmitted (e.g., influenza, measles, mumps, meningococcal meningitis, legionellosis, and tuberculosis), vector-borne (e.g., malaria, dengue, chikungunya, yellow fever), non-vector-borne zoonotic (e.g., leptospirosis), or sex- and/or blood-borne (e.g., HIV, HBV, HCV, syphilis, gonorrhea).

These are the most common diseases in the past.

Some outbreaks have occurred in the past during these major events, for example:

• a measles outbreak that occurred during the 1991 Special Olympics in the USA and another during an international youth sporting event in 2007 also in the USA;
• several cases of salmonellosis occurred at a youth ice hockey competition in Latvia in 2015;
• cases of leptospirosis occurred among participants of a triathlon competition in Reunion Island in 2013;
• The 2016 Rio Olympics have come under particular scrutiny because of an outbreak in one area of Brazil caused by infection with Zika virus, an emerging infectious disease transmitted by mosquitoes of the genus Aedes egipti and found to be associated with the development of microcephaly in children born to infected mothers.

The pandemic due to the new SARS-Cov-2 coronavirus that emerged in 2020 has, finally, highlighted how important the consequences of the global spread of an infectious disease can be.

It is therefore important, before making a trip, to be aware of possible infectious risks so that preventive measures can be implemented to minimize them.  Depending on the area where the sportsman will travel, it will be necessary to follow food and behavioral hygiene rules (e.g. avoid certain foods, avoid insect bites by using repellents, long-sleeved clothing, mosquito nets, and use of condoms in case of sexual intercourse), perform certain vaccinations (presence of international vaccination centers to refer to), perform pharmacological prophylaxis (malaria areas).   

Source

Gautret P, Steffen R. Communicable diseases as health risks at mass gatherings other than Hajj: what is the evidence?International Journal of infectious diseases, 2016;47:46-52.

Abubakar I, Gautret P, Brunette GW, Blumberg L, Johnson D, Memish ZA, Barbeschi M, Khan AS. Global perspectives for prevention of infectious diseases associated with mass gathering. The Lancet, 2012;12:66-74.