COMMENTARY

Patients Going to Rio Olympics? Here's the Advice You Should Give

Susan Yox, RN, EdD; Martin Cetron, MD

Disclosures

July 20, 2016

Editorial Collaboration

Medscape &

Zika and Other Vector-borne Diseases

Medscape: What should I tell patients about Zika?

Dr Cetron: Most Zika virus infections are asymptomatic; when symptoms develop, they are usually mild and last only a few days. Many people might not realize that they have been infected. However, Zika virus infection during pregnancy can cause microcephaly and other neurologic abnormalities. There may also be a link between Zika and Guillain-Barré syndrome.

Medscape: What can travelers do to prevent vector-borne diseases?

Dr Cetron: Travelers can reduce their risk by preventing mosquito bites. They can wear long-sleeved shirts and long pants and stay in accommodations that are air conditioned. People going to the Olympics should also use an EPA-registered insect repellent that includes DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Because Zika can also be transmitted sexually, travelers should use condoms or abstain from sex while in an area with ongoing Zika virus transmission. Travelers with a pregnant partner should use condoms or not have sex during pregnancy, even after returning from Rio (Figure 4).

Figure 4. Protection from Zika during and after the summer Olympics.

Medscape: My patients who are traveling are healthy, young, and not pregnant or planning to become pregnant. They don't perceive any risk from Zika. How can I convey the need to take precautions?

Dr Cetron: Tell your patients that even if they don't become sick, they can infect local mosquito populations after returning home. Infected people are viremic for about a week, and if they are bitten by mosquitos back at home, they can transmit the Zika virus to those mosquitos, which can then infect other people. Even if they do not feel sick, travelers returning to the United States from Brazil should take steps to prevent mosquito bites for 3 weeks (a 2-week incubation period plus 1 week of active viremia). This will prevent them from infecting mosquitoes in the United States with Zika. To prevent sexual transmission, men should use condoms or abstain from sex for 8 weeks after leaving (6 months if they become symptomatic). Women should wait at least 8 weeks after travel before trying to conceive.

Threats to Safety and Security

Medscape: My patients are worried about their safety, even in such tourist destinations as Copacabana and Ipanema. What should I recommend?

Dr Cetron: As with any international mass gathering, US travelers may be targets for criminals. Advise travelers not to travel at night, to avoid questionable areas, and to travel with a companion. If your patients drink alcohol, advise them to do so in moderation. Drunk people are more likely to hurt themselves or other people, engage in risky sex, or get arrested. More information on safe travel to mass gatherings is available at Travel to Mass Gatherings.

Medscape: This question comes up very often: What should travelers do with their passports while in Brazil? Should they carry their passports with them at all times?

Dr Cetron: No. Travelers should carry a photocopy of their passport and entry stamp but leave the actual passport securely in the hotel. Travelers should also carry contact information for the nearest US embassy or consulate in Brazil.

Medscape: What other safety tips do you have for people going to Rio for the Olympics?

Dr Cetron: Like in any other big city, travelers should not wear expensive clothing or jewelry. Keep hotel doors locked, and store valuables in secure areas. If possible, travelers should choose hotel rooms on the second through the sixth floors. A room on the first floor of a hotel may provide easier access for criminals. Rooms on the seventh floor or above may be difficult to escape in the event of a fire.

Have a question that isn't answered here? Send it to Olympics2016@cdc.gov.

Dr Martin Cetron is the director of the Division of Global Migration and Quarantine at the US Centers for Disease Control and Prevention. Dr Cetron holds faculty appointments in the Division of Infectious Disease at the Emory University School of Medicine and the Department of Epidemiology at Rollins School of Public Health. His primary research interests are global health and migration, with a focus on health disparities, emerging infections, tropical diseases, and vaccine-preventable diseases, particularly in mobile populations.

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