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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Update: WHO Relents, calls for Expert Zika Panel to Decide Fate of Olympics

June 2nd, 2016

By Gary Evans, AHC Media Senior Staff Writer

Relenting to a growing chorus of international concern, the World Health Organization will seek the opinion of a committee of infectious disease experts before it makes a final decision on allowing the Summer Olympics to be held in Rio de Janeiro, Brazil.

After stonewalling formal pleas from an independent group of concerned scientists, the WHO conceded that action was needed in a June 1 letter to U.S. Sen. Jeanne Shaheen (D-NH) from Margaret Chan, MD, director-general of the WHO. Having requested that action, Shaheen today released Chan's letter, which states in part:

“Given the current level of international concern, I have decided to ask members of the Zika Emergency Committee to examine the risks of holding the Olympic Summer Games as currently scheduled,” Chan wrote. “The experts, well versed in travel medicine, the epidemiology of vector-borne disease, seasonal patterns of mosquito-borne infections, and risk communications, will meet shortly. Their advice to me will be immediately made public on our website together with the names and affiliations of the experts,"

It makes a lot of sense. Chan was starting to resemble Nixon deflecting questions about Watergate in insisting the risk was under control and the games would go ahead as scheduled Aug. 5- 21, 2016. The history of outbreaks and epidemics, particularly the pattern of cluster and dispersal, support proceeding with caution. The 2002-2003 SARS outbreak started with an index case in a Hong Kong hotel, and then at least one case was reported in some 20 countries. Mourners at Ebola funerals gathered to intimately grieve the dead and then scattered to their villages with the virus in tow. The infamous Spanish flu pandemic of 1918 was aided and abetted by WWI soldiers based in close quarters and then dispatched across the globe.

In this sense, an array of scientists and assorted academics and medical types have the weight of history on their side in recently urging the World Health Organization to cancel the Olympics in Rio due to an epidemic of Zika virus.

“[Our] concern is for global health,” they state in a letter to the WHO. “The Brazilian strain of Zika virus harms health in ways that science has not observed before. An unnecessary risk is posed when 500,000 foreign tourists from all countries attend the Games, potentially acquire that strain, and return home to places where it can become endemic. Should that happen to poor, as-yet unaffected places (e.g., most of South Asia and Africa) the suffering can be great. It is unethical to run the risk, just for Games that could proceed anyway, if postponed and/or moved.”

Of course, the Zika virus is not spread by close contact like the aforementioned diseases. It is primarily spread by mosquitoes and is sexually transmitted. However, it is now widely thought the virus has mutated and it is certainly conceivable that travelers returning from the Olympics could cause outbreaks in countries with both Aedes mosquitoes and impoverished living conditions.

The WHO was not convinced, however, and initially rejected calls to cancel, delay or move the games. “Based on current assessment, cancelling or changing the location of the 2016 Olympics will not significantly alter the international spread of Zika virus,” the WHO recently stated. “Brazil is one of almost 60 countries and territories which to date report continuing transmission of Zika by mosquitoes. People continue to travel between these countries and territories for a variety of reasons. The best way to reduce risk of disease is to follow public health travel advice.”

Instead of moving or cancelling the games, the WHO advised pregnant women not to travel to areas with ongoing Zika virus transmission, including Rio de Janeiro. Pregnant women’s sex partners returning from areas with circulating virus should be counselled to practice safer sex or abstain throughout the pregnancy. ...Whenever possible, during the day, [those attending the Olympics should] protect themselves from mosquito bites by using insect repellents and by wearing clothing – preferably light-colored – that covers as much of the body as possible.” The WHO also said it was working with Brazil to further mitigate the risk before the Games by eradicating populations of mosquitoes that transmit Zika.

The concerned scientists group was skeptical that an 11th hour attack on mosquito populations will sufficiently reduce the risk, questioning whether the WHO has a conflict of interest in blocking efforts to delay or move the games.

“We are concerned that WHO is rejecting these alternatives because of a conflict of interest. Specifically, WHO entered into an official partnership with the International Olympic Committee, in a Memorandum of Understanding that remains secret,” the group states. “There is no good reason for WHO not to disclose this Memorandum of Understanding, as is standard practice for conflicts of interest. Not doing so casts doubt on whose neutrality.”

Also, in a second letter after the WHO response, the health experts group noted that "It is not true that 60 countries have the new, more dangerous strain of virus that is causing microcephaly and brain damage in children in Brazil. While routine travel out of Brazil already has exported that viral strain somewhat, the Olympics are different because they summon travelers from literally every country in the world and can spread infection with unsurpassable efficiency. Not even other mass gatherings like the World Cup have the global reach of the Olympics. ...Rio’s official data show that the rate of mosquito-transmitted disease is three times higher in early 2016 than early 2015, including a surprising increase in the precise neighborhood of the Olympic Park."

Message -- finally -- received.

For more information on Zika virus check out AHC Media's on-demand webinar: The Zika Virus: Separating Fact from Fiction – A Discussion with Experts. For all the latest AHC Zika coverage, please visit reliasmedia.com/Zika.