Concern for Zika at Rio Olympics is now deadly serious

by John Curnow on 12 May 2016 Alphabet soup is one description that has thus far not been used for either Guanabara Bay, or the Rio Olympics. Many others have, and they were apt, but things have changed. So here now we have a situation where one man, Associate Professor Amir Attaran, who does have a more than decent string of letters after his name, is bringing nearly as many facts to bear on the case, as he has references at the end of his article.

Attaran holds Bachelors in Arts and Law, Masters in Science along with a Doctorate in immunology, and has been widely revered for his work on Malaria. Now he brings his great expertise to the other mosquito born scourge, Zika. He is clear that the Olympics should simply not proceed in the current venue.

Now I have been to Rio, yes, a long time ago, and walked through the slums. Apart from having to be a mountain goat to get anywhere once there, you see the amount of standing water around. Not only is it in containers for drinking and so forth, it can also be in every footprint, which is all you need for mosquitoes to breed. In addition to that, you have the seepage that occurs as a result of said terrain. Where there is that occurrence, then there will be puddles elsewhere…

So then as Attaran asks, why would you insert half a million new souls into an area that has the highest incidence rate of any of Brazil’s States (26,000)? Of course it is meant to decrease during Winter, but nobody really knows to what level, because it is all new ground. What they do know is that Zika is more infectious than previously thought and that it is more widespread than they had catered for. Not good data to have when the world’s eyes are upon you.

Attaran also goes on to explain that whilst Zika itself is old news, this strain in Brazil is definitely new. Also, given that the pictures of congenital defects on infants are way past disturbing, it is the link for adults to Guillain-Barré disease that is new and not understood at all.

The five points raised by Attaran are compelling reading and we can all imagine that the Games have not been moved for one reason alone. Money. If there was oil involved you can bet there would have been real military intervention ages ago, but alas, before you go on to read Attaran’s great work, consider this, who is going to pay for the medical bills afterwards? The IOC? I think not….

Below are some of the most important paragraphs in his report.

First, Rio de Janeiro is more affected by Zika than anyone expected, rendering earlier assumptions of safety obsolete. When in January the International Olympic Committee declared Rio a “safe environment” for the Games, it was speculating, because Brazil’s Ministry of Health temporized until February to declare Zika a notifiable disease and begin counting cases.[3] [4] Now with those data finally available, the situation seems not so safe: Rio de Janeiro’s suspected Zika cases are the highest of any state in in Brazil (26,000), and its Zika incidence rate is the fourth worst (157 per 100,000).[5] Or in other words: according to the Brazil’s official data, Rio is not on the fringes of the outbreak, but inside its heart.

Later studies from Brazil now powerfully argue that the relationship is truly causal.[11] For example, in Rio de Janeiro—where the Games will take place—a very recent study shows that among women with confirmed Zika infections during pregnancy, fully 29% had fetal abnormalities on ultrasound.[12] Further, the Brazilian microcephaly cases have an unusual constellation of congenital defects severer than classical microcephaly, and suggestive of “fetal brain disruption sequence” in which the developing brain and skull collapse while other anatomical features like the scalp skin keep growing.11

All it takes is one infected traveler: indeed phylogenetic and molecular clock analyses establish that Brazil’s cataclysmic outbreak stems from a single viral introduction event likely between May and December 2013.9 A few viral introductions of that kind, in a few countries, or maybe continents, would make a full-blown global health disaster. Scientists can disagree on how much the mass migration of 500,000 foreigners will accelerate the virus’s global spread and make the pandemic worse—but none can possibly argue that it will slow it down or make things better.

Fifth, proceeding with the Games violates what the Olympics stand for. The International Olympic Committee writes that “Olympism seeks to create … social responsibility and respect for universal fundamental ethical principles”. But how socially responsible or ethical is it to spread disease? Sports fans who are wealthy enough to visit Rio’s Games choose Zika’s risks for themselves, but when some of them return home infected, their fellow citizens bear the risk too—meaning that the upside is for the elite, but the downside is for the masses. This equity problem takes on added meaning in poorer, weaker countries like Nigeria, India or Indonesia, which haven’t got the resources to fight Zika that Brazil does—and which anyway are proving insufficient. Putting them at risk for Games that are, essentially, bread and circuses seems ethically questionable.

So please avail yourself of Attaran's entire and great article from the Harvard Public Health Review