“Disease surveillance is disease surveillance every day of the week,” Garrow, Philadelphia deputy health commissioner, told CIDRAP News. “What is changing in terms of the World Cup is how intense that disease surveillance is going to look.”
While Garrow worries about heat-related illnesses and air quality, there’s one infectious disease he’s most concerned about. “Measles is probably our top worry,” he said. “We’ve already put out communications to our regional healthcare providers about what to look for.”
With recent outbreaks in the United States, lower vaccination rates, and people traveling, it seems more likely than ever that a fan with measles could be in the stands at the World Cup. This year, stadiums and Fan Festivals packed with cheering people could make it easy for measles to thrive.
“Measles tends to hang around in the air. It’s very small particles and it just floats there for up to two hours after someone with measles has been in the space,” Garrow said. “How many people could potentially have gone through that particular site in two hours after the person left?”
Risk of Ebola very low
Even in years without newsworthy infectious disease outbreaks such as Ebola and Andes hantavirus, public health experts know that infectious diseases flourish in large crowds.
“You have to think of the World Cup as a mass gathering event,” said Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security. “It’s going to be diseases of crowds or what we call crowd diseases that spread.”
Infectious diseases that thrive in crowds fall into four categories: respiratory ailments, sexually transmitted infections (STIs), vector-borne infections, and gastrointestinal (GI) illnesses. “We have to think of the gamut of infections,” Kuppalli said.
With the Ebola outbreak in the Democratic Republic of the Congo making headlines, many fans wonder what that might mean for them, but doctors don’t anticipate seeing cases during the World Cup.
“The entire global health community is watching the Ebola outbreak with deep concern,” Rebecca Katz, PhD, MPH, professor and director of the Center for Global Health Science and Security, said. “When we talk about the World Cup, the threat to the general public in North America is really quite low.”
Ebola spreads when people come in contact with bodily fluids, which is why it often infects healthcare workers and people involved in burial rituals. “You could be sitting next to somebody in a stadium, and you’re not going to get Ebola from them,” Katz said.
Gonorrhea, chlamydia ‘will definitely be attending’
Experts expect they’ll see more common types of infections, such as COVID-19 or respiratory syncytial virus (RSV). While most Americans aren’t thinking about flu in the summer, it’s infuenza season in the Southern Hemisphere, meaning teams and fans from that part of the world could arrive with it.
“You can even see outbreaks of flu,” Bernard Camins, MD, professor of infectious diseases at the Icahn School of Medicine at Mount Sinai, said. “Theoretically, [fans] can get on the plane while they’re still not sick and land and be contagious.”
GI infectious diseases such as norovirus often spread during big sporting events, including the 2026 Milan Cortina Winter Olympics in Italy and the 2018 Pyeongchang Winter Olympics in South Korea.
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