The 2014 FIFA World Cup: communicable disease risks and advice for visitors to Brazil--a review from the Latin American Society for Travel Medicine (SLAMVI).

The next FIFA World Cup will be held in Brazil in June-July 2014. Around 600,000 international visitors and participants (as well over 3 million domestic travelers) are expected. This event will take place in twelve cities. This event poses specific challenges, given its size and the diversity of attendees, including the potential for the transmission of imported or endemic communicable diseases, especially those that have an increased transmission rate as a result of close human proximity, eg, seasonal influenza, measles but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations regarding the epidemiology and risks of the main communicable diseases in the major potential destinations, recommended immunizations and other preventives measures to be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Dengue poses a significant risk in all states, including the host cities. Vaccination against yellow fever is recommended except for travelers who will only visit coastal areas. Travelers visiting high-risk areas for malaria (Amazon) should be assessed regarding the need for chemoprophylaxis. Chikunguya fever may be a threat for Brazil, given the presence of Aedes aegypti, vector of dengue, and the possibility of travelers bringing the virus with them when attending the event. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing these vector-borne infections. Other important recommendations for travelers should focus on preventing water and food-borne diseases such as hepatitis A, typhoid fever, giardiasis and traveler's diarrhea. Sexually transmitted diseases (STD) should be also mentioned and the use of condoms advocated. This review addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during a mass gathering such as the World Cup and also reviews the spectrum of endemic infections in Brazil to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.

Yellow fever in a Brazilian family returning from vacation in an endemic area: relevant clinical features and epidemiological issues.

We report three cases of yellow fever (YF) in a family traveling from the city of Sao Paulo, Brazil (without previous vaccination) to an endemic area, acquiring the disease and presenting mild-to-moderate symptoms. Despite posing the intermittent risk of YF in endemic areas, it also alerts to the threat of introduction and spread of YF in the urban cycle, when infected travelers return to non-endemic areas where potential vectors are highly prevalent.