Football fans travelling to Brazil have been warned that foodborne outbreaks could occur during the tournament, according to the European Centre for Disease Prevention and Control (ECDC).
EU citizens visiting the football World Cup from June 12 to July 13 will be most at risk of gastrointestinal illness and vector-borne infections, said the agency.
Limited foodborne outbreaks due to bacterial and viral infections are expected, especially in the warmest part of the country, where high temperatures increase the risk.
The risk to be affected by gastrointestinal illness will be reduced by standard hygienic measures, said the agency.
It advised use of bottled drinks and mineral water, factory-produced ice cubes, eating thoroughly cooked meat and fish, serving mixed meals such as feijoada (a typical Brazilian dish) or lasagne at temperatures above 60 °C, salads at below 5 °C, and sanitising all fruits and vegetables before consumption.
ECDC said it would conduct enhanced epidemic intelligence surveillance for communicable diseases from 5 June to 20 July so that public health threats can be detected early and interventions made.
The overall approach to surveillance during the 2014 Brazil World Cup will be ‘enhanced business as usual’ as during previous mass gathering monitoring, said the agency.
Ten EU national teams will participate in the 2014 World Cup in Brazil, and a large number of EU travellers will visit the country during the event.
Outbreaks per year
From 2000 to 2013, the Brazilian Ministry of Health reported an average of 665 foodborne outbreaks per year.
Causative agents were, in order of frequency, Salmonella sp., Staphylococcus aureus, E.coli and Bacillus cereus.
The settings most often associated with these outbreaks were private residences, followed by food outlets and pastry shops, reported Ritter et al.
The overall risk of food- or waterborne disease importation from Europe to Brazil is very low.
A study from Wilson et al in travellers returning from Brazil identified Campylobacter and Giardia spp. as the most frequent pathogens associated with gastrointestinal illness.
The tournament takes place in the southern hemisphere winter, and climate/weather conditions will vary significantly between the Brazilian venues, ranging from the tropical warmth in the northern and north-eastern regions to chilly weather in the southern region.
Similar enhanced surveillance was done for the Olympic Games in London in 2012 and the UEFA European Championship in Poland and Ukraine in 2012.