The 64 World Cup soccer (fotbol) matches started a week ago in 12 German cities and will continue until July 9. Three million soccer fans are expected from Europe and beyond. Three of the cities where matches will be played, Cologne, Dortmund and Gelsenkirchen, are in the German state of Nordrhein-Westfalen. So is a measles outbreak in children and young adults. The Ukraine is also experiencing a large measles outbreak, with case numbers exceeding 20,000 by the end of February. The Ukrainian National team qualified for the tournament and will undoubtedly have many fans there. Meanwhile nearby Austria is having a mumps outbreak concentrated in the 18 – 30 age group in southern Austria (Carinthia; via Eurosurveillance). A mumps case, in a 23 year old British fan has already been reported at the Nuremberg venue. The game is afoot.
Recently we posted on a measles outbreak in Boston traced to an Indian computer programmer who infected others in a high rise office building shortly after arrival. Measles and mumps are preventable diseases and vaccination has produced a substantial herd immunity in the European and American population. But because both diseases are quite contagious (high basic reproductive numbers, R0), the immunization coverage must also be high to prevent an outbreak. The strategy of “free-riding” that depends on others being vaccinated is risky, at best. We are also unsure how long the measles and mumps vaccines provide protection. The original view it was life-long is probably incorrect.
German public health authorities have instituted a special World Cup surveillance effort. If you want to follow a different kind of action you can find an an English language infectious disease play-by-play at a special website established by the Rudolph Koch Institute.
I had not thought about the public health aspects of the World Cup but it is obvious now. What other sports events bring so many from so far together in one place? Seems to me only the Olympics is in the same league.