Highlights
- •Commonwealth Games on the Gold Coast, Australia in 2018 (GC2018) will bring in visitors, athletes and officials from 71 countries.
- •Zika virus (ZIKV) infected visitors will likely be there and the local transmission of ZIKV during GC2018 will largely depend on the future growth of Aedes mosquito population in the area.
- •Control of Aedes mosquito population, and early detection and containment of any imported cases will be essential for the prevention of local transmission of Zika during GC2018.
Keywords
The ongoing outbreak of Zika virus (ZIKV) in Brazil followed introduction of the virus after international mass gatherings including the FIFA Soccer World Cup and an international canoe race, in 2014 [
[1]
]. However, phylogenetic analysis demonstrates that ZIKV circulated in Brazil from 2013 resulting from a single introduction [[2]
]. The Rio Olympics have been held and the world is waiting to see what impact this may have on the global spread of Zika. Risk assessments had given inconsistent predictions [3
, 4
]. In April 2018, the 21st Commonwealth Games will be held on the Gold Coast in Queensland, Australia (Gold Coast 2018 or GC2018) []. Among the potential health risks associated with the games is ZIKV. We discuss the likelihood of local ZIKV transmission in connection with GC2018 [].Zika, a Flavivirus, is primarily transmitted by female Aedes mosquitoes among humans resulting in short-lived (2–7 days), self-limiting illnesses with symptoms including fever, rash, joint pain, muscle pain, headache, and conjunctivitis [
7
, , 9
, 10
]. It may also be sexually transmitted [11
, 12
], although importance for transmission is unclear. Most remain asymptomatic [, 10
]. However, ZIKV may also cause more serious outcomes, Guillain–Barré syndrome and congenital Zika virus syndrome [13
, 14
]. In February 2016, World Health Organization (WHO) declared a global public health emergency of international concern after an association was suggested between ZIKV infection during pregnancy and microcephaly [13
, 15
, 16
, 17
, 18
, 19
]. Although this declaration has recently been withdrawn, the global threat of Zika virus infection and its consequences still remain [[20]
]. As of 30 November 2016, seventy-five countries and territories have reported local transmission of ZIKV since 2007, including 69 countries from 2015 onwards [WHO. Fifth meeting of the Emergency Committee under the International Health Regulations (2005) regarding microcephaly, other neurological disorders and Zika virus. Available from: http://www.who.int/mediacentre/news/statements/2016/zika-fifth-ec/en/.
[21]
]. Twenty-eight countries or territories reported microcephaly or other central nervous system malformations that can possibly be related to ZIKV infections including Brazil alone reporting more than 2000 cases.Zika has not been transmitted in Australia [
[22]
]. During 2016 to 02 December, 55 confirmed ZIKV cases have been reported in Australia, around half from Queensland. Infections were acquired from 21 countries with Pacific island nations contributing a substantial proportion. Fifty three countries are members of the Commonwealth [], and approximately 6500 athletes and officials from 71 countries are expected to travel to the Gold Coast to attend the Games []. There will be 690,000 visitors and 1.5 million people attending the ticketed events [[24]
]. ZIKV transmissions have so far occurred in several Commonwealth countries including a few from the Caribbean and Americas, South Africa from Africa, Bangladesh and Maldives from South Asia, a few countries from South-East Asia, and island nations of the Pacific [25
, 26
]. There is, therefore, a considerable likelihood some will arrive viraemic with ZIKV. The ZIKV remains in the blood on an average for 10 days, in urine for 12 days or more, and in semen for over 60 days [[27]
].The primary vector of the virus, Aedes mosquito, is currently present in Australia. Aedes aegypti is common in the Northern and Fart North coastal areas of Queensland [
28
, 29
]. It also occurred in South East Queensland in the past [28
, 30
]. Larval surveys of container habitats are the traditional methods of identifying the abundance of this vector in its immature forms [City of Gold Coast: mosquitoes fact sheet. Available from: http://www.goldcoast.qld.gov.au/documents/bf/Mosquitoes_fact_sheet.pdf.
[31]
]. But surveillance of adult mosquitoes using traps and aspirators provide more direct evidence on the disease transmission risk. The risk of occurrence of locally acquired dengue cases is increased in the country during April, following the summer wet season [[32]
]. By analogy with dengue, the risk of vector transmission of ZIKV is likely to be increased around April when GC2018 will take place.The likelihood of local transmission of ZIKV on the Gold Coast will largely depend on the future growth of Aedes mosquito population in the area and whether it goes over the transmission threshold [
[33]
]. Sexual transmission can also play a significant role in disease transmission, especially in the absence of sufficient vector density. Internal travel by attendees might trigger an epidemic in Northern and Far North Queensland. Thus control of Aedes mosquito population by targeting them directly or indirectly [[34]
], effective use of condom in preventing sexual transmission, and early detection and containment of any imported cases will be essential for the prevention of local transmission of Zika during Commonwealth Games 2018.Authorship statement
Kazi Rahman conceived the idea and prepared the first draft. David Harley and David Plummer reviewed the draft, and made edits and comments. Kazi Rahman finalized the writing for submission.
Conflict of interest
The authors declare no conflict of interest in relation to this work.
Funding
This work received funding from Griffith University School of Medicine, Gold Coast, Queensland, Australia through the start-up research funding (MED1009) mechanism for Kazi Rahman.
Provenance and peer review
Not commissioned; externally peer reviewed.
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Article info
Publication history
Published online: December 26, 2016
Accepted:
December 4,
2016
Received in revised form:
December 4,
2016
Received:
September 7,
2016
Identification
Copyright
© 2016 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.
