As the World Cup arrives in Philadelphia and other cities across the United States, public health officials and healthcare workers are preparing for rises in infectious disease cases.
Six World Cup matches will be hosted in Philadelphia from June 14 to July 4. Consequently, cases of illnesses that have been uncommon in Pennsylvania in recent years are at risk of increasing, according to doctors at the Children’s Hospital of Philadelphia who spoke with The Daily Pennsylvanian.
Measles is one illness of concern because it is highly contagious and can become severe, clinical pediatrics professor and CHOP primary care physician Katie Lockwood explained in an interview with the DP.
“If you’re not vaccinated in a room with measles, nine out of 10 people will get it,” Lockwood said, adding that the virus can “linger in the air for two hours.”
Clinical pediatrics professor Ericka Hayes — who also serves as CHOP’s senior medical director of infection prevention — told the DP that the risk of a rising number of measles cases is amplified by a recent wave of vaccine hesitancy.
“It’s really the under-vaccination in our country, which is really making us vulnerable for these continued outbreaks,” Hayes said of the disease, listing examples of measles outbreaks in Texas and South Carolina.
“We’ve always had a small trickle of international measles cases come into the United States on a pretty regular basis,” she added. “Measles isn’t out of control; however, in the United States right now because of travel-imported cases — it’s really out of control because, unfortunately, in some cases, that traveling case has found a population of under-vaccinated individuals.”
Lockwood also highlighted concerns about pertussis, a “vaccine-preventable illness” that “can be extremely dangerous, especially for our youngest children.”
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To protect “the most vulnerable,” she encouraged people to check that family members are up to date with vaccines, “especially those adults who might have forgotten that routine immunizations are still important.”
For the World Cup, Philadelphia plans to expand wastewater testing for pathogens. Measles and other respiratory illnesses — including the flu, which could travel from abroad given that the Southern Hemisphere is currently in winter — can be tracked through wastewater, CHOP attending physician Sesh Sundararaman told the DP.
“One of the things that we learned from the pandemic was that wastewater surveillance is actually a really powerful tool to identify some of these diseases and see how they’re spreading, even if patients aren’t either presenting to a hospital or being recognized immediately by clinicians,” Sundararaman explained.
Contact tracing to identify any potentially sick individuals and related measles exposures is also “really important,” he added. Meanwhile, Hayes noted that the City of Philadelphia has been “an extraordinarily strong partner” in ensuring that hospitals and clinicians are “jumping on any potential cases.”
While Sundararaman said that respiratory illnesses are the most concerning “in a setting like the World Cup,” doctors remain aware of vector-borne diseases such as dengue, which Hayes said is primarily imported from travelers.
Although the primary mosquito species that carries dengue does not live in Philadelphia, the city is home to a different species — the Asian tiger mosquito — which can pick up the disease. This species may bite someone else after it becomes infected with the virus, or it may never bite anybody else, Sundararaman said.
Beyond wastewater tracking and contact tracing, Philadelphia has also developed an on-site mobile lab to reduce the need to send specimen samples elsewhere and increase disease-testing speed.
To prevent outbreaks, Lockwood recommends that individuals have a “lower threshold to give us a call and check in if you are having symptoms, particularly high fevers, irritability, and dehydration.”
“We are a global world, and people are really one flight away,” Hayes said. “So really, we can’t put our heads in the sand thinking about infectious diseases.”
