Multiple Outbreaks Threaten the 2018 Winter Olympics


The 2018 Winter Olympics began on Thursday, February 8th in PyeongChang, South Korea. The games bring 206 countries to participate [1], comprising of nearly 3,000 athletes, coaches and team officials [2]. This year will notably include a delegation from North Korea, who will participate alongside South Korea in several events [3].


However, the games have been hindered by a norovirus outbreak days before the events commenced. Since the outbreak began there have been 199 confirmed cases of norovirus [4], with the majority of cases being security guards for the games [5]. 41 guards have been hospitalized and more than 1,200 security guards are under isolation after reports of severe gastrointestinal symptoms. The source of the outbreak is unknown; however, the security guards were all staying at a youth training center in PyeongChang. Testing is being done on water and food at the training facility [6].


Norovirus is an extremely infectious disease that is transmitted through contaminated food and water, or by touching a contaminated surface. Infection causes inflammation of the stomach and intestines, which lead to stomach pains, nausea, vomiting, and diarrhea [7]. Due to the high level of infectiousness, a serious threat is posed to athletes and spectators attending the games. The large influx of people within a close proximity could lead to an outbreak of much greater magnitude if not dealt with properly.


To cover the resulting gap in security after guards were placed under isolation, South Korea has employed around 900 military personnel to provide security during the games [8].  Hand sanitizers have been installed at the Olympic venues to prevent spread of the virus, and there will be a heightened response to reports of illness by games officials. If you are attending the games, the best individual practice to avoid transmission of norovirus is to practice proper hand hygiene and prepare food carefully before serving [7].


In addition to the norovirus outbreak directly impacting Olympic games personnel, there is rising concern over swine flu and avian flu presence in the Korean peninsula. North Korea has been experiencing an outbreak of Influenza A/H1N1, also known as swine flu [9], while South Korea has confirmed the presence of a highly pathogenic strain of avian flu at two chicken farms [10].


In North Korea, approximately 110,000 cases of Influenza A/H1N1 have been confirmed between December 1st, 2017 and January 26th, 2018 [11], with over 179,000 North Koreans in total reporting flu-like illness during that time period. This number has increased by 30,000 cases from figures reported just one week ago [11]. The North Korean Ministry of Public Health is working in partnership with the World Health Organization (WHO) to combat the outbreak. The WHO has supplied 5,000 antiviral tablets to help reduce the spread of the flu. A weekly reporting system has also been set up to improve monitoring and response time [9].


Concurrently, South Korea faces a potential outbreak of its own, as the H5N6 avian influenza virus has been identified at two chicken farms in Gyeonggi [12] (more specifically Pyeongtaek and Hwaeseong [10]), which lies approximately 80 miles west of PyeongChang. H5N6 is a strain of influenza that is found in birds; however, while rare, it can be passed on to humans through contact with an infected bird or a contaminated surface [13]. No human cases have been reported thus far. In efforts to prevent transmission, the government has culled 334,000 chickens at the two farms. The government is also calling for an additional 430,000 chickens on farms within a 500-meter radius of the farm in Pyeongtaek to be slaughtered, and nearly 500,000 eggs at the Hwaeseong farm to be destroyed as a precaution. Other farms in the area are being disinfected. The same strain has previously been found in China, with 16 human cases and six deaths occurring since 2014 [10].


As the 2018 Winter Olympics kick off, participants and spectators must work in cooperation with government officials to prevent disease transmission, and take seriously the potential for these current outbreaks to severely escalate if proper prevention measures are not adhered to.


















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