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Major disease risk is looming in Brazil as Olympics near, and it’s not just Zika

From toxic, waste-riddled water to bad air and viruses, Rio de Janeiro contains a wide variety of health risks to Olympic athletes.

Rio de Janeiro’s shameful practice of dumping household waste, medical waste, industrial waste, you name it alongside some of the globe’s most glorious beaches hasn’t gone unnoticed, exactly, in coverage leading up to the 2016 Summer Games’ opening on Friday.
REUTERS/Kai Pfaffenbach

Suddenly Rio’s beachfront sewage problem is in the headlines everywhere.

Bound to happen, I guess, when a public health expert tells the Associated Press that 1,400 Olympic sailors, windsurfers, rowers and paddlers risk “getting violently ill” from tiny amounts of seawater taken in by mouth or nose, and advises:

Don’t put your head under water.

Rio de Janeiro’s shameful practice of dumping household waste, medical waste, industrial waste, you name it alongside some of the globe’s most glorious beaches hasn’t gone unnoticed, exactly, in coverage leading up to the 2016 Summer Games’ opening on Friday.

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But the public-health horrors this contamination presents for athletes competing in Guanabara Bay — and, for that matter, to any among the half-million Gamesgoers who think a dip at Ipanema or Copacabana would yield an awesome selfie — have been overshadowed until recently by concern about, say, Zika virus. (Also, by predictions that Brazil’s imploding economy and political structure will burden enjoyment of the quadrennial sports festival with inconvenience.)

In late June we had the news that Zika worries had moved Jason Day, top-ranked golfer in the world, to take a pass on the first Olympics in more than a century to include his sport. 

Ten other golfers (none of them women, by the way) have done the same, according to a list maintained at Wikipedia, as have six tennis players and a cyclist. NBC’s Savannah Guthrie has sensibly put her pregnancy ahead covering the Games.

While Zika is a scary virus, so are a lot of other things in the waters off Rio. For that perspective, we are all indebted to the AP and its decision 16 months ago to commission a study of public health risks independent of the interests of Brazilian agencies and the International Olympic Committee (IOC).

Excerpts from Monday’s report:

The most contaminated points are the Rodrigo de Freitas Lagoon, where Olympic rowing will take place, and the Gloria Marina, the starting point for the sailing races.

Sampling at the Lagoon in March 2015 revealed an astounding 1.73 billion adenoviruses per liter. By this June, adenovirus readings were lower but still hair-raising at 248 million adenoviruses per liter. By comparison, in California, viral readings in the thousands per liter set off alarm bells.

Despite a project aimed at preventing raw sewage from flowing into the Gloria Marina through storm drains, the waters remain just as contaminated. The first sampling there, in March 2015, showed over 26 million adenoviruses per liter. This June, over 37 million adenoviruses per liter were detected.

The first results of the AP study published over a year ago showed viral levels at up to 1.7 million times what would be considered worrisome in the United States or Europe. At those concentrations, swimmers and athletes who ingest just three teaspoons of water are almost certain to be infected with viruses that can cause stomach and respiratory illnesses and more rarely heart and brain inflammation — although whether they actually fall ill depends on a series of factors including the strength of the individual’s immune system.

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Some take precautions

The AP noted that some athletes have been upgrading their clothing and equipment-cleaning practices to lower the risk of infection. Some have been taking preventive courses of antibiotics, which may help with bacterial but not viral pathogens, which turned up at 90 percent of the sites its contractors have tested.

For examples, consider Helena Scutt and Paris Henken, who plan to sail for the United States in a new women’s event centered on the 49erFX. This is a high-performance skiff fitted with special trapezes that require the crew to hang out over the water,  in the spray, throughout the race.

Though this might put them at the highest risk of waterborne infection among all the athletes in Rio, they told The New York Times in March that while they would follow certain precautions — Scutt, but not Henken, took antibiotics during a training visit to Rio — they never considered staying home. As Scutt explained:

It’s easy for people to say sailors should just throw their hands up and not compete, but the reality is that if we do that, there’s 50 people on line behind us who will take our spot.

Then there is Minneapolis native Megan Kalmoe, an Olympic rower who thinks media attention to Rio’s disease-bearing waters is misplaced and overblown, and who pledged on her blog July 19 that “I will row through shit for you, America.”

(Fine, Ms. Kalmoe.  Who asked you to?)  

Self-interest and the IOC

One way to look at Olympic athletes, and the vast apparatus supporting their endless training and events, is the conventional one: These are amateurs who push themselves through barriers for the love of excellence, and elevate us all in the process.

Another view is that the competitors, the national committees and the IOC are collaborators in an ego-driven, self-gratifying system that consumes, in the service of sport and entertainment, a host of resources in countries that sometimes haven’t yet met the basic needs of their own people.

For example Brazil, where waste handling is so abysmal that one of its own Olympic-minded competitive sailors told The New York Times two years ago of encountering dog carcasses afloat at the regatta site, and of “how his dinghy crashed into what he believed was a partly submerged sofa, capsizing him into the murky Guanabara.”

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The venue is sufficiently awful that the head of the International Sailing Federation, Britain’s Peter Sowrey, pushed last year for the Olympic events to be moved to another Brazilian location. For his trouble, he told the UK Guardian, the ISAF board invited him to shut up and then to step down.

Lest I seem simply to be beating on beleaguered Brazil, I offer this interesting bit of context from Olga Khazan’s piece in The Atlantic in March:

The world over, raw sewage routinely makes its way into bodies of water. Boston discharged sewage without treatment until 1952, when the city’s first sewage treatment plant was built. San Diego also discharges sewage directly into the water only after “primary” treatment — a preliminary step that mainly only filters out the “solids.”

Sydney, Australia, which hosted the summer games in 2000, also has several outfalls that rely on primary treatment alone. Until the late 1990s, Brussels, Belgium, dumped all of its sewage directly into the river Senne, rendering the water quality “comparable to that of sewage,” as the OECD noted at the time. Just a few months ago, Montreal dumped two billion gallons of untreated sewage into the St. Lawrence River so it could repair its old pipes. …

The problem with many of the beaches in Rio is that they are connected to canals and stormwater drains, which are home to more raw sewage than such waterways typically are in more developed countries. Rain sends even more sewage coursing through, so Ipanema and Copacabana, like many of the world’s beaches, teem with fecal bacteria after storms.

Other risks as well

Though it’s getting deserved attention at last, sewage in the bay is hardly Rio’s only public health threat of note. The city also has the worst air quality of any Olympic venue except Beijing, according to a Reuters story from Monday.

There are antibiotic-resistant “superbacteria” in the Lagoa Rodrigo de Freitas, an inland body connected by canal to the ocean not from the point where Guanabara’s waters pass the marathon swim and triathlon venues before emptying into the sea, according to the AP’s consultants.

A curated roundup in BuzzFeed adds dengue fever and the chikungunya virus to the list, along with parasites including hookworm.

And of course Zika remains a huge concern, not only for its high prevalence but also because a half-million new human carriers from 206 countries around the world are about to place themselves in some degree of contact with it.

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That was enough to move more than 100 epidemiologists and other medical experts to call for the Games to be moved or postponed but not enough — is anyone surprised?  — to persuade the IOC.