by Claire Vernon
Athletes and sports fans around the world are preparing for the 2016 Olympic Games which begin this Friday in Rio de Janeiro, Brazil  but as we look toward the imminent competition, “off-the-field” issues are at the forefront of the discussion. Public health has risen as a primary concern for Rio 2016 among the more usual speculation on whether the facilities, housing, and the host city itself will rise to support the massive tourism influx of the world’s top athletes and their fans. These public health concerns have been varied, swinging from Zika virus to contaminated water, both in competition waters and at the iconic Rio beaches. While the WHO does not expect the Games  to significantly increase the already wide spread of the Zika virus , top athletes in golf, basketball, and tennis have decided not to compete in Rio  citing both general health concerns and worry over the potential impact of Zika on their own and their families’ health.
Alarm over water quality has risen as it has become clear that clean water promises have not been achieved as planned. The city’s failure to fully achieve its water sanitation goals presents risk not only to rowers, sailors, and swimmers who practice in and will compete in contaminated waters, but also to athletes and fans planning to visit Rio’s famed beaches as part of their Olympic holiday.
Though unfortunate, public health concerns surrounding major international events are not new. Last year, the NPHR featured a story on the international public health concern over typhoid in Chicago  leading up to the 1893 World’s Fair, a story that mirrors the water sanitation dysfunction and public health problems facing Rio. Contention over the methods of quantifying water cleanliness are present in both stories: over a century ago in Chicago, chemical estimates of human waste were being used as an inaccurate proxy for bacterial load; today in Rio, reliance on bacterial chloroform levels as a proxy for pathogenic bacteria and viral load represents a major difference between groups expressing gentle notes of caution and those sounding alarm bells. Use of different testing methods has lead to opposing opinions  on the safety of both competition and recreational waters around Rio, and the lack of consensus seems to have only fanned the fire of concern over the potential public health risk from water-borne disease.
We know that Chicago successfully cleaned its water and the organizers took additional precautions in and around their fairgrounds—no typhoid cases were attributed to travel for the 1893 World’s Fair. A secondary benefit was drastic reduction of typhoid among city residents, an outcome that might well have taken years had the international community not publicly chastised Chicago for its inadequate water sanitation infrastructure. As the current international community turns its eyes to Rio de Janeiro for this pinnacle of athletic achievement, we also wait with anticipation for this impending public health event. We certainly hope that improvement is evident both in Zika prevention and water cleanliness for the city’s visitors and its residents; after months of speculation, we will have our answer soon.
 WHO statement on Zika risk at the 2016 Olympic Games: http://www.who.int/mediacentre/news/releases/2016/zika-health-advice-olympics/en/. Accessed 1 August, 2016.
 CDC report of Zika cases in the US: http://www.cdc.gov/zika/geo/united-states.html. CDC Zika travel warning for Miami, FL: http://www.cdc.gov/zika/intheus/florida-update.html. Both accessed 3 August, 2016.
 Several high-profile golfers pull out of 2016 Olympics citing Zika concerns: http://www.theatlantic.com/news/archive/2016/06/olympic-zika-jason-day/489113/. Top athletes not attending the 2016 Olympics and their stated reason: http://sports.yahoo.com/news/top-athletes-who-are-skipping-the-rio-olympics-142955670.html. Both accessed 3 August, 2016.
 Dr. Bronwyn Rae, Water, Typhoid Rates and the Columbian Exposition in Chicago in the Northwestern Public Health Review: http://www.publichealth.northwestern.edu/nphr/2015-v2i2/3-rae.html. Accessed 3 August, 2016.
 WHO statement on Rio water pollution and bacterial versus viral testing: http://www.who.int/water_sanitation_health/bathing/statement-rio-water-quality/en/. Viral levels in Rio July 2016 and prior: http://www.independent.co.uk/sport/olympics/rio-2016-water-pollution-virus-risk-danger-swimming-sailing-rowing-chance-of-infection-almost-a7165866.html.