The document summarizes advisories regarding risks of Zika and other diseases in Rio de Janeiro in August and September 2016. While some advisories have stated risk is low during winter months, weather data and infection rates show risk can still be significant. Zika symptoms include fever and joint pain. Dengue is also a major threat. Steps to prevent mosquito bites include insect repellent and protective clothing. Vitamin D may offer some protection against viruses like Zika and Dengue, but taking too much poses risks of hypercalcemia. More research is still needed.
1) Mexican officials reported no new deaths from swine flu overnight, though confirmed cases rose to 443. The virus continues spreading globally with new cases in Europe and Asia.
2) Experts are unsure if the epidemic is stabilizing in Mexico or if it is too early to tell, but systems are being implemented to better monitor the situation.
3) Scientists are working to determine the virus's mortality rate and origin, though it appears the outbreak could have been worse given the population density and time it has circulated in Mexico City.
The world’s biggest multi-sport event summer Olympics Games 2016 officially known as the Games of the XXXI Olympiad, and commonly known as Rio 2016 due to take place Rio de Janeiro, Brazil, from 5th to 21st August, 2016. More than 10,500 athletes from 206 National Olympic committees (NOCs) will take part.[1] These sporting events will take place at 33 venues in the host city Rio de Janeiro and at least 5 venues in the cities of Säo Paulo, Belo Horizonte, Salvador, Manaus and Brazil’s capital Brasilia. International Olympic Committee (IOC) have predicted around 4,80,000 tourists will arrive at Rio de Janeiro for this mega event.[2] Similar to the other tropical countries the tourists will be at risk of acquiring gastrointestinal illnesses and vector-borne infections.
Dr John Bergman discusses the true CAUSE of the most recent PANDEMIC SCARE...EBOLA! Get the real facts and research studies that reveal the truth about this "dreaded disease". Did you know that Ebola was discovered back in 1976? Why are we JUST NOW hearing about the risk to Americans? Learn 5 simple steps already proven to eliminate Ebola in Africa.
Asbestos is a naturally occurring mineral that was commonly used in construction and manufacturing due to its desirable properties such as sound absorption, strength, and heat and chemical resistance. However, inhaling asbestos fibers can cause serious illnesses like cancer and asbestosis. The European Union has banned all uses of asbestos due to these health risks, especially from long-term exposure to high concentrations of asbestos fibers. Asbestos was historically used in products that required resistance to fire, heat, or electricity.
Asbestos is a naturally occurring mineral that was commonly used in construction and manufacturing due to its desirable properties such as sound and heat resistance. However, inhaling asbestos fibers can cause serious illnesses like cancer and asbestosis. The European Union has banned all uses of asbestos due to these health risks. Asbestos was used in products that required resistance to fire, heat, or electricity but its usage has declined as the health dangers became clear.
1) Mexican officials reported no new deaths from swine flu overnight, though confirmed cases rose to 443. The virus continues spreading globally with new cases in Europe and Asia.
2) Experts are unsure if the epidemic is stabilizing in Mexico or if it is too early to tell, but systems are being implemented to better monitor the situation.
3) Scientists are working to determine the virus's mortality rate and origin, though it appears the outbreak could have been worse given the population density and time it has circulated in Mexico City.
The world’s biggest multi-sport event summer Olympics Games 2016 officially known as the Games of the XXXI Olympiad, and commonly known as Rio 2016 due to take place Rio de Janeiro, Brazil, from 5th to 21st August, 2016. More than 10,500 athletes from 206 National Olympic committees (NOCs) will take part.[1] These sporting events will take place at 33 venues in the host city Rio de Janeiro and at least 5 venues in the cities of Säo Paulo, Belo Horizonte, Salvador, Manaus and Brazil’s capital Brasilia. International Olympic Committee (IOC) have predicted around 4,80,000 tourists will arrive at Rio de Janeiro for this mega event.[2] Similar to the other tropical countries the tourists will be at risk of acquiring gastrointestinal illnesses and vector-borne infections.
Dr John Bergman discusses the true CAUSE of the most recent PANDEMIC SCARE...EBOLA! Get the real facts and research studies that reveal the truth about this "dreaded disease". Did you know that Ebola was discovered back in 1976? Why are we JUST NOW hearing about the risk to Americans? Learn 5 simple steps already proven to eliminate Ebola in Africa.
Asbestos is a naturally occurring mineral that was commonly used in construction and manufacturing due to its desirable properties such as sound absorption, strength, and heat and chemical resistance. However, inhaling asbestos fibers can cause serious illnesses like cancer and asbestosis. The European Union has banned all uses of asbestos due to these health risks, especially from long-term exposure to high concentrations of asbestos fibers. Asbestos was historically used in products that required resistance to fire, heat, or electricity.
Asbestos is a naturally occurring mineral that was commonly used in construction and manufacturing due to its desirable properties such as sound and heat resistance. However, inhaling asbestos fibers can cause serious illnesses like cancer and asbestosis. The European Union has banned all uses of asbestos due to these health risks. Asbestos was used in products that required resistance to fire, heat, or electricity but its usage has declined as the health dangers became clear.
World Wide Web memungkinkan pengguna internet mengakses dan berbagi informasi, gambar, suara, dan video melalui website. Email merupakan sarana untuk mengirim surat secara elektronik secara cepat tanpa batas ruang dan waktu. Mailing list memungkinkan pertukaran informasi secara berkelompok melalui email. Internet Relay Chat memungkinkan pengguna berinteraksi secara langsung melalui obrolan teks atau suara dan gambar.
Vitamin D for Disaster Response - summaryalanroth1
- A study at Grady Memorial Hospital found that giving trauma patients high doses of vitamin D3 upon admission and daily thereafter reduced mortality close to zero, reduced infections and inflammation, and lowered costs by reducing need for ventilators, pain medication, and length of hospital stay with no adverse effects.
- An Emory University study found critical care patients given high dose vitamin D3 had significantly shorter hospital stays, with the highest dose group having a length of stay half that of the placebo group.
- Reviews of studies show low vitamin D levels prior to surgery are associated with worse surgical outcomes and raising vitamin D levels could have major benefits with minimal costs.
ARoth AMAA article on Vitamin D for athletesalanroth1
This article discusses the potential benefits of vitamin D for improving athletic performance. It begins by outlining sources of vitamin D and how the body metabolizes it. The article then reviews several placebo-controlled studies that found improvements in muscle strength, power, and reduced injuries among athletes supplemented with vitamin D. Deficiency is defined as a blood level below 50 ng/mL. While sun exposure can provide vitamin D, excessive unprotected sun exposure risks skin cancer. The article concludes that vitamin D supplementation depending on an individual's starting blood level could lead to improvements in athletic performance.
Asbestos is a naturally occurring mineral that was commonly used in construction and manufacturing due to its desirable properties such as sound and heat resistance. However, inhaling asbestos fibers can cause serious illnesses like cancer and asbestosis. The European Union has banned all uses of asbestos due to these health risks. Asbestos was used in products that required resistance to fire, heat, or electricity but its usage has declined as the health dangers became clear.
This document discusses Road Weather Information Systems (RWIS) and Environmental Sensor Stations (ESS). It provides background on RWIS, describes the components and purpose of ESS, and outlines considerations for planning and siting new ESS. Key benefits of RWIS data include improved road safety and operations through weather and road condition monitoring. Proper planning involves analyzing operational needs, consulting maintenance staff, and partnering with other weather monitoring organizations.
1. Internet adalah jaringan komputer global yang saling terhubung, memungkinkan pertukaran informasi. Intranet adalah jaringan komputer privat yang digunakan oleh suatu organisasi.
2. Teknologi komunikasi internet seperti email dan chatting memungkinkan pertukaran informasi secara cepat. Aplikasi seperti FTP dan website memudahkan penyebaran informasi.
3. Internet telah banyak dimanfaatkan dalam berbagai bidang seperti kesehatan, perbank
FHWA and Chicago HS for Agricultural Sciences shadow day 02-08-12 picturesraymurphy9533
The document discusses a groundhog job shadowing event held by the Federal Highway Administration on February 8, 2012. The FHWA Office of Technical Services hosted students to expose them to careers in transportation and discuss potential solutions to future transportation needs. The event aimed to bring awareness of tomorrow's transportation solutions to address current transportation challenges.
The document provides a risk assessment of the 2016 Summer Olympics in Rio de Janeiro, Brazil. It identifies the main risks as health issues, infrastructure problems, and security threats. For health, the biggest concerns are water contamination, the Zika virus outbreak, and a lack of adequate medical staff and facilities. Infrastructure risks include incomplete construction of venues and transportation issues. Security risks involve high criminal activity and the potential for terrorism. The assessment rates these risks and provides recommendations, with a focus on improving health risks through measures to address water, Zika, and medical preparedness.
Globally, Dengue Fever Is Rising. What You Should Know and How to Keep SafeThe Lifesciences Magazine
Alarms are being raised by governments and public health specialists worldwide regarding the unprecedented proliferation of dengue, one of the most infamous and fatal diseases that nearly half of humanity is susceptible to contracting.
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The document summarizes predictions from universities in Singapore and Minnesota regarding the end of the COVID-19 pandemic in Brazil and worldwide. Researchers in Singapore predict that 97% of the crisis will end by May 30th, 2020 and 100% by December 2nd, 2020. They predict the pandemic will slow in Brazil by June 6th and health will be recovered by September 6th, 2020. Researchers at the University of Minnesota believe the pandemic may involve repetitive waves over 1-2 years or a severe second wave in late 2020, and that 60-70% of the population needs immunity for it to end. Overall predictions vary in optimism, with Singapore's estimates being more optimistic and Minnesota's acknowledging the pandemic may not end soon.
Migrating Diseases
Our second ‘World in 2030’ foresight focuses on the growing threat from migrating diseases that are being enabled by the escalating implications of global warming.
The fast-developing view is that with 2oC of global warming probable and 4oC possible, health systems will struggle to address the growing impact of climate change. The increased spread of vector-borne diseases is joining poor air quality as a major public health threat.
More anticipate an extension of the reach and duration of tropical disease alongside the re-emergence of old infections. Certainly, warmer conditions and changes in precipitation are facilitating the expansion of disease-carrying vectors, such as mosquitoes and ticks. Dengue fever has joined malaria and Lyme’s on the list of fast-spreading diseases that are, most significantly, entering countries with little or no prior experience of them. To stem the tide, improved surveillance, enhanced HCP education and better public understanding are all being called for.
This foresight is one of 50 looking at the key issues for the next decade that are being shared throughout 2020.
https://www.futureagenda.org/foresights/migratingdiseases/
Coronavirus effects heighten fears of recession in the world economy. Stock exchanges have had a difficult week around the world and, in Europe, the recession seems inevitable. The paralysis in China weighs on domestic growth because the supply chains of multinationals need components made in Chinese factories to guarantee their production. Consumption in western countries will be strongly affected. Tourism, air transport, leisure are already suffering the consequences.
What Insurers Can Learn From the Zika Outbreak Gen Re
In the weeks leading up to the 2016 Summer Olympic Games, a few athletes announced they would forgo the games for fear of contracting the Zika virus in Brazil. There’s a good chance athletes aren’t the only ones avoiding traveling to South America. While Zika presents with very minor symptoms that sometimes go unnoticed in adults, it can lead to microcephaly for infants born from mothers who have contracted it.
Read more here: http://www.genre.com/knowledge/blog/
U.S. Preps For Ebola Outbreak Cases May Exceed 100,000 By December “The Numbe...Hope Small
The article does not mention that a completely unrelated strain of ebola has broken out in the Congo. What are the chances of that?
Though news on the Ebola virus has been muted since two American health care workers were admitted to U.S.-based facilities last month, the deadly contagion continues to spread. According to the World Health Organization more than 40% of all Ebola cases thus far have occurred in just the last three months, suggesting that the virus is continuing to build steam.
Physicist Alessandro Vespignani of Northeastern University in Boston is one of several researchers trying to figure out how far Ebola may spread and how many people around the world could be affected. Based on his findings, there will be 10,000 cases by September of this year and it only gets worse from there.
The presentation covers known Variants Covid -19 of medical importance and the second wave Covid - 19 that hit in India. The factors that led to the abrupt raised number of cases in a short time.
The document discusses facts and opinions about the COVID-19 pandemic. It provides details about the virus such as it being derived from bats, how it spreads mainly through droplets from coughs or sneezes, and its global impact with over 7 million confirmed cases. The document also discusses the virus's symptoms and how they develop over time, from initial fever to potential respiratory distress. It emphasizes the importance of following government health protocols to prevent transmission and protect lives.
World Wide Web memungkinkan pengguna internet mengakses dan berbagi informasi, gambar, suara, dan video melalui website. Email merupakan sarana untuk mengirim surat secara elektronik secara cepat tanpa batas ruang dan waktu. Mailing list memungkinkan pertukaran informasi secara berkelompok melalui email. Internet Relay Chat memungkinkan pengguna berinteraksi secara langsung melalui obrolan teks atau suara dan gambar.
Vitamin D for Disaster Response - summaryalanroth1
- A study at Grady Memorial Hospital found that giving trauma patients high doses of vitamin D3 upon admission and daily thereafter reduced mortality close to zero, reduced infections and inflammation, and lowered costs by reducing need for ventilators, pain medication, and length of hospital stay with no adverse effects.
- An Emory University study found critical care patients given high dose vitamin D3 had significantly shorter hospital stays, with the highest dose group having a length of stay half that of the placebo group.
- Reviews of studies show low vitamin D levels prior to surgery are associated with worse surgical outcomes and raising vitamin D levels could have major benefits with minimal costs.
ARoth AMAA article on Vitamin D for athletesalanroth1
This article discusses the potential benefits of vitamin D for improving athletic performance. It begins by outlining sources of vitamin D and how the body metabolizes it. The article then reviews several placebo-controlled studies that found improvements in muscle strength, power, and reduced injuries among athletes supplemented with vitamin D. Deficiency is defined as a blood level below 50 ng/mL. While sun exposure can provide vitamin D, excessive unprotected sun exposure risks skin cancer. The article concludes that vitamin D supplementation depending on an individual's starting blood level could lead to improvements in athletic performance.
Asbestos is a naturally occurring mineral that was commonly used in construction and manufacturing due to its desirable properties such as sound and heat resistance. However, inhaling asbestos fibers can cause serious illnesses like cancer and asbestosis. The European Union has banned all uses of asbestos due to these health risks. Asbestos was used in products that required resistance to fire, heat, or electricity but its usage has declined as the health dangers became clear.
This document discusses Road Weather Information Systems (RWIS) and Environmental Sensor Stations (ESS). It provides background on RWIS, describes the components and purpose of ESS, and outlines considerations for planning and siting new ESS. Key benefits of RWIS data include improved road safety and operations through weather and road condition monitoring. Proper planning involves analyzing operational needs, consulting maintenance staff, and partnering with other weather monitoring organizations.
1. Internet adalah jaringan komputer global yang saling terhubung, memungkinkan pertukaran informasi. Intranet adalah jaringan komputer privat yang digunakan oleh suatu organisasi.
2. Teknologi komunikasi internet seperti email dan chatting memungkinkan pertukaran informasi secara cepat. Aplikasi seperti FTP dan website memudahkan penyebaran informasi.
3. Internet telah banyak dimanfaatkan dalam berbagai bidang seperti kesehatan, perbank
FHWA and Chicago HS for Agricultural Sciences shadow day 02-08-12 picturesraymurphy9533
The document discusses a groundhog job shadowing event held by the Federal Highway Administration on February 8, 2012. The FHWA Office of Technical Services hosted students to expose them to careers in transportation and discuss potential solutions to future transportation needs. The event aimed to bring awareness of tomorrow's transportation solutions to address current transportation challenges.
The document provides a risk assessment of the 2016 Summer Olympics in Rio de Janeiro, Brazil. It identifies the main risks as health issues, infrastructure problems, and security threats. For health, the biggest concerns are water contamination, the Zika virus outbreak, and a lack of adequate medical staff and facilities. Infrastructure risks include incomplete construction of venues and transportation issues. Security risks involve high criminal activity and the potential for terrorism. The assessment rates these risks and provides recommendations, with a focus on improving health risks through measures to address water, Zika, and medical preparedness.
Globally, Dengue Fever Is Rising. What You Should Know and How to Keep SafeThe Lifesciences Magazine
Alarms are being raised by governments and public health specialists worldwide regarding the unprecedented proliferation of dengue, one of the most infamous and fatal diseases that nearly half of humanity is susceptible to contracting.
Forecasts for the end of the new coronavirus pandemic in brazil and the worldFernando Alcoforado
The document summarizes predictions from universities in Singapore and Minnesota regarding the end of the COVID-19 pandemic in Brazil and worldwide. Researchers in Singapore predict that 97% of the crisis will end by May 30th, 2020 and 100% by December 2nd, 2020. They predict the pandemic will slow in Brazil by June 6th and health will be recovered by September 6th, 2020. Researchers at the University of Minnesota believe the pandemic may involve repetitive waves over 1-2 years or a severe second wave in late 2020, and that 60-70% of the population needs immunity for it to end. Overall predictions vary in optimism, with Singapore's estimates being more optimistic and Minnesota's acknowledging the pandemic may not end soon.
Migrating Diseases
Our second ‘World in 2030’ foresight focuses on the growing threat from migrating diseases that are being enabled by the escalating implications of global warming.
The fast-developing view is that with 2oC of global warming probable and 4oC possible, health systems will struggle to address the growing impact of climate change. The increased spread of vector-borne diseases is joining poor air quality as a major public health threat.
More anticipate an extension of the reach and duration of tropical disease alongside the re-emergence of old infections. Certainly, warmer conditions and changes in precipitation are facilitating the expansion of disease-carrying vectors, such as mosquitoes and ticks. Dengue fever has joined malaria and Lyme’s on the list of fast-spreading diseases that are, most significantly, entering countries with little or no prior experience of them. To stem the tide, improved surveillance, enhanced HCP education and better public understanding are all being called for.
This foresight is one of 50 looking at the key issues for the next decade that are being shared throughout 2020.
https://www.futureagenda.org/foresights/migratingdiseases/
Coronavirus effects heighten fears of recession in the world economy. Stock exchanges have had a difficult week around the world and, in Europe, the recession seems inevitable. The paralysis in China weighs on domestic growth because the supply chains of multinationals need components made in Chinese factories to guarantee their production. Consumption in western countries will be strongly affected. Tourism, air transport, leisure are already suffering the consequences.
What Insurers Can Learn From the Zika Outbreak Gen Re
In the weeks leading up to the 2016 Summer Olympic Games, a few athletes announced they would forgo the games for fear of contracting the Zika virus in Brazil. There’s a good chance athletes aren’t the only ones avoiding traveling to South America. While Zika presents with very minor symptoms that sometimes go unnoticed in adults, it can lead to microcephaly for infants born from mothers who have contracted it.
Read more here: http://www.genre.com/knowledge/blog/
U.S. Preps For Ebola Outbreak Cases May Exceed 100,000 By December “The Numbe...Hope Small
The article does not mention that a completely unrelated strain of ebola has broken out in the Congo. What are the chances of that?
Though news on the Ebola virus has been muted since two American health care workers were admitted to U.S.-based facilities last month, the deadly contagion continues to spread. According to the World Health Organization more than 40% of all Ebola cases thus far have occurred in just the last three months, suggesting that the virus is continuing to build steam.
Physicist Alessandro Vespignani of Northeastern University in Boston is one of several researchers trying to figure out how far Ebola may spread and how many people around the world could be affected. Based on his findings, there will be 10,000 cases by September of this year and it only gets worse from there.
The presentation covers known Variants Covid -19 of medical importance and the second wave Covid - 19 that hit in India. The factors that led to the abrupt raised number of cases in a short time.
The document discusses facts and opinions about the COVID-19 pandemic. It provides details about the virus such as it being derived from bats, how it spreads mainly through droplets from coughs or sneezes, and its global impact with over 7 million confirmed cases. The document also discusses the virus's symptoms and how they develop over time, from initial fever to potential respiratory distress. It emphasizes the importance of following government health protocols to prevent transmission and protect lives.
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The author thanks the McNair Scholars Program and their faculty advisor, Dr. Summer Hawkins, for their support in developing a research topic on comparing Brazil and US policies and prevention measures for the Zika virus. References are provided from sources like the CDC, WHO, and medical journals. The author's research questions examine the different responses in Brazil and the US to the Zika outbreak, effects on international travel, and comparisons of case numbers before and after the Olympics.
Similar to Advisory regarding the risk of Zika and other diseases in Rio de Janeiro (20)
Advisory regarding the risk of Zika and other diseases in Rio de Janeiro
1. Advisory regarding the risk of Zika and other diseases in
Rio de Janeiro and means of protection, for August and
September 2016.
Alan Roth, Ph.D.
July 15, 2016
Aedes aegypti/CDC
SOME ADVISORIES HAVE MISINFORMED THE
PUBLIC
The World Health Organization (WHO), on June 14,
2016, observed that “the Games will take place during
Brazil’s wintertime, when there are fewer active
mosquitoes and the risk of being bitten is lower.”1
While this is true in general, during some winters the
real numbers show that the risk can be higher.
Brazil’s new Health Minister, Ricardo Barros said,
“there’s practically “zero” risk of any of the 350,000-
500,000 expected foreign visitors contracting Zika.”
Barros said mosquito populations drop significantly in
August, a winter month in the Southern Hemisphere, and cited data showing that infections of dengue — another virus
spread by the same mosquito — tend to spike in the hot summer month and taper off in the winter.2
The Mayor of the City of Rio de Janeiro (Rio), Eduardo Paes, was quoted, "At this time of the year, in August, when
the Olympics are going on, there are no cases of dengue or Zika because of the weather…" Yet, the government says
there will be more ambulances, extra health professionals and at least 3,000 people working on anti-Zika campaigns in
the city.3 Why do this if there are no cases?
The U.S. Centers for Disease Control and Prevention (CDC) has been silent regarding the risk level of Zika and
dengue in Rio specifically for the period of August and September 2016 although they have several web pages
devoted to travel to Rio for the Games. They state, “The presence of mosquitoes may change seasonally, with
increasing temperatures or rainfall, and may change over time.” This may lead people to more readily believe the
statements of Paes and the WHO. At least the CDC is saying, “The Zika outbreak in Brazil is dynamic. CDC will
continue to monitor the situation and will adjust these recommendations as needed.”4 It’s now less than 3 weeks until
the Games start.
Real Weather Data
The weather in Rio 2+ weeks before the Games is very warm with a high of 91o.5 The highs cool down to the low 70os
the following week and then rise to the high 70os the week after. The long range forecast for early August is showing
the average daily highs and lows for that period (78o and 66o). The average rainfall for the month of August is 2 inches.
In September, for the Paralympic Games, the daily temperature averages are 77o and 67o with rainfall for the month
averaging 3.4 inches.6 During periods of drought similar to the drought of 2015, the people store more water in open
water tanks which provide more breeding opportunity for mosquitoes.7
Well, how bad could it be? Infections of dengue have been more numerous in August in some years than during the
normally peak months of March, April and May. In 2014, the August peak of dengue infections was greater than
March, April and May combined! Weather conditions vary. It could be cool and dry in August but Rio de Janeiro is
closer to the equator than Miami and historical data show that rainfall and warm weather are common that month. Last
year there were numerous August days when the high temperature was in the 90os while most days were in the high
1
WHO Statement, May 12, 2016, “Zika virus and the Olympic and Paralympic Games Rio 2016,”
http://www.who.int/mediacentre/news/statements/2016/zika-olympics/en
2
Associated Press, “Brazil health minister says Zika not a worry for Olympics,” June 10, 2016
http://bigstory.ap.org/article/be13502a40c342709289d1f193bfb476/brazil-health-minister-says-zika-not-worry-olympics
3
Davies, Wyre, “Rio Olympics Zika: The trouble with Aedes Aegypti,” BBC, 14 June 2016, http://www.bbc.com/news/world-latin-
america-36516209
4
Centers for Disease Control and Prevention, “CDC issues advice for travel to the 2016 Summer Olympic Games,” February 26,
2016
http://www.cdc.gov/media/releases/2016/s0226-summer-olympic-games.html
5
Temperature is given in Fahrenheit.
6
Weather.com, “Rio de Janeiro, Brazil Weather,” 10 Day Forecast, https://weather.com/weather/tenday/l/BRXX0201:1:BR
7
Berdjis, Noushin, “Dengue Epidemic in Brazil”, The Disease Daily, May 13, 2015
http://www.healthmap.org/site/diseasedaily/article/dengue-epidemic-brazil-51315
CONTENTS
SOME ADVISORIES HAVE MISINFORMED THE PUBLIC
Real Weather Data
Zika Symptoms
Chikungunya, Yellow Fever and Malaria
Dengue Fever is a Major Threat in Rio
VARIOUS MEANS OF PROTECTION
Steps to Prevent Mosquito Bites
An Option for Further Protection
A Focus on Vitamin D
The Risk of Taking Too Much
Vitamin D in Athletics
Sources of Vitamin D
2. 80os. A small number of nights were in the 50os with most in the low 60os.8 For the Paralympic Games in September,
the risk of mosquito bites, and therefore Zika, can still be high. This year, Zika may not be of epidemic proportion in
August and September but it is better to prepare for the worst and hope for the best.
Zika Symptoms
Aside from pregnancy issues with Zika that have received a lot of media attention, there are a number of other risks
that cause concern. The Centers for Disease Control and Prevention in Atlanta warn, “the most common symptoms of
Zika are fever, rash, joint pain, and conjunctivitis (red eyes).” The illness is usually mild with symptoms lasting for
several days to a week.9 Athletes contracting the disease could be unable to compete during the most severe days of
sickness, depending on the specific symptoms. Once bitten, a person may go more than a week before symptoms are
felt.
Also, Zika appears to trigger Guillain-Barré Syndrome (GBS) although this is rare. The CDC is studying the link
between Zika and GBS. The common symptoms of GBS are muscle weakness, and sometimes, paralysis which can
last from a few weeks to several months. It can occur days to weeks after the victim’s Zika sickness has ended.10
Chikungunya, Yellow Fever and Malaria
The Chikungunya virus has only been present in Brazil for a couple of years. It is carried by the same Aedes species
mosquitoes as Zika and Dengue. It is very unlikely that it will be present in most of Brazil including the State of Rio de
Janeiro in August.11 12
Yellow Fever virus, carried by the same Aedes species of mosquitoes, is common in most of Brazil but not in a narrow
strip of territory along the Atlantic coast that includes the State of Rio de Janeiro. For those planning inland travel, a
vaccination is advised. Malaria is not found anywhere near Rio de Janeiro. It is mostly in the watershed of the Amazon
River. The federal capital city Brazilia and its surrounding State are also clear of malaria.13
Dengue Fever is a Major Threat in Rio
According to the CDC, Dengue “is a leading cause of illness and death in the tropics and subtropics. As many as 400
million people are infected yearly.” Like Zika, there are no vaccines for it even though its presence in many countries
started to be encountered as long ago as the 1950’s.14
The CDC explains, “the principal symptoms of dengue fever are high fever, severe headache, severe pain behind the
eyes, joint pain, muscle and bone pain, rash, and mild bleeding (e.g., nose or gums bleed, easy bruising).”15 Visitors to
Rio de Janeiro should also be concerned about dengue due to these very severe symptoms and the prevalence of this
disease.
People who have had dengue may be more vulnerable to enhanced Zika infection. Laboratory tests have shown the
Zika virus can be enhanced by as much as one-hundred fold when there are dengue antibodies present. That this
could happen in a human body has not yet been shown but people who have had dengue should be more cautious
about being infected by the Zika virus.16
Various Means of Protection
The State of Rio de Janeiro (RJ) will be working to keep the mosquito population to a minimum. However, the Olympic
and Paralympic Games extend over many weeks and use many venues, complicating the task, while RJ has been
struggling to provide necessary support. The BFG at the end of June has given RJ, which is managing the Games,
$850 million of additional funding to help cover the extra cost of services.
8
Weatherspark.com “Historical Weather For The Last Twelve Months in Rio de Janeiro, Brazil,”
https://weatherspark.com/history/33372/2016/Rio-de-Janeiro-Brazil
9
CDC, “About Zika,” http://www.cdc.gov/zika/about
10
CDC, “Zika and Guillain-Barré Syndrome,” http://www.cdc.gov/zika/about/gbs-qa.html
11
Faria, Nuno Rodrigues, José Lourenço, et al, “Epidemiology of Chikungunya Virus in Bahia, Brazil, 2014-2015,” PLOS,
CURRENT OUTBREAKS, February 1, 2016, http://currents.plos.org/outbreaks/article/epidemiology-of-chikungunya-virus-in-bahia-
brazil-2014-2015.
12
Chow, Catherine, Serena Fuller, et al, “CDC Responds to the Spread of Chikungunya in the Americas, CDC, Updates from the
Field, Spring 2014, Issue 14, p. 3. http://www.cdc.gov/globalhealth/healthprotection/fieldupdates/pdf/dghp-field-updates-2014-
spring.pdf#page=7
13
Gershman, Mark D., Emily S. Jentes, et al, “Yellow Fever & Malaria Information, by Country,” CDC, Travelers' Health, Chapter 3,
Infectious Diseases Related to Travel, accessed July 13, 2016, https://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-
related-to-travel/yellow-fever-malaria-information-by-country/brazil
14
CDC, Dengue, accessed July 13, 2016, http://www.cdc.gov/dengue
15
CDC, Dengue, Frequently Asked Questions, “What is dengue?”, http://www.cdc.gov/dengue/faqfacts/index.html
16
Racaniello, Vincent, “Antibodies to dengue virus enhance infection by Zika virus,” virology blog,
http://www.virology.ws/2016/04/27/antibodies-to-dengue-virus-enhance-infection-by-zika-virus
3. Steps to Prevent Mosquito Bites (from the CDC17)
“When in areas with Zika and other diseases spread by mosquitoes, take the following steps [PDF - 2 pages]:
Wear long-sleeved shirts and long pants.
Stay in places with air conditioning and window and door screens to keep mosquitoes outside.
Take steps to control mosquitoes inside and outside your home.
Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself from
mosquito bites.
Use Environmental Protection Agency (EPA)-registered insect repellents with one of the following active
ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Choosing an EPA-
registered repellent ensures the EPA has evaluated the product for effectiveness. When used as directed,
EPA-registered insect repellents are proven safe and effective, even for pregnant and breast-feeding
women.
o Always follow the product label instructions.
o Reapply insect repellent as directed.
o Do not spray repellent on the skin under clothing.
o If you are also using sunscreen, apply sunscreen before applying insect repellent.
Treat clothing and gear with permethrin or purchase permethrin-treated items.
o Treated clothing remains protective after multiple washings. See product information to learn how
long the protection will last.
o If treating items yourself, follow the product instructions carefully.
o Do NOT use permethrin products directly on skin. They are intended to treat clothing.”
(Note: The CDC has more about Zika protection on their website (listed above)
An Option for Further Protection
Both the U.S. and Brazilian federal governments, along with WHO, are silent about other means of protection which
may be found in the complementary and alternative medical marketplace. One important reason for this is that most
products in this marketplace have not been approved by the Federal Drug Administration as drugs so they cannot be
sold for healing or protective benefit and cannot be promoted as such for sales. Many of these are considered by the
FDA to be natural, micro-nutrients with limited application.
A Focus on Vitamin D
The focus here will be on vitamin D which has a recommended daily intake (RDI) issued in November, 2010 by the
Institute of Medicine (now and since July 1, 2016 known as the Health and Medicine Division of the National
Academies of Sciences, Engineering, and Medicine) of 600 IU per day for people of ages 1 to 70 specifically for bone
health.18 Vitamin D has a long history and has been extensively studied and reported on in many peer-reviewed
medical journals. Paragraphs below contain technical language that may be difficult for some readers to understand.
You are urged to share this advisory with your doctor.
Thousands of epidemiological studies have long shown that people who are deficient in vitamin D suffer from more
diseases than those who are sufficient. While this might be enough to encourage people to raise their vitamin D levels
sufficiently, doctors are generally conservative and want to see a cause and effect relationship that is obtained by
randomized controlled trials (RCTs). These are difficult and expensive to do but slowly more and more are being done
on vitamin D.19
There have now been enough RCTs related to vitamin D and viruses to show that vitamin D has a role to play in
protecting people from some viruses. A lot of work has also been done to understand the minutiae of how vitamin D
works at the cellular level to attack viruses. It is not the vitamin D itself that does the work but rather metabolites that
the body produces using vitamin D as the raw material. Larger studies are needed and more viruses need to be
studied.20
While Zika is too new of a threat to have had any significant studies done, case studies and laboratory work have
shown that vitamin D can be at least partially effective against the dengue virus. Both Zika and dengue are of the
17
http://www.cdc.gov/zika/prevention/index.html
18
Health and Medicine Division, The National Academies of Sciences, Engineering, Medicine, Dietary “Reference Intakes for
Calcium and Vitamin D,” November 30, 2010, http://nationalacademies.org/hmd/reports/2010/dietary-reference-intakes-for-calcium-
and-vitamin-d.aspx
19
PubMed.gov, Vitamin D Search results, http://www.ncbi.nlm.nih.gov/pubmed/?term=vitamin+d, accessed July 13, 2016.
20
[Ibid]
4. Flavivirus genus of viruses. (see “Vitamin D-Regulated Micro-RNAs: Are They Protective Factors against Dengue
Virus Infection”21
The Risk of Taking Too Much
Whether someone would risk ingesting vitamin D to protect against Zika and dengue is problematic as it might not
work for any one individual and enough needs to be taken for it to work. However, the cost is only a few dollars and
there is very little risk of taking too much. While there is always a risk of ingesting almost any substance as people can
have rare allergies and sensitivities, the major problem with vitamin D is that too much can cause hypercalcemia
meaning that the vitamin D would push up calcium in the blood to a level that would cause harm in numerous ways.
However, the risk of hypercalcemia has been greatly overplayed and it continues to get media attention without serious
scientific evidence. The reality is just the opposite with studies showing very low risk.
For example, recently, the Mayo Clinic conducted a study using 20,308 tests that had values for both vitamin D (in the
form of 25hydroxyvitaminD3) and calcium, collected over a ten-year period. Of the 20,308 tests, 4 of them, using blood
serum taken from 4 different patients that showed an unhealthy level of calcium that could be attributed to high vitamin
D. Of those, 3 showed levels of both vitamin D and calcium just slightly above the normal range. Those patients had
no symptoms of hypercalcemia. The 4th test had vitamin D and calcium at very high levels. The female patient, who
had been taking 50,000 IU of vitamin D3 and 3,000 mg of calcium at least once daily for more than 3 months, had
hypercalcemic symptoms and it took some months to get her back to a normal level by stopping her intake of the two
substances. Her very high intake of calcium made it an unusual case. Her blood serum level of vitamin D was 364
ng/mL and calcium was 17.5 while normal calcium is in the 9-10 range. Those 3 other high calcium values mentioned
above were 10.2, 10.4 and 10.8.22 The report identifies this one test as an “outlier” because of the very high calcium
intake that biases the result.
The IOM Committee’s RDI of 600 IU would most often produce a blood serum level of vitamin D of about 20 ng/mL
which many vitamin D experts say is too low. The Endocrine Society recommends 40 ng/mL and the Vitamin D Council
recommends 50 ng/mL. The Endocrine Society suggests a daily dose of 4,000 IU while the Council suggests 5,000 IU.
The Mayo Clinic study had 1,714 tests that were above 50 ng/mL while 123 had concentrations of 80 ng/mL and above
and 23 were 100 ng/mL and above. The full range was 51 ng/mL to 218 ng/nL with a median of 57 ng/mL. The 3 with
moderately high calcium had vitamin D values of 74, 90 and 100 ng/mL. Note that the test with the 218 ng/mL value
had a normal calcium value. Some people can tolerate higher vitamin D intake than others. This author has been
comfortably taking 20,000 IU to 30,000 IU daily for 4 ½ years.
The Mayo Clinic study showed that it takes months of using very high doses of vitamin D before adverse effects can
occur. It’s very common for doctors to prescribe 50,000 IU at least once to quickly overcome deficiency. Doses of
100,000 IU to 300,000 IU were often given in one dose to patients at the start of RCTs. These high single doses were
reported to have no adverse effects. If an individual is deficient in vitamin D and is being medically challenged, it is
reasonable to take 100,000 IU or more in one dose and then take less in subsequent doses. 10,000 IU to 20,000 IU
daily for a few weeks or a month or two, depending on the medical challenge, is also reasonable as can be seen in the
Mayo Clinic study. Doctors often prescribe 50,000 IU per week. A recent study found that one dose of vitamin D3 has
only a 24-hour half-life while the 25hydroxyvitaminD3 metabolite has a 3-week half-life but the benefit from that
metabolite is limited to bone health. For all other uses of vitamin D3, daily dosing is recommended.23
While individuals might find it beneficial to use vitamin D for help in protecting against Zika and dengue, it’s important
to know that vitamin D does not directly treat, cure or prevent any disease. It is a raw material that gets converted in
the body into a powerful yet very safe secosteroid hormone called “Calcitriol” that then does the work. It is not an
anabolic steroid. It does its work by triggering the expression of genes that need the Calcitriol to do their intended
tasks. This explains why vitamin D deficiency results in the body not performing adequately.24
More about Vitamin D and Its Use in Athletics
21
Arboleda, John F. and Silvio Urcuqui-Inchima, “Vitamin D-Regulated MicroRNAs: Are They Protective Factors against Dengue
Virus Infection?,” Advances in Virology, vol. 2016, Article ID 1016840, 14 pages, 2016. doi:10.1155/2016/1016840,
http://www.hindawi.com/journals/av/2016/1016840
22
Dudenkov, Daniel V. et al., “Changing Incidence of Serum 25-Hydroxyvitamin D Values Above 50 ng/mL: A 10-Year Population-
Based Study,” Mayo Clinic Proceedings , May 2015, Volume 90 , Issue 5 , 577 – 586
http://www.mayoclinicproceedings.org/article/S0025-6196(15)00185-8/abstract
23
Hollis BW, Wagner CL. The Role of the Parent Compound Vitamin D with Respect to Metabolism and Function: Why Clinical
Dose Intervals Can Affect Clinical Outcomes. The Journal of Clinical Endocrinology and Metabolism. 2013;98(12):4619-4628.
doi:10.1210/jc.2013-2653.
24
Hossein-nezhad A, Spira A, Holick MF. Influence of Vitamin D Status and Vitamin D3 Supplementation on Genome Wide
Expression of White Blood Cells: A Randomized Double-Blind Clinical Trial. Campbell M, ed. PLoS ONE. 2013;8(3):e58725.
doi:10.1371/journal.pone.0058725. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604145
5. Vitamin D is not a banned substance in sports and unlikely ever to be as an individual can get a high dose from the
sun just by spending sufficient time outdoors during the right season at the right times. It would be inconceivable that
track and field regulations would change to ban athletes from spending time in the sun.
Humans have vitamin D receptors in all of their cells and tissues and naturally that includes the heart and muscles.
One must assume that they are there to serve a purpose. Controlled trials have shown that supplementing with vitamin
D or getting it from the sun or even sunlamps can result in better athletic performance. Besides stronger muscles, it
helps to reduce injuries and inflammation.25 You can read about this in an article by this author that has the title
“Vitamin D: An Opportunity for Improving Athletic Performance.” It was published in the peer-reviewed medical journal
of the American Medical Athletic Association in the Spring of 201426. Note that in Recommendations on the last page
of the AMAA article, “5,000 ng/mL” is a typo and should be changed to “50 ng/mL”. This current advisory includes new
information that wasn’t available when writing the AMAA article.
The reduction of injuries using vitamin D has become of interest to college and professional sports teams.27 What
became most apparent is that vitamin D deficiency was correlated with those players who suffered more injuries.28 29 30
Sources of Vitamin D
The best source of vitamin D is the sun. When its UVB rays reach your skin there is a chemical process that produces
vitamin D3. You can also get vitamin D3 from fortified foods, fatty fish and supplements.31. There are two vitamin D
substances: D3 is natural and is what you get from the sun while D2 is synthetic and is often what doctors prescribe
because that’s what most pharmacies carry. Many studies have shown that D3 is far superior to D2 and most doctors
don’t know that.32 There will be 5 hours each day in Rio during the Games during which UVB rays from the sun will be
available. The sun’s UVB schedule is 9:30 am to 2:30 pm. The sun needs to be above 45 degrees in the sky for the
UVB rays to penetrate through the atmosphere. Once it exceeds 45 degrees, your shadow will be shorter than your
height. This can be used as a guide anywhere on earth.
If you wish to use the sun for your vitamin D, it’s important not to get sunburned. How much sun you can get will
depend on your skin. People with dark skin can take much more sun but they need much more time in the sun to
obtain the vitamin D. Some people with very light skin may have trouble getting any sun without getting burned. For
people in between, it’s best to start with only getting a light pink color (which may take only ten to fifteen minutes) and
then build up slowly over days and weeks to a tan color. More time can be spent in the sun without skin protection as
the skin gets darker. Some people have fear of getting sun exposure on bare skin. Studies have shown that people
who spend their lives working outdoors have less skin cancer than people who work indoors. Sun exposure is not a
major cause of melanoma.33
There are online vendors that sell vitamin D3 in sizes of 5,000 IU and 10,000 IU. Those gelcaps are very small as
10,000 IU equals only 250 micrograms. 50,000 IU gelcaps are also available online through amazon.com.
Contact information for Alan Roth: alan@alanroth.net, 301 928-6314
Dr. Roth was a USATF Board of Directors member for ten years and was Chair of both the Associations Committee
and the General Competition Division. He led the USATF medical study on pre-run stretching
http://www.usatf.org/stretchstudy, and the USATF advisory on hydration that was issued in April, 2004.
https://www.usatf.org/news/showRelease.asp?article=/news/releases/2003-04-19-2.xml
25
Yin K, Agrawal DK. Vitamin D and inflammatory diseases. Journal of Inflammation Research. 2014;7:69-87.
doi:10.2147/JIR.S63898. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070857
26
Roth, Alan, Vitamin D: An Opportunity for Improving Athletic Performance,” AMAA Journal, Winter/Spring 2014.
http://www.amaasportsmed.org/Assets/American+Medical+Athletic+Assoc+Digital+Assets/AMAA+Journal/vitamind.pdf
27
The Wall Street Journal, “Elite athletes try a new training tactic: More vitamin D,” January 26, 2016,
http://www.foxnews.com/health/2016/01/26/elite-athletes-try-new-training-tactic-more-vitamin-d.html
28
Life Extension Magazine, “Vitamin D insufficiency associated with football injuries,” July 15, 2011,
http://www.lifeextension.com/newsletter/2011/7/Vitamin-D-Insufficiency-Associated-with-Football-Injuries/page-
01?source=eNewsLetter2011Wk28-2&key=Article&l=0#article
29
Angeline, ME, Gee AO, et al, “The effects of Vitamin D in Athletes,” Am J Sports Med, February 2013vol. 41 no. 2 461-464,
http://www.ncbi.nlm.nih.gov/pubmed/23371942
30
Melville, Nancy, “’Alarming' Vitamin D Deficiencies in NFL Football Players,” Medscape Medical News, July 13, 2011,
http://www.medscape.com/viewarticle/746310
31
Wacker, Matthias, and Michael F. Holick. “Sunlight and Vitamin D: A Global Perspective for Health.” Dermato-endocrinology 5.1
(2013): 51–108. PMC. Web. 13 July 2016, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897598
32
Tripkovic L, Lambert H, Hart K, et al. “Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-
hydroxyvitamin D status: a systematic review and meta-analysis. ”The American Journal of Clinical Nutrition. 2012;95(6):1357-1364.
doi:10.3945/ajcn.111.031070. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349454
33
Vuong K, McGeechan K, Armstrong BK, AMFS Investigators, GEM Investigators, Cust AE. Occupational sun exposure and risk of
melanoma according to anatomical site. International journal of cancer Journal international du cancer. 2014;134(11):2735-2741.
doi:10.1002/ijc.28603.