Carnival season in Brazil runs from 1 to 9 March in 2019, and in the country’s capital of Rio de Janeiro, one million participants are expected, including many travellers from Europe. During mass gathering events, the most common health risks are related to vaccine-preventable diseases, gastrointestinal illnesses and vector-borne diseases in favourable climate conditions.
The European Centre for Disease Prevention and Control (ECDC) has issued a series of recommendations for travellers to the event: “Prior to travel to Brazil, Carnival participants should ensure that all their vaccinations are up to date in accordance with the national immunisation schedule in their country of residence, particularly two doses of measles-containing vaccine (usually MMR), rubella, diphtheria, tetanus and polio. In addition, vaccination against hepatitis A, meningococcal ACWY vaccine, typhoid and yellow fever should also be considered.”
The yellow fever vaccine is of particular note as, according to the Brazilian Ministry of Health, there have been 12 confirmed and 116 suspected cases of yellow fever across the country since June 2018 as of 18 January 2019. “Travellers to yellow fever risk areas, including the state of Rio de Janeiro, should consult their healthcare provider before the trip and receive the yellow fever vaccine at least 10 days before travelling (unless vaccination is contraindicated). They should also follow measures to avoid mosquito bites and be aware of yellow fever symptoms,” said the ECDC. With over 174,000 cases of dengue fever being confirmed last year, 90,000 probable cases of chikungunya, and approximately 8,000 probable cases of Zika virus in Brazil, not to mention over 10,000 cases of measles, the health risks to travellers in crowded spaces during the carnival season seem significant.