Could flu outbreaks in South Korea undermine Olympic athletes’ hopes for gold?
The World Health Organization has warned travelers to the 2018 Olympic and Paralympic Winter Games in Pyeongchang of a heightened risk of respiratory infections.
In addition, the Korean Centers for Disease Control and Prevention have reported an increase in influenza A and influenza B this season.
“It’s clear that an additional participant at the Olympics will be the influenza virus, in its various strains,” Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine in Tennessee, told Healthline.
One of the flu strains that has hit the Korean peninsula hard this year is H3N2, a particularly virulent variant of influenza A.
“If you look back over the years, H3N2 is a virus that causes more severe illness than some other strains of influenza. Other strains can cause severe illness too, but this one is clearly on the more severe end of the spectrum,” Schaffner said.
H3N2 has also contributed to serious outbreaks of influenza in the United States this year.
Avian flu, norovirus also identified
Influenza A and B aren’t the only viruses that are raising concerns in South Korea this month.
An outbreak of highly pathogenic avian flu (H5N6) has also hit poultry farms near Seoul.
So far, reported cases have been limited to birds, and no cases of H5N6 have been detected in humans.
While avian flu can potentially spread to people, Schaffner suggested the risk of transmission to Olympic competitors is low.
“Avian flu usually occurs only among the farmers who are very close to the poultry and, if they get sick, sometimes people who have prolonged intimate contact with them. This is not yet a virus that’s picked up the genetic capacity to spread readily from person to person,” Schaffner said.
In comparison, he expressed more concern about the recent outbreak of norovirus among venue personnel and staff members of the Pyeongchang Olympics Organizing Committee.
Norovirus is a stomach bug that spreads easily from person to person, causing symptoms such diarrhea and vomiting.
In just two days, the number of confirmed cases of norovirus at the Winter Games has risen from 32 to 86, the New York Times reported.
Olympic Village might provide protection
The Olympic Village might provide athletes with some protection against certain strains of influenza, specifically those circulating in the local population.
“I’m sure that the athletes who are somewhat sequestered will be somewhat protected just because of their removal from the general population,” Schaffner said.
“But the more the athletes leave the Olympic Village and interact with people — go to restaurants, go to bars, go shopping, go sightseeing — the more it will bring them into contact with other people and provide opportunities for the acquisition of the influenza virus,” he added.
Some athletes may also bring strains of influenza or other viruses with them from home.
They may also come into contact with contagious viruses and other pathogens while traveling to the Winter Games or staying in the close quarters of the Olympic Village.
Athletes must take precautions
To help protect themselves, it’s important for athletes, trainers, and others to stay up to date on their vaccinations, Dr. Aaron Rubin told Healthline.
Rubin is a member of the American College of Sports Medicine who served as the medical director of the Special Olympics World Games in 2015.
When it comes to stopping the spread of infection, he’s “a huge believer” in the importance of flu shots and other vaccines as well as good overall hygiene.
“The big things are to get your vaccines, stay away from people who are sick, wash your hands frequently, don’t share water bottles or towels, and be careful with your food and drink intake. You know, make sure it’s all clean as can be,” Rubin said.
“Especially with norovirus, you really need to wash your hands with soap and warm water several times a day. Don’t just use hand gels,” he added.
Aaron Brock, a member of the National Athletic Trainers’ Association and director of sports medicine and performance for USA Volleyball, also emphasized the importance of vaccinations and good hygiene for keeping athletes healthy.
Brock noted the importance of eating a colorful diet that is rich in fruits and vegetables, and getting enough sleep for boosting immunity.
“The necessary amount of sleep varies, but it is common for elite athletes to need a full eight to nine hours to recover from their grueling regimens,” Brock told Healthline.
“Not only does adequate sleep help prepare you for competition the next day, but it also gives you an immune system boost, hopefully making the athlete more resilient to unwanted viruses or bacteria,” he said.
Certain treatments are off-limits
When athletes do get sick, it’s important for them to seek early treatment.
For example, taking the antiviral medication Tamiflu may help reduce the severity and duration of influenza infections.
Other medications are also available to treat flu-like symptoms, but some common treatments are off-limits to top-level athletes, due to strict anti-doping regulations.
“It is important that athletes work with their physician and athletic trainer to ensure medications are in compliance with international anti-doping regulations, and that proper paperwork is completed as needed,” Brock explained.
“Tamiflu is not on the World Anti-Doping Agency’s prohibited substance list. However, medications that a physician may prescribe to treat potential associated symptoms, such as prednisone and pseudoephedrine, are banned in competition. In addition, intravenous infusions have some regulations around its administration and this technique must be evaluated with anti-doping authorities,” he added.
Brock also noted the benefits of replenishing lost fluids, electrolytes, and nutrients for managing symptoms and promoting recovery.
In some cases, athletes might be able to continue participating in certain training activities.
“I suggest that athletes move and activate their body in a light and controlled manner if they feel up to it. Foam rolling, stretching, and light movements may help stave off stiffness and weakness due to inactivity and long periods of time in bed,” Brock said.
“At times, mental engagement is still possible, so film studies and tactical planning can continue,” he added.