NaTHNaC | Games of the XXIX Olympiad, Beijing, China 2008 – advice for travellers, 17 Jun 08, Travellers

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17 June 2008 [updated 26 June 2008]
Games of the XXIX Olympiad, Beijing, China 2008 – advice for travellers

Beijing, China will host the 2008 Summer Olympics and the thirteenth Paralympics between 8 August and 17 September 2008. Approximately 10,500 athletes will take part [1], and 1.1 million Chinese and 600,000 foreign nationals are expected to attend the games [2].

The Olympic Venues are in:

Beijing
Tianjin
Qinhuangdao
Shenyang
Shanghai
Qingdao
Hong Kong

Further information can be found on the official websites of the International Olympic Committee, the Beijing 2008 Olympic Games and the China National Tourism Administration.

Advice for travellers

Insurance, Medical Care, Safety and Security

Travel health insurance

There is no Reciprocal Health Care Agreement between the United Kingdom and China (or Hong Kong). All travellers should obtain comprehensive medical insurance and declare any pre-existing conditions. An evacuation clause should be included to allow for emergencies.

Medical Care

Officials in Beijing have organised an emergency response system to cope with medical problems faced by athletes and visitors to the Games. This includes more than 150 fully equipped first-aid stations at competition, non-competition and training venues, and an equal number of stations throughout Beijing. There are 24 hospitals that have been designated for Olympic services. Measures include an emergency blood transfusion service and public health monitoring of restaurants and hotels to combat food-borne diseases. However, travellers should be made aware their regular medications may not be available in China, and that they should carry an adequate supply. Counterfeit drugs may also be a problem. Advice on the transportation of personal medications by travellers is available. Further information about health is available on the website of the Beijing 2008 Olympic Games.

Safety and security

The Foreign and Commonwealth Office (FCO) state that there is an underlying risk of terrorism in China reflecting both a global risk of terrorist attacks and the possibility of terrorist acts by groups opposed to the Chinese Government. There has been unrest following protests in the city of Lhasa, Tibet and in some of the nearby provinces. All travellers should be vigilant, avoid street protests, and should not travel to areas of unrest.

On 12 May 2008, an earthquake measuring 7.8 on the Richter scale struck the south western province of Sichuan, China. The epicentre was in Wenchuan county, 92 kilometres northwest of the provincial capital Chengdu. Maps of the affected area and the latest updates can be found on the Reliefweb website. Areas hosting the Olympic Games were not affected.

Detailed information on travel requirements, safety and security can be found on the Foreign and Commonwealth Office (FCO) website.

Road traffic

Road traffic accidents (RTAs) in China are amongst the highest in the world [3]. Drivers, passengers and pedestrians are vulnerable to RTAs where road culture and rules are unfamiliar. All travellers should exercise care in order to avoid the risk of injury or death as a result of road traffic accidents during international travel.

Personal Health

Food and water hygiene precautions

All travellers should practise food and water hygiene precautions. Travellers’ diarrhoea is common and can be debilitating. Maintaining hydration is important in hot and humid climates. Travellers can consider carrying with them self-treatment for diarrhoea.

Vaccinations

All travellers to China should be up to date with the British schedule of vaccinations. Other vaccinations can be considered after an individual risk assessment by a health care professional. NaTHNaC recommendations can be found on the NaTHNaC Country Information Page for China. In addition, influenza vaccine can be considered, particularly for those with chronic medical conditions [4], as transmission of influenza can occur during mass gatherings.

Animal bites

Travellers should be aware that animal bites are common in China. China has the second highest incidence of rabies in the world and it has been the most prevalent cause of death from reportable infectious disease in China since 2006 [5]. The number of fatalities from the disease rose to 3,293 in 2006, an increase of 27% over 2005 [5]. Children are at higher risk because they play with animals and may not report bites or scratches [6]. Travellers who undertake activities putting them at increased risk (e.g. cycling, jogging, or contact with domestic unvaccinated pet animals) can consider pre-exposure rabies vaccine.

Medical treatment should be sought as soon as possible following a bite wound even if rabies vaccine has been received prior to the bite [7].

Insect bite avoidance

All travellers should take care with insect bite precautions.

Malaria

Malaria chemoprophylaxis is not recommended for travellers visiting the Olympic venues. Travellers may be at risk if they intend to travel to rural remote areas or the provinces of Hainan and Yunnan. Risk areas can be found at on the NaTHNaC Country Information Page for China.

Hand foot and mouth diseases (HFMD)

Since January 2008 China and Hong Kong have experienced outbreaks of HFMD due to enterovirus (EV-71) [8]. HFMD is a common illness affecting young children and outbreaks frequently occur around the world, particularly during the summer months. Outbreaks are usually associated with school settings, where the virus is easily spread among children. HFMD is usually a mild infection although in rare cases, meningitis and brain stem complications can occur. Good personal hygiene will help to prevent infection. Current outbreaks can be found on the NaTHNaC Outbreak Surveillance Database.

Avian influenza

To date, 30 human cases including 20 deaths have been reported in China [9]. The most recent death occurred in Shanwei city, Guangdong province on 25 February 2008 [9]. There have been no cases in travellers. Travellers should take precautions to prevent infection against avian influenza by avoiding live animal and bird markets and farms, not eating raw or undercooked poultry or egg or duck products, and exercising good personal hygiene with frequent hand washing.

Climate and Pollution

Weather

The climate of China is variable, ranging from cold to tropical. Temperatures and humidity during the summer months in north eastern China will be high and conditions may be uncomfortable. Recommendations for preventing heat-related illness include wearing loose-fitting, light coloured clothing and a protective hat, increasing fluid intake of non-alcoholic drinks, and getting out of the hot, humid environment whenever possible [10,11].

Air pollution

Initiatives to improve air quality in the area around Beijing are underway [12]. However, travellers should be aware that there are high levels of air pollution in Beijing, as well as in other cities and industrial areas of China [1,12]. Exposure to air pollutants may result in initiation of cardiovascular or respiratory disease or exacerbation or worsening of pre-existing illness [13-16]. Those with pre-existing conditions who have to travel to areas of high pollution should carry adequate supplies of their regular medication. Disposable face masks do not provide protection against pollutant particles or gases. A daily Air Pollution Index for China is available.

References

1. Shaw MTM, Leggat PA, Borwein S. Travelling to China for the Beijing 2008 Olympic and Paralympic Games. Travel Med Infect Dis 2007; 5:365-73. Available at: http://www.cdc.gov/travel/sdarticle_mod.pdf

2. MacDonald S. Beijing 2008 Olympics: preparations for medical emergencies. GeoSentinel Annual Site Directors Meeting 2007. Victoria, Canada [unpublished]

3. Peden M, Scurfield R, Sleet D, eds. World Health Organization. World report on road traffic injury prevention 2004; Geneva, Switzerland. [Accessed 6 June 2008] Available at: http://www.who.int/violence_injury_prevention/publications/road_

traffic/world_report/en/

4. Salisbury D, Ramsay M & Noakes K (eds). Immunisation against infectious disease. Department of Health, London 2006. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/P

ublicationsPolicyAndGuidance/DH_079917

5. World Health Organization, 2007. Rabies and envenomings: a neglected public health issue. [Accessed 30.May 2008] Available at: http://www.who.int/bloodproducts/animal_sera/Rabies.pdf

6. Arguin P, Kozarsky P & Reed C (eds). Health information for International Travel. Chapter 4; Rabies. Centers for Disease Control and Prevention, Atlanta, 2008. Available at: http://wwwn.cdc.gov/travel/yellowBookCh4-Rabies.aspx

7. Department of Health, 2000. Memorandum on rabies. [Accessed 30 May 2008] Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets

/@dh/@en/documents/digitalasset/dh_4080657.pdf

8. NaTHNaC Travellers News. Enterovirus in Asia – update. 5 June 2008. [Accessed 20.6.08]. Available at: http://www.nathnac.org/travel/news/hfmd_050608.htm

9. World Health Organization. Avian influenza – situation in China - update 2, 26 February 2008. [Accessed 30 May 2008] Available at: http://www.who.int/csr/don/2008_02_26/en/index.html

10. Tsouros AD, Efstathio PA (eds). Mass Gatherings and Public Health: The experience of the Athens 2004 Olympic Games. World Health Organization, Europe. Ministry of Health and Social Solidarity. [Accessed 21 May 2008] Available at: http://www.euro.who.int/document/e90712.pdf

11. Centers for Disease Control and Prevention. Prevention and management of heat-related illness among spectators and staff during the Olympic Games – Atlanta, July 6-23, 1996. Available at: http://www.cdc.gov/mmwr/PDF/wk/mm4529.pdf

12. Streets D, Fu JS, Jang CJ et al. Air Quality during the 2008 Beijing Olympic Games. Atmos Environ 2007;41:480-92.

13. Brook RD, Franklin B, Cascio W et al. Air pollution and cardiovascular disease – a statement for Healthcare Professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. J Amer Heart Assoc 2004;109:2655-71. Available at: http://circ.ahajournals.org/cgi/reprint/109/21/2655

14. World Health Organization. Meta-analysis of time-series studies and panel studies of Particulate Matter (PM) and Ozone (O3). 2004, WHO Europe. [Accessed 6 June 2008] Available at: http://www.euro.who.int/document/e82792.pdf

15. Department of Health. Cardiovascular disease and air pollutants: a report by the Committee on the Medical Effects of Air Pollutants. Department of Health 2006. [Accessed 21 May 2008] Available at: http://www.advisorybodies.doh.gov.uk/comeap/statementsreport

s/CardioDisease.pdf

16. Atkinson RW, Anderson HR, Sunyer J et al. Acute effects of particulate air pollution on respiratory admissions; Results form the APHEA 2 Project. Am J Respir Crit Care Med. 2001;164:1860-6.