JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges –June 28, 2026 – World Cup
“Ebola is in the headlines again as Central Africa faces an Ebola outbreak whose case numbers have risen faster than any other outbreak of the disease to date. With players and fans from outbreak areas attending packed World Cup games, how worried should the average American be?
Few people understand what Ebola is or how you contract and treat it. Starting 8 to 10 days after exposure to the virus, “dry” symptoms appear, including fever, headaches, fatigue, muscle aches and sore throat. “Wet” symptoms follow, primarily vomiting and severe diarrhea. Late-stage disease can cause hemorrhaging, liver and kidney failure.” (1)
“The international picture is even more concerning. According to the Pan American Health Organization, measles is also spreading in Canada, and Mexico has exceeded 11,000 cases. Globally, outbreaks are active in every region of the world. The 48 national teams and their traveling fan bases represent a comprehensive sampling of that global exposure map.
The Pan American Health Organization is urging health officials in host cities to boost surveillance, and the organization launched a public health campaign specifically urging fans to confirm their vaccination status before attending matches.
The 11 U.S. host cities — New York, Los Angeles, San Francisco, Dallas, Houston, Atlanta, Philadelphia, Seattle, Boston, Kansas City, and Miami — will each host multiple matches over several weeks. Every one of these cities is a major international airport hub, meaning any measles case generated at or around World Cup events can rapidly disperse to other cities and countries.
The Philadelphia Inquirer reported that health officials found the Philadelphia region is “pockmarked with vulnerable communities, where vaccination rates have fallen below the rate scientists say is necessary to prevent widespread illness.” Jessica Caum, director of disease control for Philadelphia’s Department of Public Health, noted: “We’re in a different place now with measles. More cases, increases in vaccine hesitancy, decreases in vaccination rates — all of these things are important to keep in mind.”” (2)
“When public health workers prepare for infectious disease threats, the question is rarely whether risk exists. It is where to focus first.
That question is at the center of recent work by the Atlantic Coast Center for Infectious Disease Dynamics and Analytics (ACCIDDA), a multi-institutional center supported by the Centers for Disease Control Center for Forecasting and Outbreak Analytics, with several researchers from the UNC Gillings School of Global Public Health playing key roles.
ACCIDDA’s work was recently featured in for a rapid analysis of infectious disease threats associated with the 2026 FIFA World Cup, which is bringing millions of fans to host cities across the United States, Canada and Mexico.
The article links to a preprint of a study for which the team analyzed more than 70 infectious disease threats to help public health workers in US host cities prioritize preparedness around game-day travel and large gatherings. The analysis identified 14 pathogens or pathogen groups “of interest,” including mosquito-borne diseases, out-of-season respiratory infections, measles, norovirus, some chronic infections that are rare in the US but more common globally, and “Disease X” wildcards.
The findings point to the need for thoughtful preparedness — but not panic. While the World Cup will bring a surge of travelers to host cities, the analysis found that the tournament represents a relatively small increase compared with routine global travel to and from the US. As a result, the incremental increase in infectious disease risk is likely small.” (3)
“Health care professionals at the nation’s oldest hospital in New York City have been quietly preparing for an influx of soccer fans to come watch the 2026 FIFA World Cup this summer.
Such a large increase in visitors from around the world also raises the risk of imported infectious diseases – including “high-consequence” ones, or special pathogens that have high mortality rates, like Ebola or the Marburg virus.
That’s why doctors, nurses and others at NYC Health + Hospitals/Bellevue Hospital have been practicing elaborate drills that include actor patients and even chartered and commercial airplanes. As part of that broader preparation effort, some 500 health care professionals working at hospitals near the main World Cup venue in New Jersey have received training to ensure they’re ready to treat what comes.
“We’re training a lot,” said Dr. Vikramjit Mukherjee, an intensive care physician who is chief of critical care and the special pathogens program at Bellevue. “Through June, we’re going to the hospitals next to the MetLife stadium, where people will be more prone to present with symptoms, and making sure their front-end capabilities are ready.”
MetLife Stadium in East Rutherford, New Jersey, a venue that holds 82,500 spectators, will host eight World Cup matches starting June 13, including the championship on July 19. Greater New York is expected to see more than 1.2 million visitors this summer for the tournament, as the United States expects up to 10 million. Sixteen major cities, and a few smaller ones, across North America will host matches.
Big crowds will gather. A watch party in Central Park is expected to draw some 250,000 viewers. A separate party is scheduled for Liberty State Park in Jersey City.
Public health leaders see this year’s World Cup, billed as the largest tournament in world history, as the world’s largest temporary migration into the United States’ most densely populated urban corridor. They are planning accordingly.
“We’re looking at it as if it’s a huge global migration event,” Mukherjee said while giving Healthbeat a tour of Bellevue, including its biocontainment lab and tuberculosis ward. “The whole health care system in New York City will be a bit on alert for all of these events.”” (4)
“Collaboratively Addressing Public Health Emergencies.
The COVID-19 pandemic illuminated longstanding inequities that if left unaddressed will continue to leave people behind during future public health emergencies.
Through an award from the New York City Economic Development Corporation, Columbia University launched PRI with key partner the City University of New York Graduate School of Public Health & Health Policy (CUNY SPH) and a consortium of academic, community, government, and corporate partners. Within Columbia University, PRI is led and operated by ICAP, a global health center at the Columbia University Mailman School of Public Health
In coordination with the NYC Department of Health and Mental Hygiene and NYC Emergency Management, PRI works hand-in-hand with New Yorkers in communities across the five boroughs to enhance their capacity to develop locally tailored health solutions, information, and resources to prepare for, respond to, and recover from future health crises.” (5)
“”I think the overall risk to the public is not as high as many may think,” Dr. Gavin Harris, a critical care and serious communicable diseases specialist, said in an interview before Ebola reached France.
Harris, who is with Emory Healthcare, said Atlanta is unusually qualified to handle such a dangerous disease.
Emory has a biocontainment unit and has been collaborating for years with specialists at Grady Memorial Hospital, the Georgia Department of Public Health, and the Centers for Disease Control and Prevention, down the street from the Emory School of Medicine, where Harris is an assistant professor.
In 2014, two American health care workers who were infected while treating Ebola patients in Liberia were isolated and treated at Emory University Hospital. Kent Brantly and Nancy Writebol were cured.
Emory’s Serious Communicable Disease Unit had been established a dozen years before with help from the CDC, which wanted such a service available for any of its employees who fell ill during overseas assignments.
“We are probably more prepared than a lot of other places are, and especially in the metropolitan area of Atlanta,” Harris said.” (6)
“The global spotlight is on Seattle as thousands of soccer fans pack the city for the FIFA World Cup, driving an economic surge for local businesses. Among those scoring big are legal cannabis shops near “Seattle Stadium,” which report a rise in sales from tourists.
However, the influx of visitors prompted state and local health agencies to issue a safety warning: Washington’s legal cannabis products are likely much stronger than what visitors are used to back home.
“If you’re coming from an area where cannabis isn’t legal, you may not understand that one gummy or one cone is a dose. It will take an hour or more to kick in,” said Jimmy Leonard, pharmacist and chief clinical officer with the Washington Poison Center.
To bridge the gap, Public Health – Seattle & King County launched a World Cup resource page designed to guide out-of-towners. It includes information about Washington cannabis products that often contain much higher levels of THC (the psychoactive component in marijuana) than visitors realize.” (6)
“Horny football fans are being warned that the World Cup could cause a huge rise in sexually transmitted infections (STIs). Brits are expected to lead a charge across the Atlantic next month when England and Scotland take part in the tournament.
But supporters have been told to tackle their urges after health experts warned a summer of sin could see cases soar. Officials reckon the number of STIs will surge when supporters visit the US and indulge in boozy celebrations and partying.
The New York City Health Department has now issued a red alert over the issue. While supporters of the Three Lions and members of the Tartan Army prepare for battle on the pitch, city officials are terrified of what’s happening in the bedrooms.” (7)
1.Ebola and the World Cup: How worried should Americans really be? By Rogers Victor, https://www.detroitnews.com/story/opinion/columnists/2026/06/27/the-world-cup-ebola-and-what-americans-actually-need-to-know-opinion/90707575007/
2.Public Health Officials Say Measles Poses a Bigger World Cup Threat Than Ebola, By Dorothy Brooks, https://www.medicaldaily.com/measles-world-cup-2026-health-risk-philadelphia-public-health-warning-475807
3.Gillings-supported center helps public health teams prioritize infectious disease risks, from measles to the World Cup, https://sph.unc.edu/sph-news/gillings-supported-center-helps-public-health-teams-prioritize-infectious-disease-risks-from-measles-to-the-world-cup/
4.NYC infectious disease experts prep for World Cup as ‘huge global migration event’ with 1.2M visitors, By Trenton Daniel, https://www.healthbeat.org/newyork/2026/02/13/world-cup-outbreak-preparedness-drills/
5.The New York City Preparedness & Recovery Institute, https://pandemicresponse.columbia.edu/
6.Low Ebola risk, but Atlanta on guard for World Cup crowds, Ty Tagami, https://www.augustachronicle.com/story/news/healthcare/2026/06/28/how-prepared-atlanta-is-for-ebola-during-world-cup-matches/90721377007/
7.World Cup fans warned of horror STI surge as health bosses gear up for ‘summer of sin’, by Liam Randall, https://www.msn.com/en-gb/health/other/world-cup-fans-warned-of-horror-sti-surge-as-health-bosses-gear-up-for-summer-of-sin/ar-AA23g5Eh
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai