Risk Assessment: The Manchester United experience in Nigeria -July 2008
Could the v i r us that struck Wayne Rooney and Michael Carrick one of his fellow players been avoided? Indeed, did it really come from Nigeria, South Africa or even the countries he may have visited before then or even his home country.
I am not trying to place the source of the virus on any countries door steps, but I want to show the possibilities of prevention, the possibilities of how and where it could have been transmitted and also with proper lab diagnosis, how the virus can with almost all certainty point to a particular country. I may also rule out certain possibilities taking into consideration incubation period, pre travel medication and vaccination and the possible immunity level of the traveller.
The purpose of this article is to do a brief risk assessment of a traveller, who in this case is a Wayne Rooney who is part of an International football team. He is well and in top physical condition and is travelling to various tropical and subtropical destinations. He is on both vaccine and non-vaccine preventive measures.
Many diseases including malaria and many viruses are usually defined in terms of likely hood of getting infected, for example the longer your stay, the higher your chances of getting it.
In chronological order of the visit to Africa, Manchester United visited thus : 15th July departs for South Africa, 19th July kaizer Chiefs v Manu, 22nd Orlando Pirates v Manu, 26th kaizer chiefs v Manu, 27th Manu v Portsmouth (In Abuja, Rooney did not play), 28th July Manu arrive England from Nigeria(2days total in Nigeria). kaiz. It seems the foreign press had already tagged the visit to Nigeria a controversial one.
Some say that, revelation will call into question United’s decision to fly to Nigeria for a money-spinning exhibition game against Portsmouth at the end of their ten day trip to South Africa.
Sir, Alex is quoted as saying “It’s a virus he’s picked up in Nigeria, I believe, and it’s not a nice one”. I do not know if he was quoting medical personal or just his own layman statement.
They say United took all the necessary precautions ahead of the Nigeria trip. The players took malaria tablets and, for those who had not travelled to central Africa in the last ten years, received the required Yellow Fever jab. Both illnesses have been ruled out. “We have a laboratory here so we have all the facilities to treat it,” added the boss. “And the players took malaria tablets, so it’s not that.”
A comprehensive risk assessment is not a guarantee of 100% protection but drastically reduces your chances of getting into trouble/illness overseas. Your personal life style measures are very important.
As a footballer and a young man, he is at high risk of injury, sexually transmitted diseases and insect bites due to outdoor activities and late nights and should have a complete vaccine schedule which should include Tetanus update, Hepatitis B and A and flu shot. He will be covered by vaccinations recommended for living in Britain and may only need boosters in some cases.
Risk assessment involves taking a comprehensive history, age and sex, medical history past and present family history current health status including pregnancy actual or planned, medication, food and drug allergies etc, also information on the travellers itinerary like destination departure date, length of stay, purpose of trip etc is necessary for proper advice and care.
Risk assessment will be guided by the assessment in terms of;
The Host factors: The Health of the traveller and his Expected behaviour abroad.
Destination Factors: In assessing the environment he is going to, location, duration of travel and reason for travel will play a key role.
Considering risk both to the individual and community, Significance To The Individual Traveller (1 to 5 points), Significance to the Community (1 to 5), Likelihood of Exposure (1 to 5) and Evaluation of Active Intervention for example Vaccines (1 to 5) the nearer you are to 20 which is the highest possible total, the more likely that intervention including anti-malaria’s or vaccines will be necessary.
The big question is: “Did Wayne get the virus from Nige- ria?” I have no doubt that Manu must have had their players consult with some of the best travel health consultants in the world. To briefly analyse the situation, 10 days in South Africa and then 2 days in Nigeria. Did they come into South Africa (Sub tropical) from Asia (tropical and sub tropical), the UK or any third party country? Two nights is a short period especially in good accommodation. That is not to say he cannot get infected.
I believe it is premature to put the blame on Nigeria unless a more comprehensive analysis is done including finding out the strain of the virus if indeed it was a virus. Why Wayne not play in Nigeria did, was he already ill? From travel itinerary, incubation period of the bug, the strain of bug amongst other critical analyses, I believe it is easy to determine which country the bug came from, -not that it really matters (It does) -, because travel is fun and risk.
Find below for your information only, extracts on the latest British behaviour abroad2014 Report- The Foreign and Commonwealth Office released their annual report on British behaviour abroad. The report provides incidence figures from the Foreign Office records that highlight the key problems British nationals experience when away from home.
In the 2013/ 2014 period, 17,517 Britons needed Total Consular assistance whilst abroad, 717 were arrested for drug offences, Total arrests including drugs 5,418, Deaths4,110, Hospitalisations 3,157, Rapes 106, Sexual assaults 152, other assistance 4,485, Lost and stolen passports/ Emergency Travel documents 31,134.
If you look through the British Foreign Commonwealth office statistics especially for all countries were records are kept, you will be surprised at what can go wrong when you travel. Don’t forget to always have your fully charged international roaming mobile phone handy and the worldwide emergency number in any country is 112.