Health authorities have issued a checklist to help football fans travelling to Russia for the World Cup this month stay safe and healthy.
The top priority should be to ensure they are up to date with vaccines, particularly in the light of a continuing measles epidemic in Europe, the NHS said.
Depression for England's Rose
On the pitch, the focus switched from customary injury concerns for the England team to mental health after defender Danny Rose revealed that he had been treated for depression.
In a newspaper interview, the Tottenham full-back, 27, said his depression had been triggered by injury and fitness concerns and a series of family problems, including the suicide of his uncle, racial abuse of his mother and an attack on his brother.
Michael Bennett, head of player welfare at the Professional Footballers' Association, told BBC Radio 5 live last week: "There are pressures and high demands in football. It is a constant battle to stay fit, win games and a pressurised environment. You have up and down emotions so if you have that 7 days a week, it will impact on your well-being."
Dr Mark Salter, a consultant psychiatrist, told Medscape News UK: "I'm not sure how much preparation that youngsters these days actually have for the downs and the ups of a stellar career in the public spotlight as a football star. So, he's in a bit of a tricky situation for lots of reasons."
At a press conference, the England manager Gareth Southgate said: "He's part of our team and part of our family for the next few months and we intend to support our players as well as we possibly can."
Thirty Years of Hurt
Southgate appeared free of injury worries following friendlies against Nigeria and Costa Rica. But, said Steve Allen, a chartered physiotherapist with 30 years' experience treating footballers on and off the pitch, there is plenty of potential for problems as the competition progresses.
"The significant ones are damage to the knee joint, where you get damage to the major stabilising ligaments in the knee like the anterior cruciate which would keep a player out for anything from 6 to 10 months," he told Medscape News UK.
Allen, who has been head physiotherapist at a string of clubs, including Wimbledon, Crystal Palace and West Ham, said: "The more common types of injuries you're going to get at the World Cup are going to be more over-use type injuries – more muscular injuries, hamstring strains, adductor strains, which are the muscles on the inside of the leg, [and] thigh strains.
"Most injuries occur in match situations. So, when you've got a condensed amount of time with more games there's more exposure and more risk for frequency of injury." A compounding factor is that "some of the lads have had a particularly hard season and they've probably had a very short rest".
Allen's main advice for England's coaches and players is that "less is more" and they "probably don't need to spend hours and hours on the training pitch".
Health Advice for Fans Heading to Russia
Football fans heading to the World Cup have been advised they do not need any vaccinations for travel but should ensure they are up to date with vaccines required for life in the UK, including MMR vaccine, combined diphtheria, tetanus and polio vaccine.
UK health authorities said there was currently a measles epidemic in Europe and surrounding countries, putting individuals not immune to the disease at extra risk of infection as fans crowd together in stadiums.
In 2017, 35 people died from measles in Europe. In total, 21,315 people were affected by the disease – a fourfold increase on the previous year. The number of cases was highest in Romania, Italy and Ukraine. There were 408 cases in the Russian Federation.
Official NHS advice for travellers is to ensure that they have had 2 doses of measles vaccine within their lifetime or that they are naturally immune from having previously had measles.
Russia has 11 host cities for the event, which takes place between June 14th and July 15th. The England team are scheduled to play Tunisia in Volgograd on 18 June, Panama in Nizhny Novgorod on 24th June, and Belgium in Kaliningrad on 28th June.
If England progress beyond the group stages, they could play in Moscow, St Petersburg, Kazan, Rostov-on-Don, or Samara.
Other key messages for staying healthy during the World Cup are:
Avoid excessive alcohol and recreational drugs which increase the risk of injury, assault, and high risk sex
Use good quality condoms with any casual sexual partner
Stay well hydrated and having access to safe, clean water, and food
A basic first aid kit containing diarrhoea treatment, pain relief, gauze, antiseptic, tape and plasters, should be packed. Any prescription and over the counter medicines should be carried in hand luggage.
Travellers are also being warned that Russia is designated as a 'high-risk' country for rabies in animals. An additional vaccine should be considered for anyone planning on extending their trip, particularly to rural areas.
Health authorities say football fans should ensure they take out adequate personal insurance and remember that a European Health Insurance Card (EHIC) is not valid in Russia.
Cite this: Peter Russell. Can We Expect a Healthy and Injury-free World Cup? - Medscape - Jun 11, 2018.
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