The 2026 FIFA World Cup: A Public Health Challenge Across Three Nations

"Local health departments are being asked to prepare for a massive, extended international event without a dedicated federal public health funding stream."
— Dr. J. Nadine Gracia, CEO, Trust for America's Health

Event Scope and Timing

The 2026 FIFA World Cup, scheduled from June 11 to mid-July across 16 cities in the United States, Canada, and Mexico, is the largest mass gathering in the tournament's history. With over five million tickets sold, the event will feature 104 matches across three countries.

U.S. host cities include Atlanta, Dallas, New York/New Jersey, Los Angeles, Kansas City, Philadelphia, and Houston.

The tournament coincides with:

• The summer season
• Other major public events (250th anniversary celebrations, Pride month)
• Ongoing outbreaks of various infectious diseases

Infectious Disease Risk Assessment

Health officials are monitoring multiple threats, with risk levels varying by transmission mechanism, outbreak status, and preparedness measures.

Ebola

In May 2026, the World Health Organization declared a Public Health Emergency of International Concern for an Ebola outbreak caused by the Bundibugyo strain in the Democratic Republic of the Congo (DRC) and Uganda. No approved vaccines or treatments exist for this strain.

"The risk of widespread Ebola transmission during the World Cup is low."
— Experts from multiple institutions

The virus requires direct contact with bodily fluids from symptomatic individuals, and infected persons are typically too ill to attend large public events.

The U.S. has implemented entry restrictions for non-citizens who have been in affected countries within the past 21 days, with enhanced screening at designated airports. Mexico and Canada have similar measures.

The CDC's Health Alert Network notified clinicians five days after the WHO declaration; the Africa CDC issued a same-day response.

Measles

Measles is identified by multiple health officials as a high concern due to its extreme contagiousness. The virus can remain airborne for up to two hours.

As of June 4, 2026, the U.S. CDC confirmed 2,030 measles cases in 2025—the highest number since 1991. Georgia has reported five cases, three in metro Atlanta. Kansas City detected measles in wastewater in May. Outbreaks are also reported in Canada and Mexico.

The Pan American Health Organization (PAHO) has issued a warning about measles.

Respiratory Viruses (COVID-19, Influenza, RSV)

• COVID-19 causes an estimated 290,000–450,000 hospitalizations annually in the U.S.
• The 2025–2026 flu season reached a 30-year high in the U.S.
• Respiratory illnesses remain a concern due to airborne transmission, particularly as the Southern Hemisphere is in its flu season during the tournament.
• Avian influenza H5N1 has caused 70 human infections in the U.S. since 2024; no person-to-person transmission has been detected.

Other Infectious Diseases

• Norovirus and foodborne illnesses are considered common risks at mass gatherings
• Mpox continues to circulate
• Syphilis is resurging globally
• Mosquito-borne diseases: Dengue set a U.S. record in 2024 (nearly 3,800 cases). Locally acquired dengue has occurred in Los Angeles. Yellow fever is absent from the U.S. but poses a risk for travelers. Oropouche virus saw its largest epidemic in 2024, with over 8,000 confirmed cases in Brazil
• Hantavirus is currently circulating in South America

Public Health Preparations by City

Atlanta (8 matches, including a semifinal)

The Fulton County Board of Health is implementing a "three I's" strategy (identify, isolate, inform) for potential measles cases, including contact tracing.

• Cooling stations with air-conditioning and hydration for heat-related illnesses
• Daily inspections of food vendors planned
• Grady Memorial Hospital will have extra staff on site and at the Fan Festival

"We've been focusing on expecting the expected" regarding weather, health, and human behavior.
— Dr. Marcus Plescia, Fulton County Health Director

Dallas (9 matches)

• Enhanced wastewater surveillance for influenza, COVID-19, and other pathogens via genomic sequencing
• Expanded mosquito traps to test for West Nile, dengue, chikungunya, and Zika
• Medical staff monitoring for symptoms of Ebola and hantavirus
• Health tips provided in multiple languages

"To be able to begin preparations a year out is a luxury for us."
— Dr. Philip Huang, Dallas County Health Department

New York/New Jersey (Finals, July 19)

• Practice simulations conducted for outbreaks and mass casualty events
• An incident command system established to divert resources for emergencies
• Bellevue Hospital operates the only biocontainment unit in New York City—with two beds for viral hemorrhagic fevers

Los Angeles (8 matches)

• Risk-assessment teams monitor for chemical exposures and biological threats
• Staff encouraged to forgo vacation; overtime expected
• Routine food inspections postponed

Philadelphia

• Intensified monitoring for measles, heat-related illnesses, and air quality
• Officials anticipate respiratory illnesses and gastrointestinal infections

Coordination, Funding, and the Federal Role

Federal Funding

FEMA's $625 million FIFA World Cup Grant Program funds security activities only. Public health, biosecurity, and food safety expenses are excluded from this program, according to a FEMA spokesperson.

No single entity is accountable for public health coordination across the three host countries.

Host cities have formed voluntary networks but lack a centralized command structure. The CDC has not conducted a World Cup-specific national risk assessment, instead advising local health departments to identify their own risks.

CDC and Federal Workforce

The CDC has lost nearly a quarter of its staff due to firings and resignations, according to a federal employee union estimate. Some federal groups—such as the National Security Council's biosecurity group and the Office of Pandemic Preparedness and Response Policy—have been disbanded or left vacant.

HHS Response

An HHS spokesperson stated that HHS and the CDC are actively coordinating with state, local, and global partners.

University and Military Support

• Georgetown University and MedStar Health built the Health Security Operations Center (HSOC), which provides daily situation reports to the Department of Homeland Security, the White House, and HHS
• The Armed Forces Health Surveillance Division produced importation risk maps for each U.S. host city—which the CDC did not create or request

Surveillance Tools

Wastewater monitoring and other surveillance methods have been scaled up. However, BioWatch air detection systems were not fully operational in Dallas as of early June.

Hospital Capacity and Preparedness Gaps

• Nationally, there are 26 biocontainment beds across 13 centers for viral hemorrhagic fevers
• Texas, host to matches in Dallas and Houston, scores "low" on national public health preparedness rankings
• Kansas City health officials identified finding and quarantining people in unsanctioned encampments as a top concern if an outbreak occurs

"Travel history needs to be a vital sign."
— Dr. Krutika Kuppalli, infectious disease physician, Dallas

Standard rapid diagnostic panels do not test for MERS, Kuppalli noted.

Health Advisories for Attendees

Public health officials advise fans to:

• Update vaccinations for measles, influenza, and COVID-19
• Practice safe sex
• Use mosquito repellent
• Stay home or wear a mask if sick