Risk assessment: Importation of infectious disease pathogens related to the 2026 FIFA World Cup

Assessment completed: May 1, 2026

On this page

• Reason for assessment
• Scope
• Risk question
• Risk statement
• Risk assessment summary
• Other considerations for risk in Canada
• Options for response for public health authorities in host jurisdictions
• Appendix A: Acknowledgements
• Footnotes
• References

Reason for assessment

Local and provincial public health agencies in Ontario and British Columbia have completed risk assessments to identify priority hazards for planning and surveillance related to FIFA World Cup 2026 (FWC 2026). Their focus ranged from all-hazard risk assessments at the local level (e.g., including environmental hazards, substance use, and injuries), to more specific risk assessments at the provincial level (e.g., focusing on infectious diseases such as foodborne, waterborne, and vaccine-preventable diseases).

In response to interest from partners at the local and provincial levels, the Public Health Agency of Canada (PHAC) initiated an assessment of infectious disease importation risks associated with FWC 2026 over and above those already planned for by local and provincial jurisdictions, in order to complement their work.

The purpose of this assessment is to estimate the risk of importation of selected pathogens related to the FWC 2026 matches and associated fan festivals in Toronto and Vancouver. The findings are intended to enhance situational awareness and support public health agencies in the host provinces and regions as they prepare for this major mass gathering event. Broader health security considerations related to FWC 2026 are being examined through security and intelligence partners.

Scope

Importation-related infectious disease pathogens were discussed and agreed upon with the Risk Assessment Committee (RAC; see Acknowledgements for members). Inclusion criteria consisted of pathogens with immediate human-to-human transmission risk or that are rare and high consequence, and where coordination across multiple levels of public health may be required as part of the response. Exclusion criteria included pathogens known to be endemic across Canada (e.g., pertussis) and therefore not primarily a risk due to international travel, those already being planned for at the local and provincial levels (e.g., seasonal respiratory viruses, including SARS-CoV-2, food-borne outbreaks, sexually transmitted infections) to limit duplication of work, and those where importation is not expected to lead to transmission within the chosen time period (e.g., establishment of a new vector-borne disease). Given this limitation in scope, local and regional risk assessments provide a better reflection of general infectious disease risks in relation to FWC 2026, see for example the Public Health Ontario assessment.^{Footnote 1}

The following 14 pathogens were chosen for this assessment: avian and swine influenzas detected globally in humans within the last 3 years^{Footnote a}, Crimean-Congo Hemorrhagic Fever virus, toxin-producing strains of diphtheria, hyperinvasive strains of meningococcus, Lassa virus, poliovirus, Marburg virus, Middle Eastern Respiratory Syndrome Coronavirus, mpox virus clades Ia and Ib, measles virus^{Footnote b}, Ebola virus and Sudan virus, Nipah virus, and Yersinia pestis (pneumonic plague only).

Risk question

For each pathogen, what is the likelihood and impact of an infected international traveller^{Footnote c} entering a Canadian host city^{Footnote d} between May 24 and August 1, 2026?

Risk statement

Fourteen infectious disease pathogens were identified that pose an importation risk during FWC 2026. The overall risk landscape is heterogeneous reflecting global epidemiology and dominant modes of transmission (see Risk assessment summary). Further details, including rationale and evidence supporting each estimate, are provided in the risk assessment Technical Annex, available upon request RAP-PER@phac-aspc.gc.ca.

Overall, risk can be summarized into the following main categories.

Category 1: Pathogens with higher likelihood of importation and broader transmission

Pathogens that have a higher likelihood of importation and result in broader transmission include measles virus and clade Ib mpox virus, estimated to pose high and moderate risk, respectively.

Measles is estimated to have a high likelihood of importation driven by high global burden and would result in transmission to susceptible community^{Footnote e} and close contacts^{Footnote f}, leading to moderate impact on the population of a host city.

Clade Ib mpox virus is estimated to have a moderate likelihood of importation driven by increasing community transmission outside of the African region, and would result in transmission to close contacts, including household or sexual contacts, leading to minor impact on the population of a host city.

Category 2: Pathogens with lower likelihood of importation and/or broader transmission

Pathogens that have a lower likelihood of importation and/or are expected to result in broader transmission, leading to minimal or minor impact on the population of a host city and low risk overall, include hyperinvasive meningococcus, toxigenic strains of Corynebacteria (diphtheria), poliovirus, and clade Ia mpox. These relatively rare pathogens may be imported sporadically, but have well-defined transmission pathways, with transmission limited to close or susceptible contacts.

Category 3: Pathogens with very low likelihood of importation and no/limited transmission

Pathogens that have a very low likelihood of importation and result in limited transmission^{Footnote g} to close contacts, leading to minimal impact on the population of a host city and low impact overall, include Crimean-Congo Hemorrhagic Fever virus, Lassa virus, Middle Eastern Respiratory Syndrome Coronavirus, Marburg virus, Ebola virus, Sudan virus, and Yersinia pestis (pneumonic plague only). These pathogens are rare and currently circulating in regions where high travel volumes to a host city are not anticipated and have not been linked to long transmission chains. However a detection of one of these pathogens would require provincial and federal collaboration to support testing and international reporting and may attract media attention.

Pathogens with very low likelihood of importation and would not result in any further spread, leading to minimal impact on the population of a host city and negligible risk overall, include avian and swine influenza viruses^{Footnote a}, and Nipah virus. These pathogens have not demonstrated sustained human-to-human transmission, and while limited human-to-human transmission may occur in specific settings, infection most often occurs due to exposure to infected animals or vectors.

Risk assessment summary

For definitions of likelihood, impact, and uncertainty levels, see Risk assessment method.

Table 1. Likelihood and impact estimates of infectious disease pathogens at risk of importation during the FWC 2026 timeframe (May 24 – August 1, 2026)

Infectious disease pathogen	Likelihood estimate [uncertainty]	Most likely spread scenario	Individual impact estimate [uncertainty]	Population impact estimate [uncertainty]	Overall risk
Category 1: Higher likelihood of importation and broader transmission
Measles virus	High [low]	Transmission to susceptible communityFootnote a and close contactsFootnote b	Moderate [low]	Moderate [moderate]	High risk
Clade Ib mpox virus	Moderate [low]	Transmission to close contactsFootnote b, including household or sexual contacts	Minor [moderate]	Minor [low]	Moderate risk
Category 2: Lower likelihood of importation and/or broader transmission
Corynebacterium spp. (toxigenic strains causing diphtheria)	Low [moderate]	Limited transmissionFootnote c to close contactsFootnote b	Moderate [moderate]	Minimal [low]	Low risk
Hyperinvasive meningococcusFootnote d	Low [moderate]	Transmission to susceptible close contactsFootnote b	Moderate [low]	Minor [high]	Low risk
Poliovirus (wild and vaccine-derived)	Low [moderate]	Limited transmissionFootnote c to close contactsFootnote b	Moderate [low]	Minimal [low]	Low risk
Clade Ia mpox virus	Very low [moderate]	Transmission to close contactsFootnote b, including household or sexual contacts	Minor [high]	Minor [low]	Low risk
Category 3: Very low likelihood of importation and no/limited transmission
Crimean-Congo hemorrhagic fever virus	Very low [low]	Limited transmission to close contactsFootnote b	Major [moderate]	Minimal [low]	Low risk
Lassa virus	Very low [low]	Limited transmission to close contactsFootnote b	Major [moderate]	Minimal [low]	Low risk
MERS-CoV	Very low [moderate]	Limited transmissionFootnote c to close contactsFootnote b	Major [low]	Minimal [moderate]	Low risk
Marburg virus	Very low [low]	Limited transmissionFootnote c to close contactsFootnote b	Severe [low]	Minimal [low]	Low risk
Ebola virus and Sudan virus	Very low [low]	Limited transmissionFootnote c to close contactsFootnote b	Severe [low]	Minor [low]	Low risk
Yersinia pestis  (pneumonic plague only)	Very low [low]	Limited transmissionFootnote c to close contactsFootnote b	Severe [low]	Minimal [low]	Low risk
Avian influenzaFootnote e	Very low [low]	No further spread	Minor to major [high]	Minimal [low]	Negligible risk
Swine influenzaFootnote e	Very low [low]	No further spread	Minor [high]	Minimal [low]	Negligible risk
Nipah virus	Very low [low]	No further spread	Severe [moderate]	Minimal [low]	Negligible risk
Footnote 1 Community contacts: Contacts exposed through encounters in public or commercial spaces or otherwise through sharing a public or commercial space. In the context of FWC 2026, this includes contacts at stadiums, fan events, restaurants and bars, clinics and urgent care, public transportation, etc. Return to footnote a referrer Footnote 2 Close contact: Those providing care for infected individuals, sharing households or accommodations with infected individuals, or those with intimate contact with infected individuals; including but not limited to congregate living settings, sexual contacts, caregivers or personal support workers, healthcare workers, those handling infected bodily fluids Return to footnote b referrer Footnote 3 Limited transmission: Infection to only a small fraction of all potential contacts and exposures which may result in short chains of transmission Return to footnote c referrer Footnote 4 Hyperinvasive meningococcus: Neisseria meningitidis genotypes that are responsible for a disproportionately high fraction of invasive meningococcal disease (IMD) cases or have caused previous IMD outbreaks and have not been detected within Canada in the past 5 years. Return to footnote d referrer Footnote 5 Avian and swine influenzas: Emerging swine and avian influenza strains identified in Canada's human emerging respiratory pathogens bulletin that have resulted in a human detection globally in the last 3 years (since January 2023). Return to footnote e referrer

Further details, including rationale and evidence for estimates, are available in the risk assessment Technical Annex available upon request at RAP-PER@phac-aspc.gc.ca.

Other considerations for risk in Canada

Several non-endemic pathogens were excluded from the formal risk assessment because their likelihood cannot be reliably estimated (i.e., pathogens that are not yet known to exist), or their potential impacts are unlikely to occur within the defined risk period. However, these pathogens remain important global public health concerns. Key considerations related to these pathogens are available in the risk assessment Technical Annex (available upon request at RAP-PER@phac-aspc.gc.ca) and summarized below.

The emergence of a novel influenza virus or coronavirus is unpredictable and cannot be estimated in terms of likelihood within this assessment, but could have significant impact given the rapid global transmission seen in past pandemics.

Rubella cases continue to be reported across all WHO regions in 2025^{Footnote 2}, and although Canada has maintained elimination since 2005^{Footnote 3}, increased international travel for FWC 2026 could heighten the risk of importation, particularly posing danger to pregnant individuals due to congenital rubella syndrome and related complications.^{Footnote 4}

Similarly, antimicrobial-resistant organisms such as extensively drug resistant (XDR) tuberculosis, XDR Neisseria gonorrhoeae, and macrolide-resistant pertussis are increasingly detected in other parts of the world.^{Footnote 4 Footnote 5} Introduction to Canada by international visitors would pose treatment challenges and enable further transmission.

Although infectious diseases that are broadly endemic across Canada or that follow seasonal patterns are out of scope for this risk assessment (see Scope above), seasonal influenza circulating in the southern hemisphere or a new SARS-CoV-2 variant of concern could also drive outbreaks.

Additional mass gatherings in the host cities such as concerts, sports events, and annual celebrations (e.g., Pride events) will draw both local and international attendees, creating various opportunities for infectious disease importation and transmission.

Options for response for public health authorities in host jurisdictions

These options are for consideration by health authorities in municipal and provincial jurisdictions hosting or directly impacted by the FWC 2026 in Canada. Jurisdictional actions should be considered in descending order of risk, and guided by local epidemiology, policies, resources, and priorities. These options assume that the standard operational protocols and preparedness and response measures in host jurisdictions are being effectively maintained. PHAC will continue to engage and collaborate with federal, provincial, territorial and other non-governmental organizations to assess public health risks associated with importation of infectious diseases related to FWC 2026.

Preparedness and response

• Re-assess the risk posed by the pathogens in this risk assessment immediately preceding, during, and immediately following the FWC 2026 to identify emerging risks and initiate appropriate actions as necessary
• Consider the feasibility and utility of enhanced surveillance for infectious disease pathogens if risk increases for any of the pathogens during the risk assessment period to enable early detection and response.
• Consider pre-arranged expedited sample shipping to the appropriate reference laboratory to support timely diagnosis and patient management.
• Ensure capacity, supply, and availability of medical countermeasures (e.g., vaccines, immunoglobulins, antitoxins, specific therapeutics, other). Especially consider stockpiling needs and supply lines (e.g., Special Access Program) for the diphtheria antitoxin (DAT) given the ongoing global supply shortage.
• Prepare for the utilization of an appropriate emergency response structure including an Incident Management System (IMS) or similar to enable effective and clear coordination of response efforts if required.

Risk communication

• Consider timely, coordinated risk communication activities tailored to the needs of specific audiences in the context of increased international visitors and mass gatherings associated with the FWC 2026.
• Enhance targeted communications to healthcare professionals in host jurisdictions to support early detection, diagnosis/testing, management, and reporting of infectious disease pathogens, particularly those rarely encountered in Canada.

For the complete report, please contact RAP-PER@phac-aspc.gc.ca.

Acknowledgements

Completed by the Public Health Agency of Canada in collaboration with partners from:

• Health Canada
• British Columbia Centre for Disease Control
• City of Toronto
• Government of British Columbia
• Public Health Ontario
• University of Toronto
• Vancouver Coastal Health