The specter of the Zika virus, which has been linked both to microcephaly in newborns and Guillain-Barre, a condition that causes paralysis in adults, has loomed large over the Rio Olympics in Brazil, the epicenter of the outbreak. Now the first American athlete has withdrawn from the competition because of worries about catching the bug.

American cyclist Tejay van Garderen has removed himself from consideration to compete in the games due to concerns about passing it on to his pregnant wife, who is due to give birth in October. Van Garderen was a top contender for one of the two spots on the U.S. cycling squad, having competed in the 2012 Olympics and multiple Tours de France.

Other, more high-profile Americans have expressed concerns about competing in Rio. They include U.S. women’s soccer goaltender Hope Solo, although she says she will play but won’t leave her hotel room other than to play in the games.

Van Garderen’s decision comes after a group of 150 health experts called for the Rio games to be moved or postponed because of Zika, which can be transmitted by mosquito, by sexual means and through blood-to-blood contact. The World Health Organization insists the games should proceed as planned.

As of May 25, the most recent Centers for Disease Control and Prevention data available, there have been 591 reported Zika cases in the United States. There has been one Guillain-Barre syndrome case. All acquired the virus outside the United States. Public health experts warn it’s likely only a matter of time before the virus is transmitted on U.S. shores.

The outbreak is worse in U.S. territories, especially Puerto Rico, where the CDC estimates 20 percent of the island’s residents will catch it. Of the 939 cases across U.S. territories, almost all – 935 – were contracted in American Samoa, Puerto Rico, and the U.S. Virgin Islands. There have been five Guillain-Barre cases in the three U.S. territories.

On Thursday in Lausanne, Switzerland, Rio organizers told the International Olympic Committee executive board that the Zika threat should diminish dramatically during Brazil’s winter months. They showed a graphic indicating the rate of infection falls significantly from June to September.

“The rate of infection drops to very low numbers, very near zero,” said a Rio spokesman, Mario Andrada.

The organizing committee chief, Carlos Nuzman said athletes such as Usain Bolt, Rafael Nadal and members of the U.S. basketball team have said they have no worries, though others, including Solo and Serena Williams, have reservations.

“This’s no public health risk” to warrant postponing or moving the games, Nuzman said.

Andrada said zero cases of Zika were recorded during 44 test events involving 7,000 athletes and 8,000 volunteers. Rio organizers will ramp up a campaign to convince athletes and visitors the games will be safe, though Andrada said pregnant women or women planning to get pregnant should take precautions.

“We believe women that are planning pregnancies have to take extra care, and it is up to them and their family to decide,” Andrada said. “They have to make this decision in privacy.”

An IOC spokesman, Mark Adams, said he hadn’t heard about van Garderen’s withdrawal but added that the committee “follows the recognized global authority on health, the WHO.”

“Everyone would expect a sports organization to follow the advice of the authority,” Adams said. “They issued new advice on Saturday with some clear steps to be taken, especially involving pregnant women. We think that’s good advice and we stick by it.”

U.S. track cyclist Sarah Hammer, who will compete in two events, said she’s not concerned about Zika but she is educating herself before going to Brazil.

“There’s always something. In Beijing it was air quality, in London it was security,” Hammer said. “Am I worried? No. Am I totally ignorant on it? No. I’m going to take all the proper precautions I need.”

USA Cycling chief executive Derek Bouchard-Hall said the U.S. Olympic Committee has taken the lead on educating athletes and “we defer to them” when it comes to preparations.

Bouchard-Hall did say South America’s first Olympics has been beset by problems.

“I think it’s been dogged more than normal. Some things are beyond their control, and some are not,” he said. “For us it’s the velodrome (delays) and some infrastructure problems and the Zika virus, which is not Brazil’s fault per se. But they’re facing a lot of difficult challenges.”

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