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Ivan Bulaja, the Croatian-born coach of Austria's 49er-class sailing team, has seen it firsthand. His sailors have lost valuable training days after falling ill with vomiting and diarrhea. "This is by far the worst water quality we've ever seen in our sailing careers," said Bulaja.

Training earlier this month in Guanabara Bay, Austrian sailor David Hussl said he and his teammates take precautions, washing their faces immediately with bottled water when they get splashed by waves and showering the minute they return to shore. And yet Hussl said he's fallen ill several times.

"I've had high temperatures and problems with my stomach," he said. "It's always one day completely in bed and then usually not sailing for two or three days." It is a huge risk for the athletes, the coach said.

"The Olympic medal is something that you live your life for," Bulaja said, "and it can really happen that just a few days before the competition you get ill and you're not able to perform at all."

Dr. Alberto Chebabo, who heads Rio's Infectious Diseases Society, said the raw sewage has led to "endemic" public health woes among Brazilians, primarily infectious diarrhea in children. By adolescence, he said, people in Rio have been so exposed to the viruses they build up antibodies. But foreign athletes and tourists won't have that protection.