Healthy Olympics 2012: Disease surveillance and mass gathering medicine

In the blockbuster Contagion, Gwyneth Paltrow travels to Hong Kong on business and returns to suburban Minneapolis with flu-like symptoms. Within days she is dead. Paltrow is the index case in a pandemic that sweeps across the world. Contagion is a dramatic example of how a series of mundane, every day activities—such as shaking hands, drinking from a glass and blowing on dice for good luck—can rapidly and effectively spread disease.

Starting Friday, this year’s summer Olympics will kick off in London, the international hub of Europe. Can you imagine the potential for disease spread in a city that will host ten million athletes and tourists from all over the world?

It is not uncommon for mass gathering events to result in disease outbreaks. Most recently, Ukraine, host of the Euro 2012 soccer championshipreported an upsurge in measles cases and sexually transmitted infections (STIs). In February, the state of Indiana reported a measles outbreak following the Superbowl. The game provided fertile soil for 16 cases of measles—quite a lot, given that the disease is no longer considered endemic in the United States.

Major sporting events are not the only gatherings with epidemic potential. Consider the Hajj, the annual pilgrimage to Mecca that attracts millions of Muslims. Pilgrims from all different walks of life are obligated to camp within religious boundaries, which they do not leave until the ceremony has ended. Some stay on site for several weeks, eating, sleeping and washing together. Cholerameningitis and influenza have all plagued past pilgrimages.

When it comes to this summer’s Olympics, public health authorities in the United Kingdom are fully prepared. In addition to existing and well-tested measures to detect, assess and respond to disease outbreaks, the British Health Protection Agency (HPA) will introduce and operate “the world’s first comprehensive, automated outbreak detection system,” one that monitors over 3,000 types of infections during the Games. This state-of-the-art “syndromic” surveillance system—which relies on a number for data sources, including official sources like the HPA’s Emergency Department (EDSSS) and GP Out of Hours/Unscheduled Care (GPOOHSS) syndromic surveillance systems, as well as social networking sites like Facebook and Twitter—assesses reports of symptoms before disease onset, as well as other health-related data, to enable effective public health action. “This suite of surveillance systems is unique to the UK,” reveals Brian McCloskey, MD, who is leading the HPA’s Olympics efforts.

The HPA is bolstering its syndromic surveillance efforts by partnering with a number of outside organizations to improve disease detection. For instance, the authority has joined with the European Center for Disease Prevention and Control (ECDC) and the HealthMap team at Boston Children’s Hospital to create a global disease map for the Games (similar to one HealthMap created for the 2011 Hajj) The map allows public health officials to tell which countries are experiencing disease outbreaks, and which countries and cities are sending the highest number of tourists to the UK. Special emphasis is being placed on influenza, as the map also tracks any influenza-like-illnesses occurring in the southern hemisphere that could potentially spread north. Additionally, HealthMap, in collaboration with Bio.Diaspora, is studying transportation networks to better understand the movements of international travelers.

“We’re fairly confident we have the right systems in place to know if anything is happening, and we have the right resources to respond if it does happen,” McCloskey recently told the Chicago Tribune. ” But the balance of the evidence available to us is that the most likely thing to happen is nothing at all.”


This was originally posted on the Children's Hospital Boston Vector Blog. To view the original post and other great articles on medicine and innovation, check out the blog.

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