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London prepares for Olympian disease-monitoring task

As the world’s athletes limber up for the forthcoming Olympic games in London, infectious-disease experts are preparing for their own trials. Their competition is with the diseases that millions of athletes, officials, media and spectators bring with them as they converge from across the globe on the UK capital.

There is already a body of literature on how large gatherings of people can lead to outbreaks of infectious diseases, from music festivals to religious gatherings. This has led to the establishment of a new and growing branch of research: mass-gathering medicine.

“In advance of these games a huge effort needs to go into public-health preparedness,” John McConnell, editor of The Lancet Infectious Diseases, told the audience at a special session of the European Congress of Clinical Microbiology and Infectious Diseases in London.

The man in charge of that preparedness is Brian McCloskey. McCloskey, the London director of the UK Health Protection Agency (HPA), says that although the city is used to hosting ‘mass gatherings’, the Olympics is a special case owing to its scale and international character and the huge scrutiny it draws from the media.

“The most likely thing to happen is nothing at all,” he assured the congress. “Most Olympic games go off without problems.”

But the HPA is planning for potential incidents, such as bioterrorism and large accidents at stadiums or on public transport, and looking at the potential impacts of more recent and more unusual events such as the poisoning in 2006 of Alexander Litvinenko with polonium, a radioactive element, triggering some public-health issues.

The HPA, says McCloskey, will be following up on surveillance both faster and at a lower threshold than normal. He gives the example of a three people falling ill after eating at the same restaurant near a stadium. Outside of the Olympics, this might not merit an immediate, detailed look. During the Olympics, such an occurrence will need heavy scrutiny. Managing rumours will be a major task, especially given that a large number of reporters will be searching for stories of trouble, says McCloskey. Learning from past experiences will be vital, and McCloskey admits that the need to react quickly will mean that sometimes “we will be making public-health decisions in the absence of public-health information” during the games.

The HPA is also keeping modellers on call, and has linked up with Kamran Khan, an infectious-disease clinician at the University of Toronto in Ontario who works on the Bio.Diaspora project. This crunches data on international air travel to predict where diseases might spread and to help those working in public health to identify which outbreaks around the world might be heading their way and merit close watching. With the interconnectedness of many locations, disease monitoring can’t just occur locally anymore.

“You don’t have to be hosting a mass gathering,” notes Khan. “You just have to be connected to it.”

Other speakers at the session included Ziad Memish, of the Saudi Arabian public-health ministry. Memish is responsible for public health during the huge Hajj pilgrimage, which sees millions of people a year converge on Mecca. He told the conference that there was now a realization that ‘mass-gathering medicine’ was increasingly important.

In January this year the World Health Organization (WHO) passed a resolution on ‘global mass gatherings’, declaring that guidance on planning, management, evaluation and monitoring of such events needed to be developed.

“This is a major achievement,” says Memish. “This is going to take mass-gathering medicine forward.”

McCloskey says London is ready, even if he is going to have to get up before sunrise to prepare a 6 a.m. report for the WHO every day. “We’ve got in place all the surveillance we need,” he told the meeting. “Its all in place. Come and enjoy it.”

Photo courtesy of bryangeek via Flickr under Creative Commons.


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