Coupling surveillance systems that use the internet to detect infectious disease outbreaks around the world in near real-time with novel technology that tracks and predicts global population movements through commercial air travel, could create new opportunities for hosts of mass gatherings (MGs) to better prepare for and respond to infectious disease threats, according to the fifth paper in The Lancet Infectious Diseases Series on MGs health. An analysis of potential threats to the 2012 Olympic Games using this novel approach is described in the paper.
"An integrated platform of this kind could help identify infectious disease outbreaks around the world that could threaten the success of MGs at the earliest possible stages, provide insights into which of those outbreaks are most likely to result in disease spread into the MG, and identify the most effective public health measures to mitigate the risk of disease importation and local spread, all in near real-time"*, explains Kamran Khan from St Michael's Hospital in Toronto, Canada, lead author of the paper.
Novel disease surveillance tools such as the Global Public Health Intelligence Network (GPHIN) and HealthMap that use informal data sources from the internet (eg, online news outlets) to find early reports of disease outbreaks and to monitor global disease activity, have the potential to overcome some of the limitations of traditional surveillance systems (eg, government reports), including delays in reporting and poor sensitivity.
Moreover, the authors note that since commercial air travel is the main mode of transport to and from MGs, understanding global air travel patterns around the time of a MG is critical. Bio.Diaspora is a novel technology that tracks worldwide patterns of air travel to help anticipate the global spread of infectious diseases.
It can be used to predict the numbers and global origins of travellers to MGs, and consequently to direct disease surveillance activities to targeted global locations where large population movements to the MG host city are expected.
Using this approach for the 2010 Winter Olympic Games in Vancouver, Khan and colleagues identified that the vast majority of passengers travelling to Vancouver at the time of the Games originated from just 25 cities. Real-time infectious disease surveillance efforts were then focused on those cities to monitor and assess potential threats leading up to, during, and immediately following the Games.
In this paper, they describe how this concept will be applied, for the first time, to real risk assessment and planning for the 2012 Olympic Games in London, by helping public health officials in the UK prioritise which global outbreaks need their greatest attention at the time of the Games.
But, caution the authors, to provide the best intelligence for MGs, surveillance needs to be integrated at local and global levels: "Although the scientific and technological components and data sources needed to generate real-time intelligence that could mitigate risks of infectious diseases during MGs exist, their integration is suboptimum…So far, these systems remain weakly connected to local surveillance efforts, including those of MGs."
Key to resolving these fundamental issues will be the development of processes to bridge gaps in knowledge integration at local and global levels; strengthening engagement between "traditionally isolated but complementary scientific specialities"; and the encouragement of greater international cooperation to motivate countries that share common risks of infectious disease threats to work together.
Notes to Editor: *Quote direct from author and cannot be found in text of paper.
Journal
The Lancet Infectious Diseases