MGs and Disease transition; The 2010 Winter Olympic Games

By: Rosemary Stephen PMed, (cert) EOH, IPM, Elements: Environmental Health Intelligence

Athletes will soon be competing for gold at the Vancouver 2010 Winter Olympics. They, however, will certainly not want to win gold in one category — communicable diseases. Every Olympic game, be it winter or summer, sees athletes and tourists from all over the world congregate in a small geographic area; the XXI Vancouver Olympic games is no exception. It is anticipated that Vancouver, British Columbia, Canada will host nearly 7,000 Olympic and Paralympic athletes, as well as numerous officials, from over 82 nations [1]. Added to these numbers will be an estimated 350,000 visitors [2]. This represents an increase of the local population of 14% to 25% [3]. It also represents an increase in the number of infectious diseases that may affect athletes and visitors. What has Vancouver done to prepare ?

In 2008, the World Health Organization invited all health agencies to participate in a workshop to address the difficulties of defining mass gatherings (abbreviated as MGs) [4] and to examine how to protect the health of participants and locals during these events. The WHO asked agencies to review a publication entitled “Communicable disease alert and response for mass gatherings” [5]. Vancouver Health officials were involved in this workshop, and further participated as one of the agencies that drafted the publication [6]. The resulting definition of a mass gathering is “more than a specified number of persons at a specific location for a specific purpose for a defined period of time… The number of persons may be as few as 1000, although much of the available literature refers to gatherings exceeding 25,000 persons. MGs can broadly be divided into those that are planned well in advance and those that are spontaneous or take place at very short notice. Planned MGs may be oneoff occasions, such as a royal wedding, may be repeated regularly but at different locations, such as the Olympic Games, or may be held regularly at the same location, such as the Hajj.” [7]. Mass gatherings also have common characteristics in that they “take place within a confined time span and location, that can be unpredictable and where priority is given to enhancing the capacity of public health related services is usually triggered by political interest, public or media scrutiny, national pride or a combination of these factors” [8]. Based on the results from the 2008 workshops, the WHO felt that the most effective way to reduce the potential impact of any outbreak was to maintain lines of communication among public health authorities, health care services and emergency operation units [9,10]. That is why the WHO has sent a representative to the Vancouver Winter Olympics to monitor for potential disease outbreaks [11].

Studies done on infectious outbreaks during previous Olympic games identified that diseases are transmitted by close, person to person contact, by contact with common sources and by airborne routes [12]. Person to person disease transmission can occur during individual competitions but it is more likely to occur during social events and gatherings [13]. Vancouver health authorities are currently aware of the possible presence of H1N1 and seasonal flu viruses and they hope that most visitors have been vaccinated. The Olympic organizing committee requested volunteers to have vaccinations. Vancouver organizers and the International Olympic Committee have also asked that athletes and officials be vaccinated. If athletes were not vaccinated prior to landing in Canada, they will be offered vaccinations upon arrival [14]. Another concern of Canadian health officials is the presence of Norwalk virus in British Columbia [15]. The Olympic Committee has hence signed a hand-sanitizer sponsor to encourage everyone to maintain good hand sanitation [16].

There are also genuine concerns over the transmission of sexually transmitted diseases between athletes. Local Health Authorities have made sure that condoms, some 100,000 in number, will be available to the athletes free of charge; this represents 15 condoms per athlete. Some athletes think that this reserve will be used up very quickly [17]. The US Curling Association will also be selling special Olympic condoms to raise funds for their curling team [17]. These condoms can be used or kept as unique souvenirs of the 2010 Games.

With the games only a few days away, syndromic surveillance is in place and Vancouver is ready to receive the world. The Elements Team would like to take this opportunity to wish good luck to all who are participating in the XXI Olympiad !

Rosemary Stephen PMed, (cert) EOH, IPM (2010). MGs and Disease transition; The 2010 Winter Olympic Games Elements: Environmental Health Intelligence

References:

[1] Syndromic Surveillance Workshop Ontario Agency for Health Protection and Promotion (2009) Public Health Surveillance for Vancouver 2010. (On-line) Available: http://www.oahpp.ca/resources/documents/presentations/2009mar30/OAHPP%20Syndromic%20Surveillance%20Workshop%20Mar%2009%20-%20Patricia%20Daly.pdf. Cited Feb 05.

[2] Ibid. Cited Feb 05.

[3] 2010 media faq (2010) Media Centre, Canadian Tourism Commision media Site. (On-line) Available: http://mediacentre.canada.travel/media-faq. Cited 2010 Feb 03.

[4] Kaiser,R. and Coulombier,D. Epidemic Intelligence during mass gatherings (2006) Eurosurveillance. (On-line) Available: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3100. Cited 2010 Feb 04.

[5] Communicable disease alert and response for mass gatherings (2008) Epidemic and Pandemic Alert and Response,World Health Organisation (WHO). (On-line) Available: http://www.who.int/csr/resources/publications/WHO_HSE_EPR_2008_8c.pdf. Cited 2010 Feb 03.

[6] Levitz, S. Experts: H1N1 no threat to 2010 Games (2009) Health and Welness News, CTV Vancouver 2010. (On-line) Available: http://www.ctvolympics.ca/health/news/newsid=20922.html. Cited 2010 Feb 05.

[7] Communicable disease alert and response for mass gatherings (2008) Epidemic and Pandemic Alert and Response,World Health Organisation (WHO). (On-line) Available: http://www.who.int/csr/resources/publications/WHO_HSE_EPR_2008_8c.pdf. Cited 2010 Feb 03.

[8] Ibid. Cited 2010 Feb 03.

[9] Ibid. Cited 2010 Feb 03.

[10] Ibid. Cited 2010 Feb 03.

[11] WHO to monitor for flu outbreaks at Vancouver; organizers have taken steps to stem H1N1 threat (2010) Business News. (On-line) Available: http://blog.taragana.com/business/2009/11/29/who-to-monitor-for-flu-outbreaks-at-vancouver-organizers-have-taken-steps-to-stem-h1n1-threat-4549/. Cited 2010 Feb 05.

[12] Goodman, R.A. And al. Infectious diseases in competitive sports (1994) PubMed.gov, US National Library of Medicine, National Institutes of Health. (On-line) Available: http://www.ncbi.nlm.nih.gov/pubmed/8114242. Cited 2010 Feb 03.

[13] Ibid. Cited 2010 Feb 03.

[14] WHO to monitor for flu outbreaks at Vancouver; organizers have taken steps to stem H1N1 threat (2010) Business News. (On-line) Available: http://blog.taragana.com/business/2009/11/29/who-to-monitor-for-flu-outbreaks-at-vancouver-organizers-have-taken-steps-to-stem-h1n1-threat-4549/. Cited 2010 Feb 05.

[15] Officials wary of the possible viral outbreak during Olympics (2010) Health and Wellness News, CTV . (On-line) Available: http://www.ctvolympics.ca/health/news/newsid=27354.html. Cited 2010 Feb 03.

[16] Levitz, S. Experts: H1N1 no threat to 2010 Games (2009) Health and Welness News, CTV Vancouver 2010. (On-line) Available: http://www.ctvolympics.ca/health/news/newsid=20922.html. Cited 2010 Feb 05.

[17] Vancouver 2010: 100,00 condoms for Olympic athletes (2010 YouTube. (On-line) Available: http://www.youtube.com/watch?v=Wj8fom1FCUk. Cited 2010 Feb 05.

Tagged as: 2010 Winter Olympics, B.C., Canada, Disease, H1N1, Mass gatherings, Public Health, Vaccine