Hosts of mass gatherings (MGs) could benefit from new opportunities that would assist in the preparation and response to threats of infectious diseases, as revealed by the fifth paper on MGs health in The Lancet Infectious Diseases Series. One of these opportunities would be to couple surveillance systems that use the Internet to identify outbreaks of infectious diseases around the globe in near real-time with a novel technology, which can track and predict global population movements through commercial air travel. The authors have described an analysis of potential threats to the 2012 Olympic Games using this novel approach.
Lead author, Kamran Khan from St Michael's Hospital in Toronto, Canada explains:
"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."
The Global Public Health Intelligence Network (GPHIN) and HealthMap are novel disease surveillance tools that use informal internet data sources like online news outlets, in order to detect early reports of disease outbreaks and for monitoring global disease activity. In contrast to traditional surveillance systems, i.e. government reports, which can be subject to delays in reporting and poor sensitivity, the novel surveillance tools have the potential to overcome these limitations.
Furthermore, the authors comment that understanding global air travel patterns before, during and after MGs are vital, given that this is the main mode of transport to and from MGs, and refer to Bio.Diaspora, a novel technology that can track worldwide air travel patterns to predict the worldwide spread of infectious diseases.
The system can be utilized to predict the amount of travelers, as well as their global origins from MGs. Therefore, in areas where large population movements to the MG host city are expected, the system is able to direct disease surveillance activities to specific global locations.
By applying this method, Khan and his team discovered that the vast majority of passengers traveling to Vancouver for the 2010 Winter Olympic Games originated from only 25 cities. Consequently, the real-time infectious disease surveillance efforts were then aimed on those particular cities to monitor and evaluate potential threats before, during, and immediately after the Games.
The fifth paper in this series describes how this method will be applied for the first time in London at the 2012 Olympic Games, for real risk assessment and planning purposes. It will assist UK public health officials in prioritizing which global outbreaks require the greatest attention at the time of the Games.
However, the authors warn that surveillance needs to be integrated at both local and global levels in order to provide the best intelligence for MGs. They state:
"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."
An essential part in resolving these fundamental issues will be to develop methods to overcome the gaps in knowledge integration at local and global levels, to reinforce the collaboration between "traditionally isolated but complementary scientific specialties", as well as encouraging a greater international cooperation to inspire those countries that share threats of common risks of infectious diseases to collaborate with each other.
Written by Petra Rattue