Elsevier

Public Health

Volume 127, Issue 8, August 2013, Pages 777-781
Public Health

Short Communication
Syndromic surveillance – a public health legacy of the London 2012 Olympic and Paralympic Games

https://doi.org/10.1016/j.puhe.2013.05.007Get rights and content

Introduction

The London 2012 Olympic and Paralympic Games (Games) provided a global sporting spectacle, attracting approximately 11 million visitors over 30 days of competition and 805 medal events across the United Kingdom.1 This international mass gathering also brought with it unprecedented public health challenges; the UK Health Protection Agency (HPA; the HPA became part of Public Health England (PHE) on 1 April 2013) played an integral role in planning and executing a national enhanced public health surveillance programme for the duration of the Games.

Mass gatherings can impact on the health of the general public, including: the increased risk of importation of an infectious disease, in particular those diseases to which the host population have naive immunity; exposure of international visitors to endemic diseases in the host country; increased disease transmission across large populations gathered in one location; increased opportunity for transmission of infectious disease (due to close mixing and/or pressures on catering and sanitation systems); the increased risk of bioterrorist activity; and the increased strain on health services caused by the gathering.2 Public health surveillance during mass gatherings therefore affords an opportunity to identify, and quantify any impact (or reassure on the absence of impact) on public health in a timely manner.

One of the key components of the HPA enhanced surveillance programme for the Games was syndromic surveillance. Syndromic surveillance is the near real-time collation, interpretation and dissemination of data to allow the early identification of potential public health threats and their impact, enabling public health action.3 Within the HPA, the Real-time Syndromic Surveillance Team (ReSST) has delivered a national syndromic surveillance service since 1999, based upon a suite of different surveillance systems that extract health data from different levels of the National Health Service (NHS).4 The Games necessitated the expansion of this service, developing new syndromic surveillance systems and strengthening existing systems in order to deliver a more complete, comprehensive service.

Section snippets

The syndromic surveillance systems

Prior to 2012, the HPA coordinated two national syndromic surveillance systems. The NHS Direct syndromic surveillance system, monitoring daily telephone calls reported to the NHS Direct telephone health advice line service.5 Anonymized call data are stratified by age and geography and contain a reference to the presenting symptoms and the health outcome (recommendations for further health consultation) of each caller. The second existing system was a large national general practitioner (GP)

The translation of syndromic surveillance into public health action

The development of the new syndromic surveillance systems provided added confidence in monitoring syndromic trends. Data from each system can now be used to triangulate intelligence thus providing reassurance that coinciding alarms (when a test statistic significantly exceeds its expected value) are a result of a genuine incident. More importantly, these developments have strengthened the ability to provide reassurance during public health incidents, providing evidence of a lack of impact in

The enhanced Games syndromic surveillance service

During the HPA's daily Games time reporting, the HPA's national Olympic Coordinating Centre (OCC) included 59 new public health events (predominantly identified through even-based surveillance reporting) in the daily situation report (SitRep) to the Games Chief Medical Officer, however no events were assessed as a serious threat to public health.9 The majority of the incidents identified by HPA were those routinely seen during summer (e.g. related mainly to gastroenteritis, possible food

The postgames public health legacy

There are examples of surveillance systems that have been developed in response to mass gatherings that have then been discontinued following the conclusion of the gathering.2 The success of the London 2012 Olympic and Paralympic Games has been widely attributed to its emphasis on the ‘legacy’, including urban and social regeneration and increased sports participation by all sectors of the community, especially children.10, 11 With respect to public health legacy, the HPA have ensured that,

Acknowledgements

The authors would like to acknowledge support from NHS Direct; College of Emergency Medicine, EDs participating in the EDSSS, Ascribe Ltd and L2S2 Ltd; OOH providers submitting data to the GPOOHSS and Advanced Heath & Care; the contribution of EMIS and EMIS practices to the HPA/QSurveillance GP surveillance system, University of Nottingham and ClinRisk.

Ethical approval

Not required.

Funding

This work did not receive any external funding and was supported through core surveillance funding by the UK Health Protection

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