2014.ISDS.Abstracts.Final.pdf


ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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ISDS 2014 Conference Abstracts

What did Syndromic Surveillance Show During London 
2012? Lessons for Mass Gatherings

Dan Todkill1, 2, Helen Hughes*1, Alex Elliot1, Roger Morbey1, Obaghe Edeghere1, Sally 
Harcourt1, Brian McCloskey2 and Gillian Smith1

1Public Health England, Birmingham, United Kingdom; 2Public Health England, London, United Kingdom

Objective
We assessed the impact of the London 2012 Olympic and 

Paralympic Games on syndromic surveillance systems including the 
incidence of syndromic indictors and total contacts with health care.

Introduction
Mass gatherings can impact on the health of the public including 

importation of infectious diseases, exposure of international 
visitors to endemic diseases in the host country and the increased 
risk of bioterrorist activity.1 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.

In preparation for the Games, Public Health England undertook 
a programme of work to expand the existing suite of syndromic 
surveillance systems to include daily general practitioner out of 
hours (GPOOH) consultations and emergency department (ED) 
attendances at sentinel sites.2 These new systems complemented 
existing syndromic surveillance systems offering the opportunity to 
monitor trends in patient contacts with GPs outside of normal day 
time opening hours, as well as potentially the more severe end of the 
disease spectrum which would present at EDs.

We assessed the impact of the 2012 Olympics on national 
surveillance systems, comparing to periods before and after the 
Games and in previous years and also the impact of specific events 
during the Games.

Methods
The daily syndromic surveillance data gathered during the 

Olympic period 2012 were compared to the comparable surveillance 
data collected throughout the period preceding and following, and 
equivalent time period in 2013.

Results
The principal finding was that very few differences were found 

between years, within both the ED and GPOOH systems, nationally 
or within London. Some exceptions were noted; insect bite and sting 
related indicators were at higher levels during and immediately after 
the Olympic period in 2012 than the equivalent time period in 2013 
and an increase in attendances for acute alcohol consumption related 
diagnoses were observed in London EDs around the Olympic opening 
ceremony. A reduction in total daily ED attendances and GPOOH 
contacts during summer 2012 was observed, but a similar pattern was 
observed in the following year and this appears to be a secular trend 
coinciding with school holidays.

Conclusions
The 2012 London Olympic Games had very little obvious impact 

on the daily number of ED attendances and GPOOH contacts both 
nationally and within London, with what has now been observed to 
be a normal summer reduction observed across both systems. This 
highlights the importance for any surveillance system to be used for 
a mass gathering to have a sufficient amount of baseline information 

from the same time period in at least one previous year to aid in 
the identification of any departures from what is considered to be 
‘normal’ within each system, at each location at that time of the year.

The ED and GPOOH systems provided valuable reassurance of no 
emerging public health issues during the Games, with the two items 
found to have been at higher levels than 2013 being those related 
to non-infectious causes (i.e. bites and stings) and only one of these 
having a potential link to the Games itself (acute alcohol related ED 
attendances around the timing of the opening ceremony).

Keywords
syndromic surveillance; mass gathering; Olympic Games; baseline

References

1. Tsouros AD, Efstathiou PA. Mass gatherings and public health - the
experience of the Athens 2004 Olympic Games. 2007. http://www.
euro.who.int/document/e90712.pdf (accessed 13 February 2013).

2. Elliot AJ, Morbey RA, Hughes HE, et al. Syndromic surveillance - a
public health legacy of the London 2012 Olympic and Paralympic 
Games. Public Health 2013;127:777-81.

*Helen Hughes

E-mail: helen.hughes@phe.gov.uk    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e167, 201