ISDS Annual Conference Proceedings 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution,  
and reproduction in any medium, provided the original work is properly cited.

ISDS 2016 Conference Abstracts

Enhanced syndromic surveillance during the 9th 
Indian Ocean Island Games, 2015
Pascal Vilain*1, Frédéric Pages1, Guy Henrion2, Xavier Combes2, Marc Weber3, 
Pierre-Jean Marianne Dit Cassou4, Katia Mougin-Damour5 and Laurent Filleul1
1French national public health agency, Regional unit (Cire) Océan Indien, Saint-Denis, Réunion; 2University Hospital Centre,  
Saint-Denis, Réunion; 3Hospital Centre, Saint-Benoît, Réunion; 4Univertsy Hospital Centre, Saint-Pierre, Réunion; 5Hospital Centre, 
Saint-Paul, Réunion

Objective
To describe how syndromic surveillance was enhanced to detect 

health events during the 9th Indian Ocean Island Games (IOIG) in 
Reunion Island.

Introduction
The 9th IOIG took place in Reunion Island from July 31 to August 

9, 2015. This sport event gathered approximatively 1 640 athletes,  
2 000 volunteers and several thousand spectators from seven islands: 
Comoros, Madagascar, Maldives, Mauritius, Mayotte, Seychelles and 
Reunion.

In response to the import risk of infectious diseases from these 
countries where some of them are endemics, the syndromic 
surveillance system, which captures 100% of all Emergency 
Department visits, was enhanced in order to detect any health event.

Methods
In Reunion Island, syndromic surveillance system is based on 

OSCOUR® network (Organisation de la surveillance coordonnée 
des urgences) that collects data from all emergency departments of 
the island. Data are daily transmitted to the French national public 
health agency then are available to the regional office. At the regional 
level, data are integrated into an application that allows the built of 
predefined syndromic groups according to the health risks related to 
mass gatherings (Table 1, parts 1 to 3) and complemented by specific 
syndromic groups (table 1, part 4). Daily analyses with temporal 
[1] and spatial-temporal [2] algorithms were performed during the 
surveillance period of July 27 to August 13, 2015. In addition to this 
monitoring, ED physicians were requested to proactively tag Y33 
(ICD-10) as secondary diagnosis, each ED visits related to IOIG. Line 
lists were reviewed daily. Each day, an epidemiological report was 
send to public health authorities.

Results
From July 31 to August 9, 2015, the activity of EDs was in 

accordance with that expected. No health events were detected by 
the syndromic surveillance system except for the syndrome “alcohol 
intoxication” for which consecutive signals were observed from 
August 6 to 9, 2015. This increase occurs commonly at the beginning 
of each month (due to the social benefits payday) [3] nevertheless this 
event has probably been increased by IOIG (finals for team sports 
and games closing ceremony). In total, 8 ED visits were tagged Y33 
as secondary diagnosis. In over half the cases, visits were related to 
trauma.

Conclusions
The syndromic surveillance system proved to be useful for the 

surveillance of mass gathering events due to its capacity to detect 
health events but also to provide reassurance public health authorities 
[4]. As described in literature [5], few ED visits were tagged in relation 
to IOIG. Indeed, the tag of ED visits was implemented two weeks 
before the games, and given the shifts of ED physicians, some of them 
may have not been informed. In the future, preparation meetings with 
physicians will have to be planned several months before in order to 
improve the response rate for mass gathering events.

Table1. Syndromic groups monitored by the surveillance syndromic system 
during IOIG, 2015

Keywords
syndromic surveillance; emergency department; sporting event; mass 
gathering

Acknowledgments
All emergency departements of Reunion Island

References
1. Vilain P, Pagès F, Mougin-Damour K, et al. Using an Emergency

Department Syndromic Surveillance System to Assess the Impact
of Cyclone Bejisa, Reunion Island. Online Journal of Public Health
Informatics. 2015;7(1):e171.

2. Vilain P, Cossin S, Filleul L. Interest of Prospective Spatio-Temporal
Analysis from ED Data to Detect Unusual Health Events. Online
Journal of Public Health Informatics. 2016;8(1):e171.

3. Vilain P, Larrieu S, Combes X, et al. Using a Syndromic Approach
to Study Health Impact and Risk Factors of Alcohol Intoxication
in Reunion Island. Online Journal of Public Health Informatics.
2014;6(1):e171.

4. Henning KJ. What is syndromic surveillance? MMWR Suppl.
2004;53:5-11.

5. Kajita E, Z. Luarca M, Chiang C, Wu H, Hwang B. Syndromic
Surveillance of Emergency Department Visits for the 2015
Special Olympics. Online Journal of Public Health Informatics.
2016;8(1):e129.

*Pascal Vilain
E-mail: pascal.vilain@ars.sante.fr

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e167, 2017