ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health)-Universitat de Barcelona, Barcelona, Spain.
Biomedical Image Technology, Electronic Engineering, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, Spain.
PLoS One. 2018 Aug 22;13(8):e0201943. doi: 10.1371/journal.pone.0201943. eCollection 2018.
Zika virus has created a major epidemic in Central and South America, especially in Brazil, during 2015-16. The infection is strongly associated with fetal malformations, mainly microcephaly, and neurological symptoms in adults. During the preparation of the Rio de Janeiro Olympic Games in 2016, members of Olympic Delegations worldwide expressed their concern about the health consequences of being infected with Zika virus. A major risk highlighted by the scientific community was the impact on the spreading of the virus into new territories immediately after the Games.
To detect real-time incidence of symptoms compatible with arboviral diseases and other tropical imported diseases among the Spanish Olympic Delegation (SOD) attending the Rio Olympic Games in 2016.
We developed a surveillance platform based on a mobile application installed in participant's smartphones that monitored the health status of the SOD through a daily interactive check of the user health status including geo-localization data. The results were evaluated by a study physician on-call through a web-based platform monitoring system. Participants presenting severe symptoms or those compatible with Zika infection prompted an alarm in the system triggering specialized medical assistance and allowing early detection and control of the introduction of arboviral diseases in Spain.
The system was downloaded by 189 participants and used by 143 of them (76%). Median age was 38 years (IQR 16), and 134 (71%) were male. Mean duration of travel was 19 days (+/-9SD). During the Games the highest accumulated incidence observed was for headache: 6.06% cough: 5.30% and conjunctivitis: 3.03%. The incidence rate of cough during the Olympic Games was 1.1% per day per person, followed by headache 0.8% and 0.4% conjunctivitis or diarrhea. In our cohort we observed that non-athletes experienced more incidence of symptoms, except for incidence of cough which was the same in the two groups (1.1%). No participants reported symptoms fulfilling Zika definition case.
Our system did not find cases fulfilling Zika definition amongst participants of the SOD during the Games, consistent with limited cases of Zika in Rio during the Games. The app showed good usability and the web based monitoring platform allowed to manage infectious cases in real-time. The overall system has proven to serve as a real-time surveillance platform for detecting symptoms that could be present in tropical imported diseases, especially arboviral diseases, contributing to the preparedness for the introduction of vector borne-diseases in non-endemic countries.
2015-2016 年，寨卡病毒在中美洲和南美洲，特别是巴西，引发了一场重大疫情。该感染与胎儿畸形密切相关，主要是小头畸形，以及成人的神经症状。在 2016 年里约热内卢奥运会筹备期间，世界各地的奥运代表团成员对感染寨卡病毒的健康后果表示担忧。科学界强调的一个主要风险是，运动会结束后，病毒传播到新领土的风险。
检测参加 2016 年里约热内卢奥运会的西班牙奥运代表团（SOD）中与虫媒病和其他热带输入性疾病相符的症状的实时发病率。
我们开发了一个基于移动应用程序的监测平台，该应用程序安装在参与者的智能手机上，通过用户健康状况的每日互动检查（包括地理定位数据）监测 SOD 的健康状况。研究医生通过基于网络的监测系统对结果进行评估。出现严重症状或疑似寨卡感染症状的参与者，系统会发出警报，触发专门的医疗援助，并允许早期发现和控制虫媒病在西班牙的传播。
该系统被 189 名参与者下载，并被其中 143 名（76%）使用。中位数年龄为 38 岁（IQR 16），134 名（71%）为男性。平均旅行时间为 19 天（+/-9SD）。在奥运会期间，观察到的最高累积发病率为头痛：6.06%咳嗽：5.30%和结膜炎：3.03%。奥运会期间咳嗽的发病率为每天每人 1.1%，其次是头痛 0.8%和结膜炎或腹泻 0.4%。在我们的队列中，我们观察到非运动员经历更多的症状发生率，除了两组的咳嗽发生率相同（1.1%）。没有参与者报告符合寨卡定义的症状。
在奥运会期间，我们的系统没有发现符合 SOD 参与者寨卡定义的病例，这与奥运会期间里约热内卢有限的寨卡病例一致。该应用程序显示出良好的可用性，基于网络的监测平台允许实时管理传染病病例。整个系统已被证明是一个实时监测平台，用于检测可能存在于热带输入性疾病中的症状，特别是虫媒病，有助于为非流行国家引入媒介传播疾病做好准备。
