Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan.
PLoS Negl Trop Dis. 2018 Sep 20;12(9):e0006755. doi: 10.1371/journal.pntd.0006755. eCollection 2018 Sep.
Participants in mass gathering events are at risk of acquiring imported and locally endemic infectious diseases. The 2014 dengue outbreak in Tokyo gathered attention since it was the first time in 70 years for Japan to experience an autochthonous transmission. Preparation for emerging infectious threats is essential even in places where these outbreaks have been largely unknown. The aim of this study is to identify strategies for early detection and prevention of dengue infection during the 2020 summer Olympics and Paralympics in Tokyo.
METHODOLOGY/PRINCIPAL FINDINGS: We modified and adapted the failure mode and effect analysis (FMEA) methodology, generally used in industrial manufacturing, to examine the current controls for dengue detection and assessment. Information on existing controls were obtained from publicly available resources. Our analysis revealed that the national infectious disease control system to detect dengue in Japan is robust. However, in the case of large assemblies of international visitors for special events when the spread of communicable and vector-borne diseases increases, there are three main gaps that could be reinforced. First, cyclical training or a certification program on tropical disease management is warranted for physicians, especially those working in non-infectious disease-designated hospitals or clinics. Second, multi-language communication methods need to be strengthened especially in the health and hospitality sector. Third, owners of accommodations should consider incorporating a formal tropical disease-training program for their staff members and have a contingency plan for infectious disease-suspected travelers.
CONCLUSIONS/SIGNIFICANCE: Our findings may facilitate physicians and public health officials where new controls would be beneficial for the 2020 summer Olympics and Paralympics. The FMEA framework has the potential to be applied to other infectious diseases, not just dengue.
参与大型集会活动的人有感染输入性和本地流行传染病的风险。2014 年东京登革热疫情引起了关注,因为这是日本 70 年来首次发生本地传播。即使在这些疫情尚未广泛出现的地方,也必须为新出现的传染病威胁做好准备。本研究旨在确定在 2020 年东京夏季奥运会和残奥会期间发现和预防登革热感染的策略。
方法/主要发现:我们修改和调整了故障模式和影响分析(FMEA)方法,该方法通常用于工业制造,以检查当前用于登革热检测和评估的控制措施。现有控制措施的信息是从公开资源中获得的。我们的分析表明,日本的国家传染病控制系统能够有效地检测登革热。然而,在特殊活动期间有大量国际游客聚集的情况下,传染病和媒介传播疾病的传播风险增加,存在三个主要的薄弱环节,可以加以强化。首先,需要为医生,特别是在非传染病指定医院或诊所工作的医生提供热带病管理方面的周期性培训或认证计划。其次,需要加强多语言沟通方法,特别是在卫生和酒店业。第三,住宿业主应考虑为其员工制定正式的热带病培训计划,并为疑似传染病旅行者制定应急计划。
结论/意义:我们的发现可能会为 2020 年夏季奥运会和残奥会的医生和公共卫生官员提供便利,新的控制措施可能会有所帮助。FMEA 框架有可能适用于其他传染病,而不仅仅是登革热。