Abstract

Background

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.

Author summary

Dengue is a mosquito-borne disease that is most prevalent among the emerging arboviruses. Most patients recover from dengue without complications, but a small portion of cases may progress to severe dengue which carries a high mortality rate if left untreated. In 2014, a dengue outbreak unexpectedly occurred in Tokyo, which was the first time in 70 years for Japan to experience an autochthonous transmission. Thus, preparation for dengue and other emerging infectious threats is essential even in places where these outbreaks have been largely unknown. Tokyo will be hosting the Olympic and Paralympic games in 2020, and interventions are warranted to mitigate the risks. We modified and adapted the failure mode effect analysis (FMEA) methodology to test the vulnerability and resiliency of the current controls. Although the FMEA methodology is generally used in industrial manufacturing, it has the potential to be utilized for health preparedness for other infectious diseases as well. Our analysis identifies three strategies to reinforce early detection of dengue infection and prevent further transmission during the Olympic and Paralympic Games.

PLOS

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