Enhanced syndromic surveillance for mass gatherings in the Pacific: a case study of the 11th Festival of Pacific Arts in Solomon Islands, 2012.

Damian Hoy,Alison Sio,Cynthia Joshua,Yvan Souares,Paul White,Roy Roger Maraka,Divi Ogaoga,Sala Duituturaga,Christelle Lepers,Adam Roth,Pascal Frison,Dennie Iniakawala,Ian Wanyeki,Salanieta Saketa

doi:10.5365/wpsar.2016.7.1.004

Damian Hoy, Alison Sio + Show 12 more

Open Access

https://doi.org/10.5365/wpsar.2016.7.1.004

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Abstract

Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere. In July 2012, the 11th Festival of Pacific Arts (FOPA), a mass gathering event involving 22 Pacific island states and territories, was hosted by Solomon Islands. An enhanced syndromic surveillance (ESS) system was implemented for the event. Throughout the capital city, Honiara, 15 sentinel sites were established and successfully took part in the ESS system, which commenced one week before the FOPA (25 June) and concluded eight days after the event (22 July). The ESS involved expanding on the existing syndromic surveillance parameters: from one to 15 sentinel sites, from four to eight syndromes, from aggregated to case-based reporting and from weekly to daily reporting. A web-based system was developed to enable data entry, data storage and data analysis. Towards the end of the ESS period, a focus group discussion and series of key informant interviews were conducted. The ESS was considered a success and played an important role in the early detection of possible outbreaks. For the period of the ESS, 1668 patients with syndrome presentations were received across the 15 sentinel sites. There were no major events of public health significance. Several lessons were learnt that are relevant to ESS in mass gathering scenarios, including the importance of having adequate lead in time for engagement and preparation to ensure appropriate policy and institutional frameworks are put in place.

Highlights

Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere
The total daily number of syndrome cases peaked eight times throughout the surveillance period (Fig. 1); four peaks occurred during the Festival of Pacific Arts (FOPA)
This peak pattern was largely due to an influx of patients on Mondays to clinics that had been closed for the weekend

Summary

Introduction

Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere. In July 2012, the 11th Festival of Pacific Arts (FOPA), a mass gathering event involving 22 Pacific island states and territories, was hosted by Solomon Islands. Solomon Islands hosted the 11th Festival of Pacific Arts (FOPA) from 1 to 14 July 2012 in Honiara, the country’s capital. It was the largest event ever hosted by Solomon Islands, involving more than 3000 artists and performers from around the Pacific. Syndromic surveillance (SS) is used for the early detection of and response to potential public health threats.[3,4] Case definitions in SS are based on clinical signs and symptoms rather than laboratory confirmation for the early detection of outbreaks while preserving limited resources.[4] Solomon Islands’ SS system, established in 2011, monitors four syndromes at the National Referral Hospital (NRH). The objectives were: 1. to provide a simple surveillance system for detecting and responding to disease outbreaks in a timely and effective manner, 2. to sustain the surveillance system improvements beyond the mass gathering

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