Infectious Disease Prevention and Management at Tokyo 2020

This report focuses on the anticipation and management of contagious diseases during the 2020 Summer Olympics in Tokyo. It addresses the increased risk of infectious disease outbreaks due to globalization and the influx of international athletes, support staff, spectators, and tourists. The report identifies the Tokyo environment's relevance to infectious diseases, including potential foodborne illnesses and the threat of vector-borne diseases like Dengue fever. It emphasizes the importance of proactive contamination control and management organizations, highlighting the use of the Failure Mode and Effects Analysis (FMEA) framework to test the city’s preparedness. The report identifies significant diseases of concern, such as norovirus and sexually transmitted infections, and discusses the health services capacity, including the number of physicians trained in infectious conditions. It stresses the importance of up-to-date vaccination schedules, hygienic practices, and multilingual healthcare services. The report highlights the need for effective communication and emergency preparedness to mitigate the risk of disease outbreaks during the Olympics.

Running head: INFECTIOUS DISEASE PREVENTION AND MANAGEMENT 1
Contagious Disease Anticipation and Management Planning For the 2020 Summer Olympics in
Tokyo
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CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 2
Abstract
Athletes, support staff, spectators and tourists of international sporting proceedings of
the 2020 Summer Olympics in Tokyo are at risk being contaminated with locally and introduced
endemic illnesses. Tokyo, as the host country is required to be well prepared to handle the
problems as the infectious diseases outbreaks can be witnessed with no or little cautionary. Due
to the increase in globalization, the risk of a disease outbreak to occur even in environments
where the disease has not been witnessed before has significantly increased. And with the influx
of the contestants and spectators of the worldwide sporting event, there is a risk of infectious
disease contamination. This report aims at identifying the approaches for prompt discovery and
inhibition of contagious diseases in the 2020 summer Olympics in Tokyo.

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Table of Contents
Abstract............................................................................................................................................2
Introduction......................................................................................................................................2
Tokyo Environment Relevant To Infectious Disease......................................................................3
Contamination Control and Management Organisation..................................................................4
Significant Diseases of Concern in Tokyo......................................................................................6
Health Services Capacity.................................................................................................................8
Role of Transport Access in Contagious Illness Spread..................................................................9
Conclusion.......................................................................................................................................9
References......................................................................................................................................10

CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 4
Introduction
According to the international air travel association, in 2017, there were approximately
3.9 billion people who travelled through the air, and the number is expected to increase to double
by 2035(Thay, 2017). Globalization has offered an opportunity for cultural exchange, travelling,
and global trade; however, it has enabled individuals with infectious illnesses to travel in
different countries within a short duration of time (Thay, 2017). Increase and development of
transportation networks accelerate the speed at which pathogens spreads and poses a significant
risk to global travellers.
Tokyo Environment Relevant To Infectious Disease
Tokyo will host the Summer Olympic and Paralympic events in 2020. Olympics
gathering attracts global diversity with the 2020 Olympics attracting more than 206 nations
across the globe (Thay, 2017). With such a number, large catering and hospitality outlets open up
the potential for many foodborne disease epidemics among the participants. The participants
share accommodations using the same facilities which enable contagious illnesses, for instance,
influenza and measles to contaminate people Tokyo's municipal built surroundings are a major
setting for microbial transmission (Kakamu et al., 2017). The threat of infectious conditions
dwelling in the urban setting is increased by the congestion and overcrowding which brings in
physical hazards and the inadequate of sanitation, water or hygiene services(Kakamu et al.,
2017).
The city is located in the moderate climatic region; however, the vector-borne illness is a
significant concern in the city as it was witnessed before in the previous events. The occurrence
of the Dengue outbreak was unexpected in the summer of 2014 in Japan as it was the first time in

CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 5
more than seventy years to witness an autochthonous transmission (Kakamu et al., 2017). The
2014 outbreaks signify that Tokyo possesses a suitable ecological, climatic condition, with an
immunologically naïve population to the virus with a significant chance of introduction of the
infection by travellers and the presence of the competent vector of transmission, the Aedes
mosquito.
Highly contagious but vaccine-preventable illnesses for instance measles, has a low
likelihood of an outbreak in Tokyo as the majority of the visitors and participants in the games
are expected to have updated immunizations before travelling (Kakamu et al., 2017). The 2020
Olympics, however, occur outside the northern hemisphere influenza period. This significantly
depresses the threat of potential endemic; however, necessary precautions should be put into
place.
Japan has witnessed an increase in the number of tourists over the years. The influx of
tourism is a significant contribution to the risk of infectious disease. Based on the country’s
report on the Dengue outbreak that led to more than one hundred and sixty laboratories
confirmed incidents, there had been 50-200 official reports cases every year all of which were
introduced cases(Kakamu et al., 2017). Many factors contribute to the spread and occurrence of
infectious illnesses, for instance, the origin of the visitors and epidemiology of the contagious
conditions in their origin nations. Therefore Tokyo and Japan, in general, is at risk of importation
of the infectious diseases since the country has in the recent past promoted the influx of tourists
to get more than 40 million tourists by 2020(Yanagisawa et al., 2018).

CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 6
Contamination Control and Management Organisation
Preparation for emergence infections disease threat is essential even in areas like Tokyo,
where the conditions have not yet been witnessed. Due to the nature of the infectious ailments, it
is significantly hard to alleviate any pathogens from finding their way into the county just by
enforcing border control (Kakamu et al., 2017). Therefore the practical strategy is to have a
preparedness plan to enable health practitioners together with other stakeholders to know how to
identify the signs and symptoms and how to take action(Kakamu et al., 2017). In Tokyo, the
implementation of failure mode and effects analysis (FMEA) framework is key to testing the
susceptibility and resilience of the city’s readiness plan, and to boost the existing programs to
forestall fiascos.
The Japanese health managers have studied preceding Olympic infectious illness
outbreak and have put in place measures, termed health crises control plans for the 2020
Olympic events. The Tokyo municipal administration has undertaken surveys in the prevalence
of the city’s mosquitos in search of the condition of the vectors propagation and the presence of
any infections (Kakamu et al., 2017). The city managers have implemented extermination
programs for the vectors and encourage the general public to make a report on any incident of
mosquitoes and their breeding sites.
The FMEA framework is used in the diagnosis of potential failure modes in a set
structure to determine the risk of their occurrence, detection, and their severity. Japan has
enforced measures that are important in alleviating cases of infectious diseases from
occurring(Yanagisawa et al., 2018). Accommodation owners have executed tropical illness
training programs for their employees and have put in place an emergency plan for contagious
condition suspected from the tourists. Incorporation of the FMEA frameworks is, however,

CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 7
essential to ensure that the various accommodation facilities have followed the guidelines and
how to handle any arising cases.
Communication among travellers and participants is predicted to be a challenge.
Therefore healthcare institutions must be ready since acquiring accurate data from the patient is
vital in diagnosis. Measures have been put to ensure that communication in hospitals is not a
challenge(Kakamu et al., 2017). Medical translation services have been implemented in the
hospitals and can serve different languages hence increasing efficiency in the hospital.
Significant Diseases of Concern in Tokyo
Previous Olympic events witnessed different public health concerns and infectious
illnesses outbreaks. According to WHO 2016, the Rio Olympic event took place during the Zika
virus outbreak in Brazil; however, there were no recounted incidents of athletes contracting the
infections. The health administrators in the city were, however vigilant in case of any cases
(Messina et al., 2016). The same is likely to be witnessed in Tokyo since the participants
originate from different cities and the virus may be imported into the country and spread quickly
due to the high populations expected (Edmunds et al., 2013). Considering the virus was
concluded to have entered into the country during the 2014 world sprint competition, there are
higher chances it would reoccur, and hence measures to manage the condition should be effected.
Norovirus is another infectious condition that is likely to be witnessed in Tokyo. The
virus had an outbreak during the winter Olympics in Pyeongchang in 2018, and at least 250 cases
were reported(Yanagisawa et al., 2018). The same virus was witnessed in other sporting events
including the 2014 Glasgow commonwealth events and the world athletic championships of

CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 8
2017. Therefore there is a high chance of reoccurrence in the 2020 Tokyo Olympics(Yanagisawa
et al., 2018).
The primary top public infectious disease of concern in the 2020 Tokyo event is the
Dengue fever. The conditions were witnessed in 2014 for the first time in more than 70 years.
More than 160 autochthonous local dengue incidents were reported in 2014 in Tokyo
(Yanagisawa et al., 2018). However, the city’s populations are naïve to the dengue infection, as
they have not been exposed to the infection in the past few years. The dengue vector Aedes
aegypti mosquito is not found in the country; however, other Aedes mosquitoes are present and
are competent vectors for the spread of the virus. The Aedes albopictus mosquito is thriving in
cold winters and spreading its territory further to the north, which raises concerns for the
infectious disease reoccurrence in the 2020 Olympic event(Kakamu et al., 2017).
The dengue virus is likely to be brought into the county by travellers to the sporting
events. According to research, many factors contribute to the threat of the dengue importations,
for instance, the origin, number of the tourists, seasonal synchrony, and the epidemiology of the
condition in the origin countries. The country is open to more than 40 million people and hence
poses a risk of exposure to the dengue virus, which can spread significantly due to the presence
of the competent vector(Yanagisawa et al., 2018).
Sexually transmitted infections are likely to be prevalent in the 2020 Olympics. The 2000
Sydney Olympics changed the world to the possibility of STIs to spread in the gaming occasions
(Yanagisawa et al., 2018). As witnessed in the 2000 Sydney Olympics, there was a significant
increase of 28% in demand for sexual health services and an increase in bacterial sexually
transmitted infections during the Olympic proceedings. This is likely to occur in Tokyo as people

CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 9
come from different regions, and it is significantly challenging to detect the signs and symptoms
of the STI's at the borderlines.
Due to the high populations expected in Tokyo and the facilities, for instance,
accommodation, transportations, and restaurant limitations, viral, bacterial, and parasitic
gastrointestinal infections are likely to be experienced(Yanagisawa et al., 2018). Participants and
visitors emanate from different regions where there are various health conditions and may import
different gastrointestinal diseases. Due to the sharing of the facilities, including transportation
networks contaminations and lack of proper hygienic practices, digestive conditions are likely to
happen and spread quickly attributed to the congestion.
Health Services Capacity and Critical Control Points
In preparation for the 2020 Olympics, Japan has increased the number of physicians
working in the infectious conditions departments with a significant increase to the 1,048 who
were certified in the year 2014. The country has been having a significantly low number of
physicians trained in infectious condition. Many of the physicians in the country have no
experience in handling the infectious diseases and considering the number of tourists likely to
visit there has been pressure to increase and expose the physicians to infectious diseases
management training. Tokyo has 649 hospitals and 13185 clinics that offer free access to
healthcare; hence, it is essential to ensure that an experienced physician handles any case of the
infectious condition. Measures have also been enforced outlining the different health facilities
that can treat various infectious diseases. Therefore hospitals that will lack the expertise and
experience required in handling an incident have an opportunity of referring the victims to the
facilitated health facility where the condition will be management by experienced physicians.

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The maintenance of up to date routine vaccination schedule in the country has been
recommended for visitors who will be attending the 2020 championship. Hygienic practices and
measures for food and waterborne illness have been enforced in different facilities that will be
playing host to the visitors and participants of the Olympics (Edmunds et al., 2013). Health
centers are also putting into place measures to increase the number of multilingual triage
physicians in different centers around the city who will serve in the emergency departments in
case of any incidents in the event. The clinicians will offer first contact facilities and
coordination of emergency care among the visitors in the country.
The public health administrators in the country issues comprehensive publicly available
guidelines for managing differ infectious diseases (Kassens & Fukushige, 2018).
Epidemiological data on trends of different contagious conditions, including the Dengue cases,
were presented to the health centers to create awareness on the severity of the conditions.
Physicians have also been informed on how to deal with the situations after diagnosing before
passing them on to the certified infection conditions physicians. Critical control points have been
identified in the food distribution channels, accommodation facilities airport and transportation
checkpoints. Health practitioner and surveillance team will be located at the critical control
points mainly in the airports to ensure that every individual is free from contagious diseases.
Role of Transport Access in Contagious Illness Spread
Transportation networks have significantly expanded, which has increased the rapidity of
travel and capacity of the travellers and goods. Transport network has increased the movement of
pathogens and their vectors. Therefore the transportation networks expansion has become agents
of an infectious disease pandemic, vector-borne pathogen importation, and invasion of vectors

CONTAGIOUS DISEASE PREVENTION AND MANAGEMENT 11
(Tatem et al., 2012). The use of communal transportation has contributed significantly to the
prevalence of infectious diseases, mainly due to increased globalization, which brings in together
people from a different origin. During the 2020 Olympic sporting activities people will depend
on public reports network to travel to the event and their area of accommodation. Due to
increased contact and limited hygiene facilities and disinfection in the transportations networks,
people are likely to get contaminated with infectious diseases.
Conclusion
The occurrence of infectious diseases in sporting activities has been witnessed in the past.
Japan has experienced a prior outbreak of the Dengue virus, and recent findings indicate an
increase in the mortality rate due to the illness. Therefore due to factors such as climatic
variability and urbanization the trend is expected to increase which keeps the physicians on high
alert in case the condition or other infectious conditions are experienced during the Olympic
events in 2020.

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