Infectious Disease Prevention and Management at Tokyo Olympics 2020

This report examines infectious disease prevention and management strategies for the 2020 Summer Olympics in Tokyo. It addresses potential public health risks arising from a large influx of international visitors, including athletes, staff, and spectators. The report analyzes the Tokyo environment concerning infectious diseases, including outbreaks of dengue fever, measles, rubella, mumps, and other communicable respiratory, foodborne, and vector-borne diseases. It discusses infection control measures like vaccination recommendations, hygiene practices, and food safety protocols. The report also highlights the capacity of health services, critical control points, and the role of transport access in mitigating the spread of diseases. The report emphasizes the importance of proactive measures such as vaccinations, hygiene, and awareness campaigns to ensure the successful and safe conduct of the Olympic Games. The report also emphasizes the importance of proactive measures such as vaccinations, hygiene, and awareness campaigns to ensure the successful and safe conduct of the Olympic Games.

2020 Summer Olympics in Tokyo

Contents
Introduction................................................................................................................................3
Tokyo environment relevant to infectious disease.....................................................................3
Infection control and management.............................................................................................5
Major infectious diseases of concern and their relevant etiology and epidemiology................6
Infectious disease health services capacity and critical control points......................................8
Role of transport access in affecting risk of infectious disease transmission............................9
References................................................................................................................................10

Introduction
This report discusses about the infectious disease prevention and management planning for
conducting 2020 Summer Olympics in Tokyo. Being the public health advisor, I will be
responsible for establishing effective processes for management of potential risks associated
with the successful conducting of the Summer Olympic Games going to be held in Tokyo. In
this event, there will be substantial influx of local as well as international athletes, supporting
staff, spectators and tourists. During this period, when the Olympics will be held, the
population will increase extensively creating excessive stress over the local community
infrastructure resulting in potential public health risks and specifically spreading of infectious
or contagious diseases. So, this report discusses about various disease prevention techniques
and management principles that could be applied to address this issue (Nakamura, Wada,
Yanagisawa, & Smith, 2018).
Tokyo environment relevant to infectious disease
In last few years, various issues related to the health and safety of Tokyo residents have
arisen such as threat of emerging infectious diseases, which include pandemic influenza,
epidemic of Ebola hemorrhagic fever, dengue, food poisoning as well as drug abuse in
shocking quantity. These diversifying health threats are required to be addressed effectively
in order to secure the health and safety of Tokyo residents. In addition, conducting Summer
Olympics in such an environment, when the country is continuously suffering from several
communicable disease outbreaks, require the attention at the local as well as international
level.
In 2014, due to dengue fever outbreaks, firstly in 70 years, Japan suffered autochthonous
transmission. Despite vaccination available for children for diseases preventable through such
as polio, pertussis, tuberculosis, tetanus, measles, rubella, diphtheria, and above 90%

coverage of the population, the risks related to measles and rubella have amplified
substantially in Japan. However, measles has been eliminated from the country in 2015;
around 35 imported cases have been informed in that year, which increased to 159 cases to be
reported in the year 2016, out of which, 22 cases have been registered in Tokyo itself. So,
there is huge possibility that measles could be imported in Japan throughout the Summer
Olympics in 2020 to be held in Tokyo. From 2012 to 2014, rubella epidemic was experienced
all across the nation. Majority i.e. around 68% males of age group between 20 and 39 years
were affected. The increase in the number of international guests suggested that imported
rubella is seldom spread through susceptible populations due to their low vaccination rates. In
2016, out of 125 cases reported, 19 cases were reported from Tokyo.
There is no routine vaccination for Mumps in Japan and the vaccination coverage has been
around 40%. As per the report of the “National Epidemiological Surveillance of Vaccine
Preventable Diseases (NESID),” the proportion of antibody positive individuals has been
around 70%, which is insufficient for the prevention of epidemic diseases. In Tokyo, Mumps
cases have doubled from 2015 to 8526 in 2016, which suggests that mumps are likely to be a
possible danger for the international guests to Summer Olympics 2020. Similarly, Varicella
vaccinations are available due to which, the number of cases have reduced. The risk of
Hepatitis A disease during Tokyo 2020 is supposed to be low, though in 2016; around 65
cases were registered in Tokyo. As per the “Infectious Disease Surveillance Annual Report,”
Tokyo has reported higher number of cases i.e. around 24 cases.
The communicable respiratory diseases such as influenza and tuberculosis are also expected
to arise during Tokyo 2020. The food and waterborne diseases could also enhance during
Summer Olympic 2020, which requires proper addressing by the government. The vector-
borne diseases such as Malaria, Chikungunya, and Zika have also been registered in Tokyo,
so it requires proper addressing.

Infection control and management
There is availability of vaccination to achieve prevention against measles, rubella, mumps,
varicella and pertussis, for which,the visitors are strongly advised to get vaccinated for these
vaccine-preventable diseases before visiting Tokyo 2020, in order to lessen the hazard of
transmission of these viruses locally. However, for pertussis, the type of vaccine has
transformed from the whole cell pertussis vaccine to acellular pertussis associated with
diphtheria as well as tetanus (DTaP). With the estimated immunity lasting for around 5 to 10
years, the susceptibility among adults reduces (Edmunds, Hunter, Few, & Bell, 2013). That is
the reason; visitors are required to be immunized against these diseases to make sure they
could not spread or contract these viruses to the local people and to other visitors. The threat
of hepatitis A is less during Tokyo Summer Olympics; however, vaccination is advisable to
the visitors who wish to attend the games. Due to outbreak of seasonal influenza causing
epidemic like situation during summers in Japan, there is probability of communicable
respiratory diseases causing public health risks. Considering huge risks of occurrence of
communicable diseases, visitors are recommended to discuss with travel hospitals within
their countries previous to visit of Japan during Olympics. Taking into consideration, the
lengthy incubation period for symptoms of Tuberculosis, it is supposed that transmission
might not be visible during Tokyo 2020. The effectiveness of the tests before and after the
Olympics would not be sufficient so, there is probability of huge occurrence of tuberculosis
during such a huge gathering of crowd.
The continuous provision of hygienic food and water could ensure successful conducting of
Tokyo 2020. As bacterial food borne diseases such as clostridium, campylobacter, and
salmonella are generally being registered in summers, in 2016, 271cases were found in
Tokyo (Kakamu, Wada, Smith, Endo, & Fukushima, 2017). As a preventive measure, caution
on food-borne diseases associated with undercooked meat and fish in summers have been

advised. Hygiene measures provide prevention against such diseases and the Food Safety
Plan for Olympics would deal with the security of food storages within as well as around the
venue. The effective hand hygiene practices and guaranteeing carefully cooked foods will be
beneficial in preventing food-borne diseases. However, only 7 cases associated with scrub
typhus have been identified in Tokyo in 2016, the guests are suggested to get checked with
medicinal employees in case they experience any symptoms for such diseases (Edmunds, et
al., 2016).
Therefore, infection control and management is being planned by the healthcare department
of Tokyo. In majority cases, for prevention purpose, it is essential that vaccinations are made
compulsory for the visitors; however, in some diseases like tuberculosis and some vector-
borne diseases, it is essential to keep an eye on the visitors so that such diseases could be
prevented from getting imported to the country during Olympics (Ministry of the
Environment, 2017).
Major infectious diseases of concern and their relevant etiology and
epidemiology
For the majority of diseases mentioned above, there are vaccines available for the visitors as
well as for locals while there are few categories of diseases, which require proper addressing
otherwise, it could be imported or cause among mass gatherings during Olympics (Smith,
2009).
Major infectious diseases which are required to be addressed effectively include;
 Food and water-borne diseases - Are commonly caused due to eating and drinking
food and water infected by various microbes or chemicals. Variety of contaminants
includes Salmonella, Camylobacter, Clostridium, E.coli, Vibrio, Listeria and many
more. The bacterial food-borne diseases that spread usually during summers include

clostridium, campylobacter, salmonella (National Institute of Infectious Diseases,
2016). All these diseases are majorly related to eating of undercooked or
contaminated meat and sea foods. Furthermore, due to lack of hygienic processes in
food and sanitation services, possible risks associated with food-borne diseases might
result into serious public health issues among mass gatherings. The common
symptoms for these diseases include abdominal pain, nausea, vomiting, diarrhoea,
dehydration and such others. The doctors should be consulted to prevent excessive
water loss from the body (Bureau of Social Welfare and Public Health, 2018). Major
preventive measures include good hygiene practices, eating safely and hygienically
and properly cooked food and drinking purified water. Vector-borne diseases - Chikungunya, Dengue, and Zika are vector-borne diseases
that spread through Aedes albopictus, “Special Guidelines on Prevention of Mosquito-
borne Infections”, have been issued by the Health Ministry in 2015. The common
symptoms include acute and recurring fever, nausea, joints pain, reduction in platelets
counts and stomach ache and many more. The preventive measures include routine
mosquito control measures, early detection and emergency response during outburst.
 Communicable respiratory diseases - Influenza viruses and tuberculosis bacteria
infect pulmonary organs and spread quickly and easily among people through
sneezing, talking, and cough droplets into the air (Sakamoto, Rahman, & Nomura,
2018). The common symptoms include coughing, sneezing, fever, headache, body
ache, running nose, and mucus deposition and many other problems associated with
pulmonary tracts. The preventive measures includeinstructing people to stay away
from infected persons, providing masks to the infected people and providing proper
medications to the infected people.

In addition, government should advertise and promote information regarding the ways of
spread and prevention of these diseases through television programs, newspapers and
magazines. More emphasis should be given to cleanliness and hygiene practicesamong
people so that vector-borne diseases as well as food and water-borne diseases could be
prevented extensively (Edmunds, et al., 2016).
Infectious disease health services capacity and critical control points
The Summer Olympics 2020 in Tokyo proposes excellent and comprehensive healthcare
facilities for the Olympic family. There are around 10 hospitals with around 6400 beds to be
made available for athletes and for spectators. Out of these hospitals, 7 are located within 12
minutes of the Olympic village and 3 within the range of around 16 minutes to the distant
venues. The availability of medications willbe ensuredin the venue and designated
ambulances are planned for all the venues and, Tokyo 2020 ensured that the city aimed to
maintain average response time of ambulance to be of 7 minutes during the Games. The
experts and experienced volunteers will be assigned the responsibility to manage the
healthcare facilities during the Olympics (Hamajima, et al., 2017). For the games, volunteers
with the appropriate medical training will be selected and send to the venues. The team of
doctors will provide medical facilities to the spectators during the Games. So, the government
of Tokyo has planned strategically to deal with healthcare issues that might arise during the
Olympics. Furthermore, health advisories will be displayed on the LED banners across the
city so that people themselves could take preventive measures during such a huge mass
gathering. The awareness should be created among people regarding cleanliness, hygiene
practices and preventive measures so that spread and infection of the infectious diseases
could be prevented. The awareness regarding prevention from mosquitoes, mites and ticks

should be created to achieve prevention from vector-borne diseases and communicable
respiratory diseases.
The critical control points for prevention against infectious diseases mentioned above
include;
 Providing masks to the infected people and providing guidance to the people to
remain away from theinfected people
 Providing proper medications to the affected people.
 Giving strict instructions to the visitors to get vaccinations for the vaccination
prevention diseases.
 To provide ambulance and medical staff facilities near the venues to provide quick
medications to the people visiting the country for Olympics.
In this way, Tokyo will provide best possible facilities to the visitors and the local people as
well as to all the mass gatherings in the city during Olympics.
Role of transport access in affecting risk of infectious disease transmission
In order to organize such a huge event at an international level, Tokyo is highly prepared for
Summer Olympics 2020. The city is making all the arrangements to manage proper
healthcare facilities so that locals as well as international visitors could be prevented from
spread of various infectious diseases (IOC, 2013). The transport accessibility plays a
significant role in providing best possible health services so that risks of transmission of
infectious diseases could be controlled. For this purpose, easy and quick availability of
ambulances and mobile ambulances could be the best possible way. The transport availability
with buses and other public transports is also responsible for quick responses at the time of
disease outbreak. Furthermore, public transports many a times become quick transmitter for
communicable diseases. So, awareness should be created that infected people should wear

face masks to prevent the diseases from spreading epidemically. In this way, spread and
transmission of the infectious diseases should be controlled during the Olympics 2020
(National Institute of Infectious Diseases, 2016).
References
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