Infectious Disease Prevention and Management in Tokyo Olympics

This report, prepared for a Master of Public Health assignment, addresses infectious disease prevention and management for the 2020 Summer Olympics in Tokyo. It begins with a detailed description of Tokyo's environment, highlighting climatic conditions that favor the spread of pathogens, particularly dengue fever, and the impact of air pollution. The report then outlines the necessary infrastructure for infection control, emphasizing environmental management strategies like environmental modification and manipulation, as well as urban planning considerations. It identifies major infectious diseases of concern, including dengue, detailing their etiology, epidemiology, and diagnostic factors. The report assesses the capacity of infectious disease health services, pinpointing critical control points for early detection and treatment. Finally, it describes the role of transport access in affecting the risk of infectious disease transmission, underscoring the importance of connectivity. The report provides a comprehensive analysis of the public health challenges posed by the Olympics and offers strategies for effective disease prevention.

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Master of Public Health
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Author’s note

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Description of the Tokyo environment relevant to infectious disease
The climatic condition of Tokyo is based on temperate zone, making it a favorite spot for
the disease causing pathogens to survive. Recent study suggests that Tokyo may be subjected to
high rates of infection (Teparrukkul et al. 2017). Authorities have warned that climatic sensitive
illness and even dengue fever can be of severe cause of trouble for the people visiting Tokyo.
The current environmental condition of Japan can be highly understood through the phases of
high heat and humidity; that appears to be one of the prime cause facilitating the growth of
mosquitoes.
In addition to that Tokyo remains to be infamous for the increasing rates of air pollution
(Kutsuna et al. 2015). It would be fair enough to conclude that it is important to note that
increasing levels of air pollution can often lead to lung infection among people irrespective of
age. As pointed out by Senda et al. (2016), air pollution can emerge out to be one of the leading
cause of acute respiratory infection among the children under 5 years of age (who.int, 2018). The
disease causing microbes are often seen to be under the dynamic conditions and are seen to
replicate coupled with constant evolution. Judging the climatic conditions of Tokyo, it can be
clearly stated that the climate is humid subtropical climate. As pointed out by Quam et al.
(2016), dengue can be termed as one of the most infectious disease that cause some serious
damage to the population.
In terms of number of infections occurring on global basis dengue in considered to be one
of the most widely occurring disease due to arthropod (mosquito). The symptoms include severe
headache and even muscle pain and in worse cases even death. The average fatality ratio for the
fever related to dengue is about 5% (Environmental management, 2019). Dengue is caused by

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different types of flavivirus serotypes. In similar regards, it should be taken into account, the
variability in the nature of virus circulating can be prolonged and the rate of infection can be
high
Citing example from recent incidents, it can be clearly observed that nearly 55
individuals have been affected with dengue fever (McKirdy, 2014). All the cases have one thing
in common, individuals visited the Yoyogi Park, one of the largest outdoor spaces in Tokyo and
have made strong complaints against mosquito bites. The main vector of the disease is Aedes
aegypti and these mosquitoes are seen to rule the sub-tropical areas like Tokyo (Kobayashi,
2018). High levels of temperature and humidity favours the transmission of the mosquito over
wide range of geographic area; coupled with better breeding conditions. Hence, it can be stated
that Tokyo is at major threat due to the environmental conditions that favours breeding of
mosquitoes.
Outline of infrastructure related to infection control and management
Dengue appears to be one of the major health concerns in Tokyo. The open spaces such
as parks are closed and subjected to fumigation (Quam et al. 2016). However, it should be taken
into consideration that management of infrastructure needs to be specific for controlling the
diseases. It is due to the environment that dengue is widespread, thus it becomes important to
note the fact that it is important to manage the environment. Cordeiro et al. (2019), pointed out
the fact that environmental management can be termed as one of the possible ways of combating
dengue related issues in Japan.

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 Environmental modification: Long lasting physical transformation for reducing the habits
of vector larvae that includes installation of closed water surfaces (Yonejima, Nakay,
Yasumoto & Chan, 2017)
 Environmental manipulation: Temporary changes in regards to habits of the dengue
vector that makes sure that the open spaces are properly fumigated and kept closed for
some time (Yonejima, Nakay, Yasumoto & Chan, 2017)
 Change in human vector interaction: Proper actions can be undertaken by ensuring that
the humans are in limited contact with the disease causing vector
However, it should be understood that the urban planning should be taken into
consideration while planning the infrastructure. The Summer Olympics in Tokyo is
commemorated in the urban areas. Thus, during the events of planning the urban infrastructure of
Summer Olympics should be based on urban renewable schemes. For instance, there should be
no roof gutters on the buildings as it becomes difficult to maintain them Yonejima, Nakay,
Yasumoto & Chan, 2017)
In addition to that, it could be stated it is important to maintain clean streets near the
venue. Cleaning of the streets is solely concentrated on removing the stagnant waters that can
adversely reduce the larval habitat of the mosquito. In addition to that, it is important to ensure
that the solid waste generated should be maintained properly for better results against the
diseases. As stated by Srisawat et al. (2016), solid waste management is one of the prime ways to
reduce the events of dengue spread. The application of basic principles can work on reducing the
larval habitats of Ae. Aegypti. Proper storage and disposal of wastes is important, keeping the
waste in open spaces can often act as a breeding ground for the mosquito (Tajima et al. 2016).
Solid wastes should be collected in disposable plastic containers. However, the large amount of

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waste generated during the Olympics may seem a tiring task to manage. Thus, it becomes
important to note the fact that the aspect of recycling comes into play (Cordeiro et al. 2019)
Outline major infectious diseases of concern and their relevant etiology and epidemiology
The reason dengue is feared the most is due to the dormancy of the virus within the
human body that makes it even more dangerous. In similar regards it would be fair enough to
state that, lack of suitable treatment or even vaccine can be termed as one of the prominent
reasons that makes dengue a biggest threat towards the Summer Olympics in Tokyo.
Severe dengue fever is often characterised by thrombocytopenia, coupled with high levels
of haemorhage. As proposed by Kobayashi et al. (2018), severe plasma leakage often leads to
shock or even fluid accumulation with organ impairment and even respiratory distress.
Confirmatory tests are often seen to include nucleic acid detection or even viral antigen with
serology. In addition to that, it becomes important to note the fact the dengue fever related virus
DENV is difficult to be differentiated from Chikungunya or even the Zika virus without the
practise of diagnostic testing (Shimada et al. 2016)
Right now there exists no specific anti-viral antigen that has been created. The careful
fluid therapy and identifying the critical phase can be termed as one of the important prospect of
managing dengue. The implementation of tetravalent vaccine has already been approved in some
nations (Nakano, 2018). A globally critical aspect of the chosen arboviral infection is transmitted
by the mosquito of Aedes genus. The dengue virus is seen to be available in 4 genetically distinct
serotypesDENV-1, DENV-2, DENV-3, and DENV-4.
History and examination
Key diagnostic factor Other diagnostic factor Risk factor

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Fever
Skin rash
Arthralgia
Symptoms of upper
respiratory tract
Gastrointestinal
symptoms
Residence in the dengue
endemic areas
Young children from 1
to 5 years
Or even older adults due
to weak immunity
Diagnostic investigation
First investigation to
order
Investigations to be
considered
Emerging test
FBC
Testing for liver
function
Serology
Studies based on the
coagulation
Abdominal ultrasound
X-Ray of the chest to
detect symptoms of
infection upper
respiratory
Reverse transcriptase
reactions
Epidemiology
Dengue is regarded as one of the most complicated mosquito borne viral disease. The
virus has its vector widely distributed within the sub-tropical and even tropical areas of the world
such as in Japan. Significant expansion on geographic levels has been coupled with rapid

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increase in occurrences of dengue. In several instance, Nakano (2018), pointed out the fact that
the true impact of dengue is difficult to ascertain on a global level due to insufficient data about
disease surveillance and often misdiagnosis. In similar regards, it becomes important to point out
the fact that growing number of international travelling can contribute to the spread of dengue
virus.
Japan experienced a recent number of increases in regards to the outbreak of dengue
virus. Such infection has led to outbreak of Dengue in Japan in 2014. Nevertheless, outbreak of
2014 was just seasonal (Yanagisawa et al. 2018). Thus, it would be fair enough to state that
autochthonous transmission chain exposes Japan to the risk of dengue outbreak in near future. A
recent published study provided a clear idea that Japan was termed as a country that held the
maximum potential to spread dengue virus.
Owing to large proportion of infection without any potential symptoms among the
affected individuals subjected to DENV, it is possible that a large number of travellers may be
infected without even recognising the symptoms (Yamashita et al. 2016). Thus, it becomes
important to understand the fact that travelling to a new place and expose the traveller to a series
of new diseases. However, it becomes important to know the fact that travelling can expose an
individual to series of health risk. Thus, it becomes important to understand the fact that it is
important to ensure safety at all costs for better health outcomes at all level.
Infectious disease health services capacity and critical control points
The continuity in contribution of dengue fever incidents to hospitalizations and even
incidents of death are on rise (Teparrukkul et al. 2017). Japan is often seen to have delay in terms
of systematic health care that is quick enough to address the needs of the tourists or even the

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citizens. Thus, it is important to identify the reason for delay in providing the required scope of
medical assistance. The scope of health service can arise by general awareness among the public.
Research based study provided a clear understanding that affected individuals were subjected to
rise in body temperature with consumption of anti-pyretic drugs. Dengue can be termed as one of
the prevalent among the arboviruses. Recent students provide an idea that 58.4 to 96 million
individuals are seen to suffer from dengue on a global basis (Senda et al. 2018).. The case is seen
to double within a decade.
The clinical manifestation of dengue can serve as the first critical point of recognising the
seriousness of the disease. As pointed out by Kobayashi et al. (2018), high-grade fever, coupled
with headache and even vomiting is usually the first signs of dengue in febrile stage. The phase
lasts for 3 to 7 days and can be recovered without serious complications. However, 5% of the
cases are subjected to severe dengue an illness often marked with leakage of plasma leading to
hypovolemic shock and eventually death (Tajima et al. 2016). Thus, it would be fair enough to
state that the loss of lymphatic fluid can hint towards critical case. However, it should be
considered that prevention is better than cure. Hence, the period of 3 to 7 days should serve as
the actual critical point and work on saving the lives
The rate of mortality of severe form of dengue is 20% if it is not being treated on time
(Srisawat et al. 2016). However, the rate can be significantly reduced to one percent through
proper care. While, on one hand, it will be right to say that dengue can lead to severe
consequences; it can be stated that major implication related to dengue has no potential
symptoms (Shimada et al. 2016). Unfortunately, one out of every four infected individuals’
exhibit symptoms for their dengue fever and may expect complete recovery. However, most of

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the symptoms are not evident leading to high rise in dengue related infections in Japan and other
countries
Describe the role of transport access in affecting risk of infectious disease transmission
The modern facility of transportation connects the rural area to the urban ones. This
aspect of connectivity is often cited to be one of the prime causes of dengue cause. These can be
termed as one of the most probable reasons for spread of dengue among the targeted population.
As pointed out by Nakano (2018), it becomes important to understand the fact that transportation
can often be termed as a leading cause of disease among the targeted population. Thus, it would
be fair enough to conclude that transportation can help people reach the required medical
services or even cause gap in care and it depends on the ways Japan plans to use the existing
forms of transportation (Srisawat et al. 2016)

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