Epidemiology Newsletter
Office of Epidemiology December  2001 Utah Department of Health
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Public Health Surveillance for the 2002 Winter Olympic and Paralympic Games

From January through March of 2002, Utah will be host to visitors from all corners of the world who will come to be part of the Olympic and Paralympic Games. The main focus of the Games should be on athletic competition. To make sure that the focus stays on the athletes (which is where public health wants the focus to be), Utah’s public health agencies have been planning for a coordinated statewide system designed to optimally protect the health of Utah’s citizens and its guests.

The Olympic and Paralympic Games present a significant challenge to public health. Large numbers of people – estimates of 70,000 to 100,000 additional people in Utah each day during the Olympic Games - will be coming to Utah from around the world (bringing whatever germs they may be carrying with them). Many mass gatherings are planned to bring lots of people together (providing everyone, including Utah’s citizens, an ideal opportunity to share their germs with others). Tremendous quantities of food will be prepared and served every day (providing yet another mechanism to share germs with many people). Routine public health services such as immunizations and restaurant inspections will be provided, in an effort to reduce the number of germs shared before, during and after the Games. People who will be performing Olympic-related duties in addition to their regular job will provide these services. If germs were not enough, the weather and atmospheric conditions between January and March may pose threats to people’s health as well. Cold weather means people have to either stay indoors (sharing germs) or be dressed appropriately for the outdoors. Those not dressed appropriately can get frostbite, hypothermia, or just really, really cold. Cold weather may also cause ice to form on walkways or roads making them slippery and dangerous. Altitude sickness could afflict visitors not accustomed to high altitude. The inversions that we have come to expect during the winter could become a serious health problem, especially with the predicted additional traffic and its resultant pollution. There are more sinister challenges as well. Public health agencies must be ready to quickly recognize and respond to deliberate biological or chemical attacks. Finally, public health has to understand that whatever response is made to any crisis, either a naturally occurring event or a man-made attack, will be subjected to intense national and international scrutiny.

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The agencies involved with Olympic public health readiness are: the Environmental & Public Health Alliance (EPHA), Salt Lake Olympic Committee’s (SLOC’s) Medical team, and the Utah Olympic Public Safety Command (UOPSC). EPHA consists of representatives from Utah’s six local health districts that will be most heavily impacted by the Games – Davis, Salt Lake, Summit, Utah, Wasatch, and Weber-Morgan, and from three state agencies – the Utah Departments of Agriculture & Food, Environmental Quality, and Health. Many federal agencies are ready to provide assistance, including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the Environmental Protection Agency (EPA). The SLOC medical team consists of health care providers and organizers who will ensure that medical services are provided at venue sites and at the Olympic village. The UOPSC is an organization of individuals from each agency involved with any aspect of public safety. UOPSC is comprised of representatives from public safety agencies. Part of the function of UOPSC is to coordinate all law enforcement, fire, and hazardous materials (hasmat) responses during the games. These functions occur at the Olympic Coordination Center (OCC). Public health will have a desk at the OCC.

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There are five major areas of public health responsibility: Emergency Medical Services, Food & Environmental Regulation, Disease Surveillance & Control, Disaster Response, and Public Information. Coordination of emergency medical services and disaster response will be the responsibility of UOPSC. The SLOC medical team is involved with disease surveillance and control, but only at the venues. EPHA is charged with the coordination of food & environmental regulation, disease surveillance & control, and public information. The Office of Epidemiology’s (OOE’s) primary responsibilities involve those charged to EPHA, but the OOE is also part of UOPSC and will work closely with the SLOC medical team.

Traditional approaches to ensuring the public’s health will continue during the Olympic and Paralympic Games, but they will be intensified. First, efforts will be made to prevent disease and promote health. Routine messages will continue to go out through normal channels discussing activities that everyone can do to protect their health. Visitor brochures have also been prepared that describe how people can protect their health during their stay in Utah. Second, enhanced disease surveillance efforts will be ongoing. This involves monitoring disease patterns and identifying, as quickly as possible, any unusual illnesses or patterns of illness. What will be different about surveillance during the Games is that more frequent and direct contact will be made with health care providers, laboratories and other agencies to look for the earliest indication of any sort of health problem that may arise. Also, selected emergency departments and urgent care centers will be asked to provide surveillance data on people with certain syndromes that suggest a disease of possible public health concern. For example, in addition to reporting cases of influenza, the emergency departments and urgent care centers will be asked to provide numbers of people who came to their facility with a complaint of respiratory illness with fever. It is hoped that this syndromic surveillance will provide an earlier indication of a health problem than the routine surveillance that often requires laboratory confirmation. Third, if any health problems are identified, plans are in place to ensure a rapid and coordinated response. Responding to problems is a normal public health function, so the planning efforts have focused instead on improving lines of communication between public health agencies that rarely contact each other during normal operations. This will be especially important during the Games when a problem may affect more than one local health district. The goal is to have a system in place where everyone knows who to contact and how to contact them.

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Full descriptions of all enhanced public health efforts are beyond the scope of this article (and its author). However, one unique entity that needs to be described is the EpiCenter. The EpiCenter has been established to enhance disease surveillance and response efforts during the Games. It is staffed by Utah Department of Health employees, but will serve as a coordination center for multiple agencies. The EpiCenter will collect all disease surveillance data including food and environmental data, and issue daily summary reports that provide a snapshot of Utah’s health. The EpiCenter will serve as a contact to the SLOC medical team and to UOPSC. The EpiCenter also has the capacity to immediately function in a full emergency mode, if any sort of emergency situation should arise.

Prevention of a problem is the public health ideal. If prevention efforts are successful, no one will need to know of the intensive efforts undertaken to ensure the health of Utah’s citizens and its many anticipated visitors. If, however, there is a problem, the plans that have been made should serve Utah’s citizens and guests well. For more information, please contact your local health department or the Utah Department of Health.

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Important Information

When Reporting a Communicable Disease:

Call (801) 538-6191 or

Call toll free at 1 (888) EPI UTAH (374-8824)

Or you can Fax it to (801) 538-9923

AND AFTER HOURS

In a Public Health emergency call (801) 241-1172

The December 2001 Epidemiology Newsletter is the most current Newsletter online.

For Information on Fact Sheets for Diseases or Annual Report Information, as well as The Epidemiology Newsletter, you can browse our website:

health.utah.gov/epi/

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Exceptional Efforts in Public Health

     The Office of Epidemiology received a call from another state agency that was attending a conference on Emergency Medical Response at a local ski resort. The call was an initial notification of some illnesses among attendees at another conference at the resort with symptoms of nausea, vomiting, and diarrhea. That was the extent of the information that was forwarded on to Salt Lake Valley Health Department (SLVHD) to start an investigation. Due the heightened awareness of public safety and emergency responders regarding bioterrorism, the canyon was closed until it could be determined what the extent and the most likely cause of illness was. This measure caught the attention of the local media and politicians. Given all these obstacles and very little concrete information, SLVHD was able to develop a detailed questionnaire and started administering it to attendees that evening.

     We would like to recognize the “exceptional efforts” made by Ilene Risk, Melissa Stevens, and Linda Bogdonow, from the Bureau of Epidemiology at SLVHD for their response to this investigation.

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Quarterly Report of Diseases of Low Frequency Year to Date,
January - December 2001
(including a comparison for same time period 1997 - 2000)

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Utah Department of Health, Office of Epidemiology
Monthly Morbidity Summary - December 2001
Provisional Data

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The Epidemiology Newsletter is published monthly by the Utah Department of Health, Division of Epidemiology and Laboratory Services, Office of Epidemiology, to disseminate epidemiologic information to the health care professional
and the general public.

Send comments to:  The Office of Epidemiology, Box 142104,Salt Lake City, UT 84114-2104, or call (801) 538-6191

Approval 8000008:  Appropriation 3705

Rod Betit, Executive Director, Utah Department of Health
Charles Brokopp, Dr.P.H., Director, Division of Epidemiology and Laboratory Services
Gerrie Dowdle, MSPH, Manager, Surveillance and Disease Control Program, Managing Editor
Connie Dean, Community Health Technician, Surveillance and Disease Control Program, Production Assistant

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