Doctors will see increased demand during Olympics despite preparations.

Health services in London will see demand for care rise by 3-5% during the Olympic Games, despite the new system that the Health Protection Agency (HPA) has put in place to monitor and respond to outbreaks of infectious diseases and environmental hazards. Brian McCloskey, the agency’s Olympics lead and director for London, said that the increase would be in the order of the surge that the NHS sees in a mild winter. “It is not as much as the increased numbers that create a crisis in the health service; it is much less than that,” he said. Much of the predicted increase would be related to excessive alcohol consumption and acute conditions rather than infectious diseases, McCloskey added. At the Olympic Games in Athens in 2004 and in Sydney in 2000 only 1% of admissions to hospital relating to the games resulted from infections. “Wewill have outbreaks of diarrhoea and vomiting,”McCloskey said. “We have them every year in London, so we will have them this summer, and it would not be surprising if some of those are connected to the games in some way—either by a venue or something else—so we will look for those. “We might see some respiratory illness; again, that it is not uncommon. What we have to be alert to is the possibility that something new happens, like we saw in 2009 with H1N1 swine flu. It is unlikely that a new illness will emerge in London for the first time. It is more likely that it will happen overseas and that we will pick it up through our international contacts.” The agency will be on the alert for measles, after several major outbreaks in Europe, and for whooping cough, after an outbreak at an Australian water polo team training camp. It will be flu season in the southern hemisphere, so some flu cases are also expected. A seven year programme of work by the agency to prepare for the Olympics means that health professionals should be notified of any important emerging health threats far earlier than they would have been in the past. The agency’s enhanced syndromic surveillance system, which records the number of people with symptoms of diseases such as flu and gastrointestinal infections presenting at general practices or calling NHS Direct, has been extended to include services that are more likely to be used by international visitors, such as emergency departments, walk-in centres, and GP out of hours services. Existing diagnostic tests for infections such as salmonella rely on culture of the bacteria or identification of antibodies to the organism, which can take several days. During the Olympics the agency’s laboratories will run newmolecular tests to identify the infectious organism itself in parallel with its existing diagnostic techniques to identify bacterial, viral, and parasitic infections within 24 hours in many cases. If these new tests prove to be valuable they will ultimately replace the regular diagnostic tests. Meanwhile, the Royal College of General Practitioners has reminded GPs that it is a legal requirement for them to report any infectious disease. A new web based reporting tool introduced to paediatric and intensive care units of some hospitals will allow clinicians to report any unusual conditions thought to be infections, but for which they have been unable to establish a diagnosis, directly to the HPA’s undiagnosed serious infectious illness surveillance unit for further investigation. The agency will also have staff at the polyclinic in the Olympic village who will look out for and deal with any infectious diseases or other public health outbreak among the athletes, such as leptospirosis, which can be acquired through water sports. This will be the first time that public health staff will have been deployed at the athletes’ village at a summer Olympics. Justin McCracken, the HPA’s chief executive, said, “Other countries have reported improved public health systems as a result of hosting Olympic and Paralympic Games, andwe expect the same for the UK. We intend to continue with our enhanced syndromic surveillance systems after the games have finished, as a legacy.”