London 2012: monitoring food and water safety at the Olympic Games

Dr Caroline WillisFood Water & Environmental Microbiology Laboratory Porton

September 2013

Public Health EnglandEstablished on 1st April 2013

Executive agency of the Department of Health

Includes staff from more than 70 previous organisations

Working on

health protection

health improvement

addressing health inequalities

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Food Water and Environmental Microbiology ServiceTesting: testing of food, dairy, water & environmental samples for Local Authorities, Port Health Authorities, hospitals and commercial customers

Advice: Significance of results and appropriate control measures; including evidence in court

Training: Training of partner organisations

Information: Results from investigations and surveys provide a wider picture of changes which may affect public health

Research and development

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It all started eight years ago….6th July 2005:

London announced as the host for

the Olympic Games 2012

We all celebrated…..

….then, it hits home that we have

only 7 years to prepare for and

to deliver a safe Olympic and

Paralympics Games in Summer 2012!

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27th July - 9th September 2012

10 million Olympics & Paralympics tickets

0.9m-2.8m overnight visitors to London: 35% overseas

Up to 900,000 spectators and volunteers attending on any one day

400,000 athletes and staff

27,000 media

London 2012 Games

= MASS GATHERING!

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Infectious diseases and mass gatherings

Types of mass gatherings and potential infectious diseases

Examples Infectious disease risks

Religious festivals

Hajj, Christian festivals, Kumbh Mela

Respiratory infections, gastrointestinal illness

Sporting events

Olympics, soccer world cup, cricket world cup

Respiratory infections, gastrointestinal illness

Music festivals

Glastonbury, UK; Summerfest, USA

Sexually transmitted infections, respiratory infections, gastrointestinal illness

Trade meetings

World Expo Respiratory infections, measles

Abubakar et al., Lancet Infectious Diseases 2012 12:66-74

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Public Health and the Games

Infectious disease

one of the key risks to the Games

Communication with other

Olympic Games hosts

identify key risks

Commonwealth Games 2010

importance of planning

& meeting deadlines

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Role of the HPA was to provide public health governance to the Olympic and Paralympic Health Programme

Work streams included:

Risk management

Surveillance

Diagnostic capacity reporting

Responses

Emergency planning

Exercises and testing

Communication

Finance

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Food and Water Microbiology and the GamesRisk assessment identified need for:

Advice, training and support

Transport and logistics

Rapid testing and reporting

Information management

Scale up for incidents

Monitoring

Incidents and outbreaks

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Olympic Games

Paralympic Games

Advice & Support National on-call rota of FW&E microbiologists

24 hours, 7 days per week

TrainingTraining for key stakeholders

Joint Local Authority of Regulatory Services

(JLARS)

London Organising Committee of the Olympic Games

(LOCOG)

Local & Port Health Authorities

HPA FW&E Microbiology Service staff

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Advice, Training & Support

Service User Manual

Guidance notes for sampling officers

On-call sampling support

Evidence based focus for sampling activity

surveys of mobile catering at large scale events

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Sampling supportMobile filtration equipment

for on site sampling of swimming pools

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Large Scale Events Survey 2009

Between July & September 2009

139 large events

318 vendors

Total 1,364 samples:

457 foods

232 waters

536 swabs

139 cloths

Unsatisfactory

Satisfactory

Large Scale Events Survey - Timing of sampling

57% of samples collected “out-of-hours”

Follow-up Study of Large Events 2010Between May & November 2010

153 large events

Total 1,662 samples:

659 foods

209 waters

585 swabs

176 cloths

33 swabs of wrist bands worn by food handlers

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Comparison of consecutive studies

Study % Satisfactory

Food Water Swabs Cloths

Mobile Vendors 2002 N/A 50 N/A N/A

Mobile Vendors 2006 N/A 46 46 13

Large Events 2009 90 48 62 29

Large Events 2010 91 73 68 44

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On Park Training and Support

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Transport and logisticsExercises in early 2012 to test transport systems

Daily collection from JLARS for samples from Olympic Park and other London Olympic venues

Successful transport of all samples, including at weekends and Bank Holidays, despite road closures and diversions

Additional sampling supplies provided to sampling officers, including grab bags containing key consumables & additional cool boxes to facilitate increased sampling

Accreditation for three members of staff to have access to the Olympic Park & other venues to support sampling activity, as appropriate

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Rapid testing and reportingReal-time PCR implemented for rapid screening of enrichment broths for foodborne pathogens

Rapid reporting mechanisms agreed with JLARS and other Stakeholders to ensure interventions could be undertaken in real-time

Good communication lines to provide advice and support sampling activity

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Information managementActivity a part of the overall health protection support by the HPA

Involvement in daily HPA situation reporting

Mechanism to deal with queries and ensure consistency in advice to stakeholders

Daily spreadsheet of interim and final results to JLARS and other sampling officers across Local Authorities

Clear communication lines through dedicated e-mail accounts

Full traceability of all information flows

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Microbiology Services

Microbiology Cell

Reference Laboratories

Food and Water Laboratories

Clinical Laboratories

Operations

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Scale up for incidents

Five Official Control laboratories in England

Two sites (London and Porton)

directly involved in delivery of testing

for Olympic venues

Ability to transfer work between sites

to enable handling of large scale incident

Tested through pre-Games exercises

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FW&E Microbiology Service Olympic activities

All five laboratories involved in

responding to Olympic-associated

incidents in their local area

Most affected London and Porton

Approximately 12% of total work

of London (April – August 2012)

related to Olympics

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Monitoring activityIn collaboration with

JLARS, Local Authorities, Port Health Authorities

and the Drinking Water Inspectorate

Drinking water monitoring on Olympic sites, particularly the Park

Verification of the commissioning process

Results converted into public health interventions

Re-laying of water pipe runs

Assurance of cleaning for drinking water fountains & outlets

Evidence for public information on suitability of sources for drinking

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Monitoring activityWater, food and environmental monitoring

Marinas, hotels, training camps and ships

used by competitors and Olympic venue staff

Swimming pools, Spa pools

Water systems, Food service

Mobile food vendors around routes for:

Torch relay, Cycling events

Running events

Sea water monitoring (Weymouth)

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Outbreaks & incidentsJoint activities with stakeholders

Four hygiene problems with food manufacturers in Olympic food chain

two sandwich producers,

one meat pie producer

one sliced meat producer

Microbiological results & advice to

Local Authorities, Food Standards Agency and Health Protection Units

Resulted in improvements in manufacturing environments

No adverse impact on public health detected

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Outbreaks & incidentsTwo norovirus outbreaks amongst athletes

Advice to Local Authorities and Health Protection Units

Hygiene screening in hotel kitchen and food service environment

Legionella pneumophila detected in a ship water system

Ship providing accommodation for Olympic staff

Results from routine monitoring

Advice to Port Health Authority and Health Protection Unit

No cases identified

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The LegacyImproved links with key stakeholders

Proven capability of the Agency

Trained, competent individuals

Experience of large scale events and incident response

Implementation of rapid methods

Improved communication capability

Experience of command and control situations

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Thanks to all colleagues for all their hard work

and a shared experience