Mass gathering enhanced syndromic surveillance for the 8th Micronesian Games in 2014, Pohnpei State, Federated States of Micronesia

Pohnpei State’s Division of Primary Health Care implemented enhanced surveillance for early warning and detection of
disease to support the 8th Micronesian Games (the Games) in July 2014.
The surveillance comprised 11 point-of-care sentinel sites around Pohnpei, Federated States of Micronesia, collecting data
daily for eight syndromes using standard case definitions. Each sentinel site reported total acute care encounters, total
syndrome cases and the total for each syndrome. A public health response, including epidemiological investigation and
laboratory testing, followed when syndrome counts reached predetermined threshold levels.
The surveillance was implemented using the web-based Suite for Automated Global Electronic bioSurveillance OpenESSENCE (SAGES-OE) application that was customized for the Games. Data were summarized in daily situation reports
(SitReps) issued to key stakeholders and posted on PacNet, a Pacific public health e-mail network.
Influenza-like illness (ILI) was the most common syndrome reported (55%, n = 225). Most syndrome cases (75%) were
among people from Pohnpei. Only 30 cases out of a total of 408 syndrome cases (7%) presented with acute fever and
rash, despite the large and ongoing measles outbreak at the time. No new infectious disease outbreak was recorded during
the Games. Peaks in diarrhoeal and ILI cases were followed up and did not result in widespread transmission.
The technology was a key feature of the enhanced surveillance. The introduction of the web-based tool greatly improved
the timeliness of data entry, analysis and SitRep dissemination, providing assurance to the Games organizers that
communicable diseases would not adversely impact the Games.