Safeguarding Public Health at the Paris 2024 Games: A Wastewater Surveillance Roadmap

As the world eagerly anticipates the Paris 2024 Olympic and Paralympic Games, a team of researchers from the French national public health institute has undertaken a critical study to identify priority pathogens that could be effectively monitored through wastewater surveillance (WWS). This innovative approach aims to provide a comprehensive public health strategy to ensure the safety and well-being of athletes, spectators, and the local community during this global event.

Leveraging Wastewater Surveillance for Proactive Public Health Measures

Unlocking the Potential of Wastewater Surveillance

Wastewater surveillance has emerged as a powerful tool in the public health arsenal, particularly during the COVID-19 pandemic. By analyzing the presence and concentration of pathogens in wastewater, this non-intrusive and cost-effective method offers a unique vantage point for monitoring disease circulation, regardless of an individual's symptomatic status or testing behavior. As an early warning system, WWS can provide valuable insights to inform public health policies and interventions, making it an invaluable asset in the context of mass gatherings like the Paris 2024 Games.

Prioritizing Pathogens for Effective Surveillance

The researchers employed a rigorous Delphi method, integrating evidence from peer-reviewed publications and expert opinion, to identify six priority pathogens for wastewater surveillance during the Paris 2024 Games: poliovirus, influenza A virus, influenza B virus, mpox virus, SARS-CoV-2, and measles virus. These pathogens were selected based on their analytical feasibility, relevance to the event, and their potential to inform public health decision-making.

Establishing a Comprehensive Surveillance Framework

The study began by compiling an initial list of 60 pathogens of interest, which was then refined to 25 based on their detectability in sewage. A panel of 32 experts further evaluated the relevance and added value of these pathogens, ultimately leading to the selection of the six priority targets. Interestingly, while measles had not initially reached the consensus threshold, it was included due to its resurgence worldwide and the increased risk of importation and transmission during the Paris Games.

Laying the Groundwork for Successful Implementation

The researchers recognize that additional planning and refinement are necessary before implementing the WWS strategy during the 2024 Paris Games. They recommend leveraging the existing network of 54 sites for monitoring SARS-CoV-2 circulation in wastewater treatment plants across France. Once a sampling strategy is approved, operators and partner laboratories will be selected, and laboratory methods will be optimized for efficiency and cost-effectiveness.

Paving the Way for Future Mass Gatherings

The study serves as a model framework for identifying context-specific WWS targets in mass gatherings, and if successful, it could encourage the adoption of similar WWS strategies for similar events in the future. The WWS plan for the Paris 2024 Games will also provide a pilot for continued monitoring of measles virus, influenza A, and influenza B viruses in Paris wastewater, further expanding the scope and utility of this innovative public health approach.