Epidemiological surveillance and infectious disease outbreaks during mass international summertime sports gatherings: A narrative review

•Since 1992, Summer Olympics and Paralympic games or international football competitions have been associated with increased sporadic cases of infectious diseases.•The diseases have been respiratory, gastrointestinal/foodborne, but without any major communicable or other infectious disease outbreak.•Surveillance and health protection must be comprehensive rather than relying on epidemiological monitoring of targeted diseases in targeted populations.•It must be based on existing medical and laboratory systems, proven tools reinforced with the necessary human and financial resources.•Epidemiologists’ work will essentially consist in debunking false alarms and unfounded rumors. The XXXIIIrd Paris Summer Olympics followed by the XVIIth Paralympics Games will take place in France, predominantly in and around Paris, from July 26 to September 8, 2024. Public health stakeholders and decision-makers are called upon to set up or strengthen surveillance systems in areas hosting Olympic or Paralympic Games (OPGs) or large-scale international competitions, the objective being to detect and manage outbreaks should they occur during that period. We undertook a narrative review of the literature so as to identify major reported infectious disease outbreaks linked with or during OPGs / international sporting events during warm seasons. Our review found that since 1992, Summer Olympic and Paralympic games and international football competitions have been associated with sporadic cases of infectious diseases, principally respiratory, gastrointestinal/foodborne, but not with any major communicable or other infectious disease outbreak. Communicable disease risks should be assessed for the population taken as a whole, an integrated ecosystem with several population compartments potentially exchanging pathogens among one another. Although the Games afford an opportunity to federate or invent new surveillance systems to fill a gap, surveillance should be based on existing medical and laboratory systems, proven tools reinforced with the necessary human and financial resources. The performance of the public health surveillance system is ultimately predicated on trust on the part of participating clinicians, policymakers and international partners.