This year, France will host the Rugby World Cup from September 8 to October 28, 2023. For this event, large numbers of French and international fans are expected in the nine host cities across the country (Toulouse, Marseille, Saint-Denis, Bordeaux, Nantes, Saint-Étienne, Lyon, Lille, and Nice).

While major sporting events are unifying moments, their sheer scale also presents public health challenges that require heightened vigilance from our usual surveillance systems.

In this context, Santé publique France is adapting its monitoring and alert system and, in collaboration with its partners, is ensuring health surveillance tailored to the challenges associated with this type of event throughout the tournament. Since the start of the competition, regional bulletins have been published providing a summary of the results of surveillance conducted in the cities hosting matches. Following the World Cup, a surveillance report will be produced and made available on our website.

Healthcare professionals and partner networks are specifically instructed to immediately report any unusual occurrences that could pose a public health risk.

3 questions for Marie Hamsany, Major Events Project Manager at Santé publique France

How does this type of gathering pose a risk to public health?

For this type of event, France expects to welcome large numbers of fans from different countries who will gather for the matches. Health risks may increase due to:

• the concentration of a large number of people in the same place at the same time (which can facilitate the spread of diseases with epidemic potential or increase the risk of injuries related to crowd surges);

• the establishment of temporary reception and catering facilities, which, if hygiene standards are inadequate, can lead to outbreaks of foodborne illness;

• the exposure of a larger number of people to environmental risks;

• the introduction of diseases not typically present in the area;

• population mobility, linguistic diversity, or variations in healthcare practices, which can make it difficult to implement prevention and control measures within this population;

• the potential occurrence of malicious acts targeting the event;

• an increase in the number of people likely to seek care, potentially leading to overcrowding in healthcare facilities that could delay treatment;

• a possible shortage of certain medications sold at local pharmacies.

How will Santé publique France strengthen its surveillance system?

The routine health surveillance strategy relies on existing systems, which remain fully operational during this period with daily reporting of a wide range of indicators. This surveillance is strengthened during the World Cup through:

• biological surveillance via networks of volunteer physicians and laboratories and the National Reference Centers (NRCs), which provides specific information and data on numerous infectious diseases and allows for the tracking of temporal and spatial trends of these diseases

• surveillance of notifiable diseases (NDs)

• the SurSaUD syndromic surveillance system, which enables the generation of numerous epidemiological indicators based on data from the emergency departments of the OSCOUR® network and SOS Médecins associations, along with their daily monitoring

As part of surveillance for the Rugby World Cup, this system was reinforced by monitoring additional indicators specific to large gatherings (food poisoning, trauma, stress, drowning, etc.) and specific tracking of SOS Médecins medical interventions related to this event. In addition to routine analyses, data from the SurSaUD system are analyzed at the regional and national levels following each match.