Dataset Information

Infectious Diseases and Mass Gatherings.

ABSTRACT: PURPOSE OF REVIEW:Mass gatherings (MGs) are characterized by a high concentration of people at a specific time and location. Infectious diseases are of particular concern at MGs. The aim of this review was to summarize findings in the field of infectious diseases with a variety of pathogens associated with international MGs in the last 5 years. RECENT FINDINGS:In the context of Hajj, one of the largest religious MGs at Mecca, Saudi Arabia, respiratory tract infections are the leading cause of infectious diseases in pilgrims with a prevalence of 50-93%. The most commonly acquired respiratory viruses were human rhinovirus, followed by human coronaviruses and influenza A virus, in decreasing order. Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae were the predominant bacteria. The prevalence of Hajj-related diarrhea ranged from 1.1 to 23.3% and etiologies included Salmonella spp., and Escherichia coli, with evidence of acquisition of antimicrobial-resistant bacteria. In other MGs such as Muslim, Christian, and Hindu religious events, sports events, and large-scale open-air festivals, outbreaks have been reported less frequently. The most common outbreaks at these events involved diseases preventable by vaccination, notably measles and influenza. Gastrointestinal infections caused by a variety of pathogens were also recorded. Because social distancing and contact avoidance are difficult measures to implement in the context of many MGs, individual preventive measures including vaccination, use of face mask, disposable handkerchief and hand hygiene may be recommended. Nevertheless, the effectiveness of these measures has been poorly investigated in the context of MGs.

SUBMITTER: Hoang VT

PROVIDER: S-EPMC7088693 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Infectious Diseases and Mass Gatherings.

Hoang Van-Thuan VT Gautret Philippe P

Current infectious disease reports 20180828 11

<h4>Purpose of review</h4>Mass gatherings (MGs) are characterized by a high concentration of people at a specific time and location. Infectious diseases are of particular concern at MGs. The aim of this review was to summarize findings in the field of infectious diseases with a variety of pathogens associated with international MGs in the last 5 years.<h4>Recent findings</h4>In the context of Hajj, one of the largest religious MGs at Mecca, Saudi Arabia, respiratory tract infections are the lead ...[more]

PMID: 30155747

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Project description:BackgroundMass gathering (MG) events may cause delayed emergency responses via various mechanisms and strain the resources of local emergency services. Therefore, preparedness, including adequate pre-planning and sufficient resourcing during MG events, is vital. The aim of this retrospective register study was to investigate the impact of MG events on the workload of rescue and emergency medical service (EMS) personnel during events to enable more precise and sufficient deployment of these authorities' operative resources.MethodsThe data from Finland covered of 25,124 EMS and rescue service missions during a three-year period (2015-2017), including data from nine MG events and reference material for the same weekdays two weeks before and after the event. The data were analysed through statistical and geospatial analyses.ResultsOur findings showed that missions increased in most events included in this study. Analysis of the missions' reasons showed that the categories of violence, traffic accidents and other accidents and injuries increased during events, with violence-related missions showing the highest relative risk (RR 1.87, 95% CI 1.43-2.44). In the four-grade (A-D) urgency grading, the analysis showed an increase in category C missions and a decrease in non-urgent category D missions. The analysis indicated an increase in missions during the evening and night-time. The geospatial analysis revealed dense hotspots of missions in the vicinity of the event area.ConclusionThe workload for EMS and rescue service personnel increases during MG events. Most of the increase is allocated to EMS staff, peaking in evening and night hours. The geospatial analysis showed hotspots of missions on the outskirts of the actual event area during events; thus, the workload can also increase for those authority resources that are not directly allocated to the event. Detailed information regarding workloads is valuable for the authorities that are responsible for resource planning and preparedness for MG events. Replicating the study internationally would improve the methodology for the future.

Project description:BackgroundMass gathering manifestations attended by large crowds are an increasingly common feature of society. In parallel, an increased number of studies have been conducted that developed and/or validated a model to predict medical usage rates at these manifestations.AimsTo conduct a systematic review to screen, analyse and critically appraise those studies that developed or validated a multivariable statistical model to predict medical usage rates at mass gatherings. To identify those biomedical, psychosocial and environmental predictors that are associated with increased medical usage rates and to summarise the predictive performance of the models.MethodWe searched for relevant prediction modelling studies in six databases. The predictors from multivariable regression models were listed for each medical usage rate outcome (i.e. patient presentation rate (PPR), transfer to hospital rate (TTHR) and the incidence of new injuries). The GRADE methodology (Grades of Recommendation, Assessment, Development and Evaluation) was used to assess the certainty of evidence.ResultsWe identified 7,036 references and finally included 16 prediction models which were developed (n = 13) or validated (n = 3) in the USA (n = 8), Australia (n = 4), Japan (n = 1), Singapore (n = 1), South Africa (n = 1) and The Netherlands (n = 1), with a combined audience of >48 million people in >1700 mass gatherings. Variables to predict medical usage rates were biomedical (i.e. age, gender, level of competition, training characteristics and type of injury) and environmental predictors (i.e. crowd size, accommodation, weather, free water availability, time of the manifestation and type of the manifestation) (low-certainty evidence). Evidence from 3 studies indicated that using Arbon's or Zeitz' model in other contexts significantly over- or underestimated medical usage rates (from 22% overestimation to 81% underestimation).ConclusionsThis systematic review identified multivariable models with biomedical and environmental predictors for medical usage rates at mass gatherings. Since the overall certainty of the evidence is low and the predictive performance is generally poor, proper development and validation of a context-specific model is recommended.

Dataset Information

Infectious Diseases and Mass Gatherings.

Publications

Infectious Diseases and Mass Gatherings.

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