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Gallien Y, Fournet N, Delamare H, Haroutunian L, Tarantola A. Epidemiological surveillance and infectious disease outbreaks during mass international summertime sports gatherings: A narrative review. Infect Dis Now 2024; 54:104889. [PMID: 38849256 DOI: 10.1016/j.idnow.2024.104889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 06/09/2024]
Abstract
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.
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Affiliation(s)
- Yves Gallien
- Santé publique France, Direction des Régions, Cellule Régionale Île-de-France, France
| | - Nelly Fournet
- Santé publique France, Direction des Régions, Cellule Régionale Île-de-France, France
| | - Hugues Delamare
- Santé publique France, Direction des Maladies Infectieuses, France
| | | | - Arnaud Tarantola
- Santé publique France, Direction des Régions, Cellule Régionale Île-de-France, France.
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Kheimi AM, Bail JB, Parrillo SJ. Protection enhancement strategies of potential outbreaks during Hajj. Am J Disaster Med 2024; 19:71-77. [PMID: 38597649 DOI: 10.5055/ajdm.0454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study aimed to assist governments and organizers of mass gathering events in reviewing existing preventive measures for disease outbreaks to inform the adoption of enhanced strategies for risk reduction and impacts on public health. DESIGN A cross-sectional, quantitative, descriptive study. SETTING This study was conducted in a mass gathering of Hajj, an annual religious event in Mecca, Saudi Arabia. PARTICIPANTS A convenience sample of 70 personnel working in government ministries of Saudi Arabia (Ministry of Health, Ministry of Hajj, and Ministry of Interior) and the Saudi Red Crescent Authority involved in health management in Hajj, including policy formulation and implementation. MAIN OUTCOME MEASURES Perception and knowledge of health risks and outbreaks associated with Hajj. RESULTS The majority of the respondents (60 percent) expressed concern about the potential for infection transmission during Hajj. The respondents also reported having or knowing a colleague, a friend, or a family member with a history of infection during or after Hajj. However, the respondents' knowledge of the possible modes of infection of various diseases was limited. CONCLUSIONS Hajj is associated with various risks of outbreaks, and thus, better protection-enhancing measures are required. Training personnel involved in health management, including planners, coordinators, and healthcare providers, can help reduce the risks and prevent potential outbreaks.
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Affiliation(s)
- Abdulaiziz Mustafa Kheimi
- King Khalid University, College of Applied Medical Sciences, Saudi Ara-bia. ORCID: https://orcid.org/0009-0003-3869-4116
| | - Jean B Bail
- Disaster Medicine & Management Program Director, Thomas Jefferson University, Philadelphia, Pennsylvania. ORCID: https://orcid.org/0000-0002-7133-9357
| | - Steven J Parrillo
- Disaster Medicine & Management Program, Thomas Jefferson University, Philadelphia, Pennsylvania
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Albutti A, Mahdi HA, Alwashmi AS, Alfelali M, Barasheed O, Barnes EH, Shaban RZ, Booy R, Rashid H. The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial. J Infect Public Health 2024; 17 Suppl 1:34-41. [PMID: 37055268 DOI: 10.1016/j.jiph.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/04/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationship between practising hand hygiene and rates of ARI in Umrah pilgrimage amidst the COVID-19 pandemic. METHODS A parallel RCT was conducted in hotels in Makkah, Saudi Arabia, between April and July 2021. Domestic adult pilgrims who consented to participate were randomised 1:1 to the intervention group who received alcohol-based hand rub (ABHR) and instructions, or to the control group who did not receive ABHR or instructions but were free to use their own supplies. Pilgrims in both groups were then followed up for seven days for ARI symptoms. The primary outcome was the difference in the proportions of syndromic ARIs among pilgrims between the randomised groups. RESULTS A total of 507 (control: intervention = 267: 240) participants aged between 18 and 75 (median 34) years were randomised; 61 participants were lost to follow-up or withdrew leaving 446 participants (control: intervention = 237:209) for the primary outcome analysis; of whom 10 (2.2 %) had developed at least one respiratory symptom, three (0.7 %) had 'possible ILI' and two (0.4 %) had 'possible COVID-19'. The analysis of the primary outcome found no evidence of difference in the proportions of ARIs between the randomised groups (odds ratio 1.1 [0.3-4.0] for intervention relative to control). CONCLUSION This pilot trial suggests that conducting a future definitive RCT to assess the role of hand hygiene in the prevention of ARIs is feasible in Umrah setting amidst such a pandemic; however, outcomes from this trial are inconclusive, and such a study would need to be very large given the low rates of outcomes observed here. TRIAL REGISTRATION This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12622001287729), the full protocol can be accessed there.
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Affiliation(s)
- Aqel Albutti
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
| | - Hashim A Mahdi
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah 23442, Saudi Arabia.
| | - Ameen S Alwashmi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
| | - Mohammad Alfelali
- Family and Community Medicine Department, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 25732, Saudi Arabia.
| | - Osamah Barasheed
- The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi Arabia.
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Ramon Z Shaban
- New South Wales Biocontainment Centre, New South Wales Ministry of Health, Westmead, NSW 2151, Australia; Faculty of Medicine and Health Susan Wakil School of Nursing, The University of Sydney, Sydney, NSW 2006, Australia; Public Health Unit, Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
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Verma N, Sharma T, Bhardwaj A, Vemuluri VR. Comparative genomics and characterization of a multidrug-resistant Acinetobacter baumannii VRL-M19 isolated from a crowded setting in India. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2024; 118:105549. [PMID: 38181886 DOI: 10.1016/j.meegid.2023.105549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/17/2023] [Accepted: 12/31/2023] [Indexed: 01/07/2024]
Abstract
A crowded vegetable market serves as a mass gathering, posing a potential risk for infection transmission. In this study, we isolated a multidrug-resistant Acinetobacter baumannii strain, VRL-M19, from the air of such a market and conducted comparative genomics and phenotypic characterization. Antimicrobial susceptibility testing, genome sequencing using Illumina HiSeq X10, and pan-genome analysis with 788 clinical isolates identified core, accessory, and unique drug-resistant determinants. Mutational analysis of drug-resistance genes, virulence factor annotation, in vitro pathogenicity assessment, subsystem analysis, Multilocus sequence typing, and whole genome phylogenetic analysis were performed. VRL-M19 exhibited multidrug resistance with 69 determinants, and analysis across 788 clinical isolates and 350 Indian isolates revealed more accessory genes (52 out of 69) in the Indian isolates. Multiple mutations were observed in drug target modification genes, and the strain was identified as a moderate biofilm-former with 55 virulence factors. Whole genome phylogenetics indicated a close relationship between VRL-M19 and clinical A. baumannii strains. In conclusion, our comprehensive study suggests that VRL-M19 is a multidrug-resistant, potential pathogen with biofilm-forming capabilities, closely associated with clinical A. baumannii strains.
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Affiliation(s)
- Neha Verma
- Microbial Type Culture Collection and Gene Bank (MTCC), CSIR-Institute of Microbial Technology, Chandigarh 160036, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Tina Sharma
- Bioinformatics Centre, CSIR-Institute of Microbial Technology, Chandigarh 160036, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Anshu Bhardwaj
- Bioinformatics Centre, CSIR-Institute of Microbial Technology, Chandigarh 160036, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
| | - Venkata Ramana Vemuluri
- Microbial Type Culture Collection and Gene Bank (MTCC), CSIR-Institute of Microbial Technology, Chandigarh 160036, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
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Chiu KHY, Sridhar S, Yuen KY. Preparation for the next pandemic: challenges in strengthening surveillance. Emerg Microbes Infect 2023; 12:2240441. [PMID: 37474466 PMCID: PMC10478602 DOI: 10.1080/22221751.2023.2240441] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/22/2023]
Abstract
The devastating Coronavirus Disease 2019 (COVID-19) pandemic indicates that early detection of candidates with pandemic potential is vital. However, comprehensive metagenomic sequencing of the total microbiome is not practical due to the astronomical and rapidly evolving numbers and species of micro-organisms. Analysis of previous pandemics suggests that an increase in human-animal interactions, changes in animal and arthropod distribution due to climate change and deforestation, continuous mutations and interspecies jumping of RNA viruses, and frequent travels are important factors driving pandemic emergence. Besides measures mitigating these factors, surveillance at human-animal interfaces targeting animals with unusual tolerance to viral infections, sick heathcare workers, and workers at high biosafety level laboratories is crucial. Surveillance of sick travellers is important when alerted by an early warning system of a suspected outbreak due to unknown agents. These samples should be screened by multiplex nucleic acid amplification and subsequent unbiased next-generation sequencing. Novel viruses should be isolated in routine cell cultures, complemented by organoid cultures, and then tested in animal models for interspecies transmission potential. Potential agents are candidates for designing rapid diagnostics, therapeutics, and vaccines. For early detection of outbreaks, there are advantages in using event-based surveillance and artificial intelligence (AI), but high background noise and censorship are possible drawbacks. These systems are likely useful if they channel reliable information from frontline healthcare or veterinary workers and large international gatherings. Furthermore, sufficient regulation of high biosafety level laboratories, and stockpiling of broad spectrum antiviral drugs, vaccines, and personal protective equipment are indicated for pandemic preparedness.
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Affiliation(s)
- Kelvin Hei-Yeung Chiu
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Siddharth Sridhar
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Kwok-Yung Yuen
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, People’s Republic of China
- Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China
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Steffen R, Chen LH, Leggat PA. Travel vaccines-priorities determined by incidence and impact. J Travel Med 2023; 30:taad085. [PMID: 37341307 DOI: 10.1093/jtm/taad085] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Infectious disease epidemiology is continuously shifting. While travel has been disrupted by the COVID-19 pandemic and travel-related epidemiological research experienced a pause, further shifts in vaccine-preventable diseases (VPDs) relevant for travellers have occurred. METHODS We conducted a literature search on the epidemiology of travel-related VPD and synthesized data for each disease with a focus on symptomatic cases and on the impact of the respective infection among travellers, considering the hospitalization rate, disease sequela and case fatality rate. We present new data and revised best estimates on the burden of VPD relevant for decisions on priorities in travel vaccines. RESULTS COVID-19 has emerged to be a top travel-related risk and influenza remains high in the ranking with an estimated incidence at 1% per month of travel. Dengue is another commonly encountered infection among international travellers with estimated monthly incidence of 0.5-0.8% among non-immune exposed travellers; the hospitalized proportion was 10 and 22%, respectively, according to two recent publications. With recent yellow fever outbreaks particularly in Brazil, its estimated monthly incidence has risen to >0.1%. Meanwhile, improvements in hygiene and sanitation have led to some decrease in foodborne illnesses; however, hepatitis A monthly incidence remains substantial in most developing regions (0.001-0.01%) and typhoid remains particularly high in South Asia (>0.01%). Mpox, a newly emerged disease that demonstrated worldwide spread through mass gathering and travel, cannot be quantified regarding its travel-related risk. CONCLUSION The data summarized may provide a tool for travel health professionals to prioritize preventive strategies for their clients against VPD. Updated assessments on incidence and impact are ever more important since new vaccines with travel indications (e.g. dengue) have been licensed or are undergoing regulatory review.
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Affiliation(s)
- Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Travelers' Health, University of Zurich, Zurich 8001, Switzerland
- Division of Epidemiology, Human Genetics & Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA
- Faculty of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland 4810, Australia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
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Alnafisah R, Alnasiri F, Alzaharni S, Alshikhi I, Alqahtani A. Food Safety Practices during Hajj: On-Site Inspections of Food-Serving Establishments. Trop Med Infect Dis 2023; 8:480. [PMID: 37888608 PMCID: PMC10610560 DOI: 10.3390/tropicalmed8100480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
The presence of crowds during Hajj increases the risk of foodborne infection. Yet, research on the practices of food handlers during Hajj is limited. This study aimed to assess compliance with food safety practices and its associated factors during Hajj 2022. An observational cross-sectional study was conducted in Mecca and Madinah before and during Hajj 2022 and involved 195 food-serving establishments (FSEs) contracted for Hajj catering. Collected data included visit time, establishment location, licensure, whether food handlers had food safety training (professional training), and whether FSEs were under supervision from a consulting office (professional supervision). The included FSEs were 168/195 (86.2%). Two-thirds of FSEs surveyed (113, 67.3%) were under professional supervision, and 91 (54.2%) hired trained food safety workers. Compliance rates varied between outcomes (72.67 ± 17.21% to 88.3 ± 18.8%). Compared to Mecca, Madinah FSEs were more adherent to cleanliness (80.5 ± 27.9% vs. 91.5 ± 19.9%, respectively, p = 0.006). FSEs with trained workers were more likely to comply with proper food safety practices compared to those with untrained workers: cleanliness (OR: 7.2, 95% CI [2.6-20.23], p < 0.001); workers' commitment to health requirements (OR: 2.8, 95% CI [1.1-6.9], p = 0.025); handling of refrigerated and frozen food (OR: 5.27, 95% CI [1.83-15.20], p = 0.004); and food storage practices (OR: 12.5, 95% CI [2.0-12.5], p < 0.001). The role of professional training in increasing food safety practices compliance was highlighted. FSEs in Madinah were more compliant with food safety practices than those in Mecca. Therefore, Mecca FSEs may need stringent safety measures.
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Affiliation(s)
- Ruyuf Alnafisah
- Saudi Food and Drug Authority, Riyadh 13513, Saudi Arabia; (F.A.); (S.A.); (I.A.)
| | | | | | | | - Amani Alqahtani
- Saudi Food and Drug Authority, Riyadh 13513, Saudi Arabia; (F.A.); (S.A.); (I.A.)
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Cunha Filho GARD, Arliani GG, Yamada AF, Cohen M, Ejnisman B, Andreoli CV. MEDICAL PLANNING FOR MASS GATHERING SPORTS EVENTS IN BRAZIL. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012021_0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Medical planning for mass gathering events is founded on the structuring of assistance to the population involved and the preservation of the response capacities of the local healthcare system. Large sporting events attended by crowds are increasingly common in society. These events have been shown to be dangerous, generating higher incidences of injuries and illnesses than usual. Thus, planning and the interaction among various public and private sectors are required for the prevention of and response to emergencies and incidents involving multiple victims. Methods: Recently published studies on medical planning for large sports events and current federal agency legislation were selected to conduct an updated review on the subject. Results: After reading titles and abstracts, 159 papers were chosen for a full reading, 50 of which met the eligibility criteria and were included as the basis for this review. The size of the audience, the weather, and the behavior of the crowd seem to contribute significantly to the estimated need for resources in sporting events. Conclusion: Mass events require planning for prevention and to strengthen the resilience of host communities. There is a still a lack of evidence that these events increase the risk of the mass spreading of disease. Level of Evidence: V; Expert opinion .
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Yoneoka D, Eguchi A, Fukumoto K, Kawashima T, Tanoue Y, Tabuchi T, Miyata H, Ghaznavi C, Shibuya K, Nomura S. Effect of the Tokyo 2020 Summer Olympic Games on COVID-19 incidence in Japan: a synthetic control approach. BMJ Open 2022; 12:e061444. [PMID: 36127076 PMCID: PMC9490294 DOI: 10.1136/bmjopen-2022-061444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The Tokyo 2020 Summer Olympic Games (23 July-8 August 2021) were held in the middle of Japan's fifth wave of COVID-19, when the number of cases was on the rise, and coincided with the fourth state of emergency implemented by the host city, Tokyo. AIM This study aimed to assess whether the hosting of the Games was associated with a change in the number of COVID-19 cases in Japan using a synthetic control method. METHODS A weighted average of control countries with a variety of predictors was used to estimate the counterfactual trajectory of daily COVID-19 cases per 1 000 000 population in the absence of the Games in Japan. Outcome and predictor data were extracted using official and open sources spanning several countries. The predictors comprise the most recent country-level annual or daily data accessible during the Games, including the stringency of the government's COVID-19 response, testing capacity and vaccination capacity; human mobility index; electoral democracy index and demographic, socioeconomic, health and weather information. After excluding countries with missing data, 42 countries were ultimately used as control countries. RESULTS The number of observed cases per 1 000 000 population on the last day of the Games was 109.2 (7-day average), which was 115.7% higher than the counterfactual trajectory comprising 51.0 confirmed cases per 1 000 000 population. During the Olympic period (since 23 July), the observed cumulative number of cases was 61.0% higher than the counterfactual trajectory, comprising 143 072 and 89 210 confirmed cases (p=0.023), respectively. The counterfactual trajectory lagged 10 days behind the observed trends. CONCLUSIONS Given the increasing likelihood that new emerging infectious diseases will be reported in the future, we believe that the results of this study should serve as a sentinel warning for upcoming mega-events during COVID-19 and future pandemics.
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Affiliation(s)
- Daisuke Yoneoka
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
- The Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Akifumi Eguchi
- Department of Sustainable Health Science, Chiba University, Chiba, Japan
| | - Kentato Fukumoto
- The Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of Political Studies, Gakushuin University, Tokyo, Japan
| | - Takayuki Kawashima
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Yuta Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan
| | - Takahiro Tabuchi
- The Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of cancer epidemiology, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroaki Miyata
- The Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of Health Policy and Management, Keio University, Tokyo, Japan
| | - Cyrus Ghaznavi
- Medical Education Program, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Kenji Shibuya
- The Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Shuhei Nomura
- The Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of Health Policy and Management, Keio University, Tokyo, Japan
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Mass Gatherings and Emerging Infectious Diseases: Monkeypox is the Newest Challenge. J Epidemiol Glob Health 2022; 12:215-218. [PMID: 36066809 PMCID: PMC9446592 DOI: 10.1007/s44197-022-00059-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Palmer T, Benson LS, Porucznik C, Gren LH. Impact of COVID-19 Social Distancing Mandates on Gastrointestinal Pathogen Positivity: Secondary Data Analysis. JMIR Public Health Surveill 2022; 8:e34757. [PMID: 35507923 PMCID: PMC9407155 DOI: 10.2196/34757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/10/2022] [Accepted: 05/03/2022] [Indexed: 12/01/2022] Open
Abstract
Background Acute gastrointestinal (GI) illnesses are of the most common problems evaluated by physicians and some of the most preventable. There is evidence of GI pathogen transmission when people are in close contact. The COVID-19 pandemic led to the sudden implementation of widespread social distancing measures in the United States. There is strong evidence that social distancing measures impact the spread of SARS-CoV-2, and a growing body of research indicates that these measures also decrease the transmission of other respiratory pathogens. Objective This study aims to investigate the impact of COVID-19 social distancing mandates on the GI pathogen positivity rates. Methods Deidentified GI Panel polymerase chain reaction test results from a routinely collected diagnostic database from January 1, 2019, through August 31, 2020, were analyzed for the GI pathogen positivity percentage. An interrupted time series analysis was performed, using social distancing mandate issue dates as the intervention date. The following 3 target organisms were chosen for the final analysis to represent different primary transmission routes: adenovirus F40 and 41, norovirus GI and GII, and Escherichia coli O157. Results In total, 84,223 test results from 9 states were included in the final data set. With the exception of E coli O157 in Kansas, Michigan, and Nebraska, we observed an immediate decrease in positivity percentage during the week of social distancing mandates for all other targets and states. Norovirus GI and GII showed the most notable drop in positivity, whereas E coli O157 appeared to be least impacted by social distancing mandates. Although we acknowledge the analysis has a multiple testing problem, the majority of our significant results showed significance even below the .01 level. Conclusions This study aimed to investigate the impact of social distancing mandates for COVID-19 on GI pathogen positivity, and we discovered that social distancing measures in fact decreased GI pathogen positivity initially. The use of similar measures may prove useful in GI pathogen outbreaks. The use of a unique diagnostic database in this study exhibits the potential for its use as a public health surveillance tool.
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Affiliation(s)
- Tanner Palmer
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta WaySuite A, Salt Lake City, US.,bioMérieux, Inc, 515 Colorow Drive, Salt Lake City, US
| | - L Scott Benson
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta WaySuite A, Salt Lake City, US
| | - Christina Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta WaySuite A, Salt Lake City, US
| | - Lisa H Gren
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta WaySuite A, Salt Lake City, US
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Robert A, Kucharski AJ, Funk S. The impact of local vaccine coverage and recent incidence on measles transmission in France between 2009 and 2018. BMC Med 2022; 20:77. [PMID: 35264161 PMCID: PMC8907007 DOI: 10.1186/s12916-022-02277-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/25/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Subnational heterogeneity in immunity to measles can create pockets of susceptibility and result in long-lasting outbreaks despite high levels of national vaccine coverage. The elimination status defined by the World Health Organization aims to identify countries where the virus is no longer circulating and can be verified after 36 months of interrupted transmission. However, since 2018, numerous countries have lost their elimination status soon after reaching it, showing that the indicators defining elimination may not be associated with lower risks of outbreaks. METHODS We quantified the impact of local vaccine coverage and recent levels of incidence on the dynamics of measles in each French department between 2009 and 2018, using mathematical models based on the "Endemic-Epidemic" regression framework. After fitting the models using daily case counts, we simulated the effect of variations in the vaccine coverage and recent incidence on future transmission. RESULTS High values of local vaccine coverage were associated with fewer imported cases and lower risks of local transmissions, but regions that had recently reported high levels of incidence were also at a lower risk of local transmission. This may be due to additional immunity accumulated during recent outbreaks. Therefore, the risk of local transmission was not lower in areas fulfilling the elimination criteria. A decrease of 3% in the 3-year average vaccine uptake led to a fivefold increase in the average annual number of cases in simulated outbreaks. CONCLUSIONS Local vaccine uptake was a reliable indicator of the intensity of transmission in France, even if it only describes yearly coverage in a given age group, and ignores population movements. Therefore, spatiotemporal variations in vaccine coverage, caused by disruptions in routine immunisation programmes, or lower trust in vaccines, can lead to large increases in both local and cross-regional transmission. The incidence indicator used to define the elimination status was not associated with a lower number of local transmissions in France, and may not illustrate the risks of imminent outbreaks. More detailed models of local immunity levels or subnational seroprevalence studies may yield better estimates of local risk of measles outbreaks.
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Affiliation(s)
- Alexis Robert
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK. .,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.
| | - Adam J Kucharski
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - Sebastian Funk
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
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Tan MM, Musa AF, Su TT. The role of religion in mitigating the COVID-19 pandemic: the Malaysian multi-faith perspectives. Health Promot Int 2022; 37:daab041. [PMID: 33928389 PMCID: PMC8135627 DOI: 10.1093/heapro/daab041] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Social distancing is crucial in breaking the cycle of transmission of COVID-19. However, many religions require the faithful to congregate. In Malaysia, the number of COVID-19 cases spiked up from below 30 in February 2020 to more than a thousand a month later. The sudden increase was mostly linked to a large Islamic gathering attended by 16,000 near the capital, Kuala Lumpur. Another large COVID-19 cluster was from a church gathering in Kuching, Sarawak. Within a few weeks, Malaysia became the worst hit country by COVID-19 in Southeast Asia. While religious leaders have advised social distancing among their congregants, the belief that "God is our shield" is often cited for gathering. There is a need to promote sound decision-making among religious adherents so that they will not prioritize their loyalty to the subjective interpretation of religion over evidence-based medicine. Malaysia, a multi-cultural and multi-faith country, is an example of how religious beliefs could strongly influence health behaviours at individual and community levels. In this article, we detail the religious aspects of COVID-19 prevention and control in Malaysia and discuss the possible role of religious organizations in encouraging sound decision-making among religious adherents in mitigating this crisis. We make recommendations on how to promote a partnership between the healthcare system and religious organizations, and how religion and faith could be integrated into health promotion channels and resources in the response of COVID-19 and future communicable diseases.
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Affiliation(s)
- Min Min Tan
- South East Asia Community Observatory (SEACO) & Global Public Health, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
| | - Ahmad Farouk Musa
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
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14
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Health-related research publications on religious mass gatherings of Muslims: a bibliometric analysis (1980-2020). Trop Dis Travel Med Vaccines 2022; 8:1. [PMID: 34980277 PMCID: PMC8723799 DOI: 10.1186/s40794-021-00158-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/18/2021] [Indexed: 11/12/2022] Open
Abstract
Objective Mass gatherings medicine is an emerging and important field at the national and international health security levels. The objective of the current study was to analyze research publications on religious mass gatherings of Muslims using bibliometric tools. Methods Keywords related to religious mass gatherings of Muslims were used in Scopus database. The duration of the study was from January 01, 1980 to December 31, 2020. Examples of keywords used include hajj, Umrah, mass gatherings/Mecca or Makkah, mass gatherings/Karbala, pilgrim/Makkah or Mecca, and others. Bibliometric indicators and mapping were presented. Results In total, 509 documents were retrieved. The average number of citations per article was 16.7 per document. Analysis of the retrieved documents indicated that (1) more than 90% of the retrieved documents were about the mass gatherings in Mecca/Makkah; (2) two-thirds of the retrieved documents were research articles; (3) a take-off phase in the number of publications was observed after 2008; (4) the retrieved documents were disseminated in a wide range of journals but specifically the ones in the fields of infectious diseases, public health, and travel medicine; (5) the retrieved documents were mainly published by scholars from Saudi Arabia with collaborative research ties with scholars in the US, France, the UK, and Australia; (6) Saudi Arabia contributed to more than half of the retrieved documents; and (7) four research themes were found: knowledge, attitude, and practices of pilgrims to Mecca/Makkah, vaccination, etiology of hospital admission among pilgrims, and epidemiology of various types of infectious diseases. Conclusions Research on mass gatherings, specifically the Hajj, is emerging. Researchers from the Saudi Arabia dominated the field. Research collaboration between scholars in Saudi Arabia and scholars in low- and middle-income countries is needed and must be encouraged since these countries have weaker health systems to screen, monitor, and control the spread of infectious diseases because of the Hajj season.
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15
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Carlin PR, Minard P, Simon DH, Wing C. Effects of large gatherings on the COVID-19 epidemic: Evidence from professional and college sports. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101033. [PMID: 34298460 PMCID: PMC8643424 DOI: 10.1016/j.ehb.2021.101033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/14/2021] [Accepted: 06/16/2021] [Indexed: 05/05/2023]
Abstract
We compare COVID-19 case loads and mortality across counties that hosted more versus fewer NHL hockey games, NBA basketball games, and NCAA basketball games during the early months of 2020, before any large outbreaks were identified. We find that hosting one additional NHL/NBA game in March 2020 leads to an additional 7520 cases and 658 deaths. Similarly, we find that hosting an additional NCAA Division 1 men's basketball game in March 2020 results in an additional 34 deaths. Back-of-the-envelope calculations suggest that the per-game fatality costs were 200-300 times greater than per-game spending.
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Affiliation(s)
- Patrick R Carlin
- O'Neill School, Indiana University, 1315 E 10th St, Bloomington, IN 47405, USA
| | - Paul Minard
- Cégep Heritage College, Gatineau, QC, Canada
| | - Daniel H Simon
- O'Neill School, Indiana University, 1315 E 10th St, Bloomington, IN 47405, USA
| | - Coady Wing
- O'Neill School, Indiana University, 1315 E 10th St, Bloomington, IN 47405, USA.
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16
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Tavan A, Tafti AD, Nekoie-Moghadam M, Ehrampoush M, Nasab MRV, Tavangar H. Public health risks threatening health of people participating in mass gatherings: A qualitative study. Indian J Public Health 2021; 64:242-247. [PMID: 32985424 DOI: 10.4103/ijph.ijph_305_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Mass gatherings (MGs) have made many problems for the health system and potentially threaten the health of those participated in these gatherings. MGs account for a range of public health risks including communicable diseases, waterborne diseases, water treatment, and outbreaks. Objectives The present study aimed to identify public health risks threatening the health of people participating in MGs in Iran. Methods A qualitative study was designed using a conventional qualitative content analysis approach. Participants were selected using a purposive sampling method among the managers and staff who have experiences in the field of health in MGs in Iran. Subjects were interviewed through individual in-depth interviews after obtaining informed consent. Semi-structured interviews were used to collect the data from December 2018 to February 2019. To analyze the data, the content of recorded interviews was written verbatim. Preliminary data were repeatedly and simultaneously retrieved to give a general understanding of them. Results The main theme emerged from data analysis on 16 interviews was related to public health risks involving the following categories: food hygiene deficiencies, communicable diseases risks, defects in health supervision, and the risk of environmental contamination. Conclusion It is of paramount importance to identify the risks threatening the health of people participating in MGs. In the present study, the main public health risks were detected.
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Affiliation(s)
- Asghar Tavan
- PhD Student, Department of Health in Disasters and Emergencies, International Campus, Shahid Sadoughi University of Medical Sciences, Kerman, Iran
| | - Abbasali Dehghani Tafti
- Associate Professor, Department of Health in Disasters and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Kerman, Iran
| | - Mahmood Nekoie-Moghadam
- Professor, Department of Health Services Management, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohmmadhasan Ehrampoush
- Professor, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Vafaei Nasab
- Associate Professor, Department of Physical Medicine and Rehabilitation, Shahid Sadoughi University of Medical Sciences, Kerman, Iran
| | - Hossein Tavangar
- Associate Professor, Department of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Kerman, Iran
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Novel Respiratory Viruses in the Context of Mass-Gathering Events: A Systematic Review to Inform Event Planning from a Health Perspective. Prehosp Disaster Med 2021; 36:599-610. [PMID: 34261546 DOI: 10.1017/s1049023x21000662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Mass-gathering events (MGEs) occur regularly throughout the world. As people congregate at MGEs, there is an increased risk of transmission of communicable diseases. Novel respiratory viruses, such as Severe Acute Respiratory Syndrome Coronavirus-1 (SARS-CoV-1), Influenza A Virus Subtype H1N1 Strain 2009 (H1N1pdm09), Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), or Coronavirus Disease 2019 (COVID-19), may require specific infection prevention and control strategies to minimize the risk of transmission when planning MGEs. This literature review aimed to identify and analyze papers relating to novel respiratory viruses with pandemic potential and to inform MGE planning. METHOD This paper used a systematic literature review method. Various health care databases were searched using keywords relating to MGEs and novel respiratory viruses. Information was extracted from identified papers into various tables for analysis. The analysis identified infection prevention and control strategies used at MGEs to inform planning before, during, and following events. RESULTS In total, 27 papers met the criteria for inclusion. No papers were identified regarding SARS-CoV-1, while the remainder reported on H1N1pdm09 (n = 9), MERS-CoV (n = 15), and SARS-CoV-2 (n = 3). Various before, during, and after event mitigation strategies were identified that can be implemented for future events. CONCLUSIONS This literature review provided an overview of the novel respiratory virus epidemiology at MGEs alongside related public health mitigation strategies that have been implemented at these events. This paper also discusses the health security of event participants and host communities in the context of cancelling, postponing, and modifying events due to a novel respiratory virus. In particular, ways to recommence events incorporating various mitigation strategies are outlined.
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18
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Yezli S, Yassin Y, Mushi A, Aburas A, Alabdullatif L, Alburayh M, Khan A. Gastrointestinal symptoms and knowledge and practice of pilgrims regarding food and water safety during the 2019 Hajj mass gathering. BMC Public Health 2021; 21:1288. [PMID: 34210302 PMCID: PMC8252316 DOI: 10.1186/s12889-021-11381-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/22/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Food and water-borne diseases (FWBDs) are a health risk at the Hajj mass gathering. The current study documented the prevalence and management of gastrointestinal (GI) symptoms among pilgrims during the 2019 Hajj and assessed their knowledge and practice concerning food and water safety. METHOD An analytical cross-sectional study was conducted in Macca, Saudi Arabia, among adult Hajj pilgrims from 28 countries. Data was collected from 15th-20th August 2019 by facer-to-face interviews using an anonymous structured questionnaire. Basic demographic data as well as information regarding pilgrims' knowledge and practice relating to food and water safety and any GI symptoms experienced during the Hajj was collected and analyzed. RESULTS The study enrolled 1363 pilgrims with a mean age of 50.1 years (SD = 12.3) and 63.4% (n = 845) were male. At least 9.7% (n = 133) of pilgrims experience GI symptoms and 5.1% (69/1363) suffered diarrhea. Most respondents drunk bottled water (99.4%, n = 1324) and obtained their food from their hotel /Hajj mission (> 86%). In general, pilgrims had good knowledge and practice in relation to food and water safety, although risky practices were noted concerning keeping food at unsafe temperatures and hazardous sharing of food and water. Gender, nationality and suffering GI symptoms during Hajj were significantly associated with good knowledge and good practice. There was a moderate but statistically significant positive correlation between knowledge and practice scores (rs = 0.41, p < 0.0001). CONCLUSION Despite overall good knowledge and self-reported practice, risky behaviors relating to food and water safety were identified among pilgrims, many of whom suffered from GI symptoms during Hajj. Our results can form the basis for developing tailored, targeted and effective interventions to improve pilgrims' knowledge and behavior and reduce the burden of FWBDs at the Hajj and beyond.
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Affiliation(s)
- Saber Yezli
- The Global Centre for Mass Gatherings Medicine, Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia.
| | - Yara Yassin
- The Global Centre for Mass Gatherings Medicine, Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdulaziz Mushi
- The Global Centre for Mass Gatherings Medicine, Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia
| | - Alhanouf Aburas
- The Global Centre for Mass Gatherings Medicine, Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia
| | - Lamis Alabdullatif
- The Global Centre for Mass Gatherings Medicine, Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia
| | - Mariyyah Alburayh
- The Global Centre for Mass Gatherings Medicine, Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia
| | - Anas Khan
- The Global Centre for Mass Gatherings Medicine, Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Bouchouar E, Hetman BM, Hanley B. Development and validation of an automated emergency department-based syndromic surveillance system to enhance public health surveillance in Yukon: a lower-resourced and remote setting. BMC Public Health 2021; 21:1247. [PMID: 34187423 PMCID: PMC8240073 DOI: 10.1186/s12889-021-11132-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Automated Emergency Department syndromic surveillance systems (ED-SyS) are useful tools in routine surveillance activities and during mass gathering events to rapidly detect public health threats. To improve the existing surveillance infrastructure in a lower-resourced rural/remote setting and enhance monitoring during an upcoming mass gathering event, an automated low-cost and low-resources ED-SyS was developed and validated in Yukon, Canada. METHODS Syndromes of interest were identified in consultation with the local public health authorities. For each syndrome, case definitions were developed using published resources and expert elicitation. Natural language processing algorithms were then written using Stata LP 15.1 (Texas, USA) to detect syndromic cases from three different fields (e.g., triage notes; chief complaint; discharge diagnosis), comprising of free-text and standardized codes. Validation was conducted using data from 19,082 visits between October 1, 2018 to April 30, 2019. The National Ambulatory Care Reporting System (NACRS) records were used as a reference for the inclusion of International Classification of Disease, 10th edition (ICD-10) diagnosis codes. The automatic identification of cases was then manually validated by two raters and results were used to calculate positive predicted values for each syndrome and identify improvements to the detection algorithms. RESULTS A daily secure file transfer of Yukon's Meditech ED-Tracker system data and an aberration detection plan was set up. A total of six syndromes were originally identified for the syndromic surveillance system (e.g., Gastrointestinal, Influenza-like-Illness, Mumps, Neurological Infections, Rash, Respiratory), with an additional syndrome added to assist in detecting potential cases of COVID-19. The positive predictive value for the automated detection of each syndrome ranged from 48.8-89.5% to 62.5-94.1% after implementing improvements identified during validation. As expected, no records were flagged for COVID-19 from our validation dataset. CONCLUSIONS The development and validation of automated ED-SyS in lower-resourced settings can be achieved without sophisticated platforms, intensive resources, time or costs. Validation is an important step for measuring the accuracy of syndromic surveillance, and ensuring it performs adequately in a local context. The use of three different fields and integration of both free-text and structured fields improved case detection.
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Affiliation(s)
- Etran Bouchouar
- Department of Health and Social Services, Government of Yukon, Whitehorse, Canada.
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Benjamin M Hetman
- Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, ON, Canada
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Brendan Hanley
- Department of Health and Social Services, Government of Yukon, Whitehorse, Canada
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Lami F, Amiri M, Majeed Y, Barr KM, Nsour MA, Khader YS. Real-Time Surveillance of Infectious Diseases, Injuries, and Chronic Conditions During the 2018 Iraq Arba'een Mass Gathering. Health Secur 2021; 19:280-287. [PMID: 33945332 DOI: 10.1089/hs.2020.0074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Arba'een pilgrimage in Iraq is now the largest annual gathering in a single place worldwide. To monitor and address the health needs of pilgrims in field clinics near the pilgrimage route, a syndromic surveillance system was designed and implemented by Global Health Development/Eastern Mediterranean Public Health Network in collaboration with Iraq Ministry of Health. This study aimed to analyze the effectiveness of the surveillance system and the data it gathered in evaluating the burden of common acute and infectious conditions, chronic conditions, and trauma and injuries during the Arba'een pilgrimage in 2018. Data were collected at 152 field clinics located across 11 governorates in Iraq at strategic points along the Arba'een pilgrimage route from all governorates to Karbala between October 8 and November 3, 2018. A team of 24 surveillance supervisors trained, oversaw, and provided technical support for 304 data collectors. The data collectors recorded data from 338,399 patients (42.5% female and 57.5% male) in the span of 26 days. The vast majority of patients were from Iraq (n = 294,260, 87.6%) and Iran (n = 34,691, 10.3%). Of the 338,399 patients whose data were recorded by the surveillance system, 246,469 (72.8%) reported acute and infectious conditions, 202,032 (59.70%) reported chronic conditions, and 6,737 (2.0%) reported traumas and injuries. Many patients reported several conditions in multiple categories. The most prevalent acute condition treated was influenza-like illness, identified through patients exhibiting a combination of fever and cough symptoms. Findings from this study will help inform future planning efforts so healthcare workers can be better prepared for treating such cases at mass gatherings. With the latest challenges posed by the COVID-19 pandemic, preparations for a possible future outbreak of the novel coronavirus are also discussed. The information from this study serves as a foundation to inform and optimize future planning of wide-scale surveillance efforts and address challenges in health service delivery and health security.
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Affiliation(s)
- Faris Lami
- Faris Lami, PhD, is an Associate Professor, Department of Community Medicine, College of Medicine, Baghdad University, Bab Al Muadham, Baghdad, Iraq. Mirwais Amiri, MD, MPH, is Research and Policy Team Leader and Mohannad Al Nsour, MD, MSc, PhD, is Executive Director; both at Center of Excellence for Applied Epidemiology Global Health Development, Amman, Jordan. Yasir Majeed, MD, is Director, Field Epidemiology Training Program, Public Health Directorate, Ministry of Health, Baghdad, Iraq. Kira M. Barr is a Graduate Student, Epidemiology, Ohio State University, Columbus, OH. Yousef S. Khader, ScD, is a Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mirwais Amiri
- Faris Lami, PhD, is an Associate Professor, Department of Community Medicine, College of Medicine, Baghdad University, Bab Al Muadham, Baghdad, Iraq. Mirwais Amiri, MD, MPH, is Research and Policy Team Leader and Mohannad Al Nsour, MD, MSc, PhD, is Executive Director; both at Center of Excellence for Applied Epidemiology Global Health Development, Amman, Jordan. Yasir Majeed, MD, is Director, Field Epidemiology Training Program, Public Health Directorate, Ministry of Health, Baghdad, Iraq. Kira M. Barr is a Graduate Student, Epidemiology, Ohio State University, Columbus, OH. Yousef S. Khader, ScD, is a Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Yasir Majeed
- Faris Lami, PhD, is an Associate Professor, Department of Community Medicine, College of Medicine, Baghdad University, Bab Al Muadham, Baghdad, Iraq. Mirwais Amiri, MD, MPH, is Research and Policy Team Leader and Mohannad Al Nsour, MD, MSc, PhD, is Executive Director; both at Center of Excellence for Applied Epidemiology Global Health Development, Amman, Jordan. Yasir Majeed, MD, is Director, Field Epidemiology Training Program, Public Health Directorate, Ministry of Health, Baghdad, Iraq. Kira M. Barr is a Graduate Student, Epidemiology, Ohio State University, Columbus, OH. Yousef S. Khader, ScD, is a Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Kira M Barr
- Faris Lami, PhD, is an Associate Professor, Department of Community Medicine, College of Medicine, Baghdad University, Bab Al Muadham, Baghdad, Iraq. Mirwais Amiri, MD, MPH, is Research and Policy Team Leader and Mohannad Al Nsour, MD, MSc, PhD, is Executive Director; both at Center of Excellence for Applied Epidemiology Global Health Development, Amman, Jordan. Yasir Majeed, MD, is Director, Field Epidemiology Training Program, Public Health Directorate, Ministry of Health, Baghdad, Iraq. Kira M. Barr is a Graduate Student, Epidemiology, Ohio State University, Columbus, OH. Yousef S. Khader, ScD, is a Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohannad Al Nsour
- Faris Lami, PhD, is an Associate Professor, Department of Community Medicine, College of Medicine, Baghdad University, Bab Al Muadham, Baghdad, Iraq. Mirwais Amiri, MD, MPH, is Research and Policy Team Leader and Mohannad Al Nsour, MD, MSc, PhD, is Executive Director; both at Center of Excellence for Applied Epidemiology Global Health Development, Amman, Jordan. Yasir Majeed, MD, is Director, Field Epidemiology Training Program, Public Health Directorate, Ministry of Health, Baghdad, Iraq. Kira M. Barr is a Graduate Student, Epidemiology, Ohio State University, Columbus, OH. Yousef S. Khader, ScD, is a Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S Khader
- Faris Lami, PhD, is an Associate Professor, Department of Community Medicine, College of Medicine, Baghdad University, Bab Al Muadham, Baghdad, Iraq. Mirwais Amiri, MD, MPH, is Research and Policy Team Leader and Mohannad Al Nsour, MD, MSc, PhD, is Executive Director; both at Center of Excellence for Applied Epidemiology Global Health Development, Amman, Jordan. Yasir Majeed, MD, is Director, Field Epidemiology Training Program, Public Health Directorate, Ministry of Health, Baghdad, Iraq. Kira M. Barr is a Graduate Student, Epidemiology, Ohio State University, Columbus, OH. Yousef S. Khader, ScD, is a Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Bokhary H, Rashid H, Hill-Cawthorne GA, Abd El Ghany M. The Rise of Antimicrobial Resistance in Mass Gatherings. HANDBOOK OF HEALTHCARE IN THE ARAB WORLD 2021:1199-1214. [DOI: 10.1007/978-3-030-36811-1_47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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22
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Hoang VT, Al-Tawfiq JA, Gautret P. The Tokyo Olympic Games and the Risk of COVID-19. CURRENT TROPICAL MEDICINE REPORTS 2020; 7:126-132. [PMID: 33145147 PMCID: PMC7596810 DOI: 10.1007/s40475-020-00217-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2020] [Indexed: 01/19/2023]
Abstract
Purpose of Review We reviewed the occurrence of outbreaks at past Olympics and discuss the threat of the COVID-19 pandemic at the Tokyo Games. Recent Findings Evidence for large respiratory tract infection outbreaks at past Olympics is scant. Nevertheless, in order to control the spread of the COVID-19 outbreak, the Tokyo 2020 Olympics were postponed for 2021. Given the high contagiousness of the disease and the epidemiology of COVID-19 in Japan, this decision was appropriate and important in order to safeguard athletes and the public. However, it is a major problem for Japan, involving massive financial losses and a lost opportunity for athletes, coaches, and instructors. Summary Up-to-date epidemiological data is needed on which to base an appropriate decision regarding the Tokyo 2021 Olympics. The actual effect of cancellations of such events in reducing the spread of COVID-19 needs to be determined.
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Affiliation(s)
- Van Thuan Hoang
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France.,Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.,Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Department of Medicine, Indiana University School of Medicine, Indianapolis, IN USA.,Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Philippe Gautret
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France.,Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
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Aherfi S, Gautret P, Chaudet H, Raoult D, La Scola B. Clusters of COVID-19 associated with Purim celebration in the Jewish community in Marseille, France, March 2020. Int J Infect Dis 2020; 100:88-94. [PMID: 32829043 PMCID: PMC7441020 DOI: 10.1016/j.ijid.2020.08.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/12/2020] [Accepted: 08/16/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES We investigated possible COVID-19 epidemic clusters and their common sources of exposure that led to a sudden increase in the incidence of COVID-19 in the Jewish community of Marseille between March 15 and March 20, 2020. METHODS All data were generated as part of routine work at Marseille university hospitals. Biological diagnoses were made by RT-PCR testing. A telephone survey of families in which a laboratory confirmed case was diagnosed was conducted to determine possible exposure events. RESULTS As of March 30, 2020, 63 patients were linked to 6 epidemic clusters. The 6 clusters were linked to religious and social activities: a ski trip, organized meals for the Purim Jewish celebration in community and family settings on March 10, a religious service and a charity gala. Notably, 40% of the patients were infected by index patients during the presymptomatic period, which was 2.5 days before symptom onset. When considering household members, all 12 patients who tested negative and who did not develop any relevant clinical symptoms compatible with COVID-19 were 1-16 years of age. The clinical attack rate (symptoms compatible with COVID-19, and biologically confirmed by PCR) in adults was 85% compared to 26% in children. CONCLUSIONS Family and community gatherings for the Purim Jewish celebration probably accelerated the spread of COVID-19 in the Marseille Jewish community, leading to multiple epidemic clusters. This investigation of family clusters suggested that all close contacts of patients with confirmed COVID-19 who were not infected were children.
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Affiliation(s)
- Sarah Aherfi
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
| | - Philippe Gautret
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; VITROME, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France
| | - Hervé Chaudet
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Bernard La Scola
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
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Hinduism, Ecological Conservation, and Public Health: What Are the Health Hazards for Religious Tourists at Hindu Temples? RELIGIONS 2020. [DOI: 10.3390/rel11080416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This exploratory ethnographic study aims to understand the visitation experience and to identify health hazards at pilgrimage sites in India. Specifically, this research aims to assess the tourism potential of holy Hindu temple sites located along well-known pilgrimage routes. During our fieldwork, we visited several of the most significant Hindu temples in India. Framed by a critical ethnography lens, our study used unstructured interviews with local stakeholders, as well as observations and reflexive notes. The findings revealed that most of the temples have serious safety, hygiene, accessibility, and environmental issues. A lack of action could lead to serious consequences for locals and tourists. For example, important for tourism, warnings of pandemics have been sounded over the years, and disease pandemics originating in India may only be a matter of time. We propose some immediate solutions and areas for future research.
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Alqahtani AS, Alsharif SA, Garnan MA, Tashani M, BinDhim NF, Heywood AE, Booy R, Wiley KE, Rashid H. The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study. JMIR Public Health Surveill 2020; 6:e10959. [PMID: 32673259 PMCID: PMC7388052 DOI: 10.2196/10959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 04/23/2019] [Accepted: 11/08/2019] [Indexed: 11/20/2022] Open
Abstract
Background Pretravel health advice can play a crucial role in improving both travelers’ awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non–mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims’ health behaviors. Objective The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims’ awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses. Methods A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ≥18 years in 2015. Results A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; P=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; P=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; P=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; P=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses. Conclusions Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors.
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Affiliation(s)
- Amani S Alqahtani
- Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,School of Public Health, The University of Sydney, Sydney, Australia.,National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia
| | | | | | - Mohamed Tashani
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia.,The Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | | | - Anita E Heywood
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia.,The Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia.,WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide, Australia
| | - Kerrie E Wiley
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia.,The Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia
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Multiscale model for the optimal design of pedestrian queues to mitigate infectious disease spread. PLoS One 2020; 15:e0235891. [PMID: 32645057 PMCID: PMC7347216 DOI: 10.1371/journal.pone.0235891] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 06/25/2020] [Indexed: 11/19/2022] Open
Abstract
There is direct evidence for the spread of infectious diseases such as influenza, SARS, measles, and norovirus in locations where large groups of people gather at high densities e.g. theme parks, airports, etc. The mixing of susceptible and infectious individuals in these high people density man-made environments involves pedestrian movement which is generally not taken into account in modeling studies of disease dynamics. We address this problem through a multiscale model that combines pedestrian dynamics with stochastic infection spread models. The pedestrian dynamics model is utilized to generate the trajectories of motion and contacts between infected and susceptible individuals. We incorporate this information into a stochastic infection dynamics model with infection probability and contact radius as primary inputs. This generic model is applicable for several directly transmitted diseases by varying the input parameters related to infectivity and transmission mechanisms. Through this multiscale framework, we estimate the aggregate numbers and probabilities of newly infected people for different winding queue configurations. We find that the queue configuration has a significant impact on disease spread for a range of infection radii and transmission probabilities. We quantify the effectiveness of wall separators in suppressing the disease spread compared to rope separators. Further, we find that configurations with short aisles lower the infection spread when rope separators are used.
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Rajasekharan Nayar K, Fazaludeen Koya S, Mohandas K, Sivasankaran Nair S, Chitra GA, Abraham M, Lordson J. Public health implications of Sabarimala mass gathering in India: A multi-dimensional analysis. Travel Med Infect Dis 2020; 37:101783. [PMID: 32561393 DOI: 10.1016/j.tmaid.2020.101783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Mass gathering for religious and spiritual purposes are common in India. However, mass gathering health and travel medicine is still in its infancy in India. OBJECTIVES The study explored bio-medical, environmental and psycho-social dimensions of mass gathering in Sabarimala pilgrimage, which is annually attended by 25 million pilgrims. METHODS In a cross sectional design, the investigators travelled the pilgrim trail and stayed in the shrine area to conduct the interviews (sample = 1259), to observe the practices as well as to assess the environmental conditions including sanitation. We did in-depth interviews of a subset of samples of the pilgrims, laboratory tests for water quality and secondary analysis of health services data. RESULT 43.4% pilgrims reported at least one health problem. Leg pain, joint/muscle pain, breathlessness, were the common symptoms. Pilgrims expressed concern about drinking water and food safety and majority of them felt the crowd management as unsatisfactory. Untreated sewage and solid waste were found to pollute the water downstream. Average patient presentation rate for 2014-2017 was 4999.6 per 100,000 pilgrims and referral to Hospital Rate was 19 per 100,000 pilgrims. Mortality rate ranged from 18.5 to 21 per 100,000 pilgrims among those who attended the health centers for ailments. Death due to Coronary Artery Heart Disease (CAHD) has slightly decreased over the period of 3 years from 97.6% to 85.1%. CONCLUSION Data with respect to safety, health and environment at the pilgrim sites need to be continuously assessed to understand changes and trends and to develop an effective mass gathering and safe pilgrimage policy (MGSPP).
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Affiliation(s)
- Kesavan Rajasekharan Nayar
- Global Institute of Public Health, Trivandrum, Kerala, India; Santhigiri Research Foundation, Trivandrum, Kerala, India.
| | - Shaffi Fazaludeen Koya
- Global Institute of Public Health, Trivandrum, Kerala, India; Ministry of Health, Al Taif, Makkah, Saudi Arabia; Boston University School of Public Health, Boston, MA, USA.
| | - K Mohandas
- Santhigiri Research Foundation, Trivandrum, Kerala, India.
| | | | - Grace A Chitra
- Global Institute of Public Health, Trivandrum, Kerala, India.
| | - Minu Abraham
- Global Institute of Public Health, Trivandrum, Kerala, India.
| | - Jinbert Lordson
- Global Institute of Public Health, Trivandrum, Kerala, India.
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Abstract
Mass gatherings (MGs) are held throughout the world. The aim of this review was to assess and identify the health threats based on the type of the MG, type of diseases, and injuries. Research platforms such as Web of Science, Medline, and Scopus were searched through June 2017. All epidemiologic studies that investigated the health threats during the MGs, such as communicable diseases, injuries, high-risk behaviors, and environmental health problems, were included in this review. Out of 1264 references, 45 articles were included in the review.Three main types of MGs include religious, festival, and sporting event; and fairs such as trade, book, and agricultural types were also reported in the selected studies. In the religious MGs, infectious diseases were the most common health threat. Road traffic accidents and environmental health problems were additional health threats. At MG sporting events, injuries were the most common health problems. Infectious diseases and alcohol and drug-related disorders were other reported public health concerns. In the festival MGs, alcohol and drug-related problems were commonly reported. This review showed that health threats vary, based on the type of mass gathering. The health organizers of MGs should consider the type of the MG and the health needs and safety of the participants to help them plan their action and provide the needed health care services.
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Shahid F, Ony SH, Albi TR, Chellappan S, Vashistha A, Islam ABMAA. Learning from Tweets: Opportunities and Challenges to Inform Policy Making During Dengue Epidemic. ACTA ACUST UNITED AC 2020. [DOI: 10.1145/3392875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Social media platforms are widely used by people to report, access, and share information during outbreaks and epidemics. Although government agencies and healthcare institutions in developed regions are increasingly relying on social media to develop epidemic forecasts and outbreak response, there is a limited understanding of how people in developing regions interact on social media during outbreaks and what useful insights this dataset could offer during public health crises. In this work, we examined 28,688 tweets to identify public health issues during dengue epidemic in Bangladesh and found several insights, such as irregularities in dengue diagnosis and treatment, shortage of blood supply for Rh negative blood groups, and high local transmission of dengue during Eid-ul-Adha, that impact disease preparedness and outbreak response. We discuss the opportunities and challenges in analyzing tweets and outline how government agencies and healthcare institutions can use social media health data to inform policy making during public health crises.
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Sokhna C, Goumballa N, Hoang VT, Mboup BM, Dieng M, Sylla AB, Diallo A, Raoult D, Parola P, Gautret P. Senegal's Grand Magal of Touba: Syndromic Surveillance during the 2016 Mass Gathering. Am J Trop Med Hyg 2020; 102:476-482. [PMID: 31872797 DOI: 10.4269/ajtmh.19-0240] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The Grand Magal of Touba (GMT) is an annual 1-day Muslim religious event that takes place in Touba in Senegal. The city of Touba swells from 800,000 to four million people during the GMT. All patients who attended one of the 154 dedicated medical care public healthcare structures of the medical region of Diourbel during the GMT were included in a cross-sectional survey from November 16 to November 21, 2016. Demographic, morbidity, and mortality data were collected on a daily basis using a standardized article form that allows data to be recorded in a free-text format. Data were obtained from a total of 20,850 healthcare encounters, and 30.9% patients were aged ≤ 15 years. The most frequent conditions were gastrointestinal and respiratory diseases. Most frequent gastrointestinal symptoms were abdominal and gastric pain, nausea and vomiting, and diarrhea, suggesting that most patients suffered gastroenteritis. The predominance of cough, rhinitis, influenza-like illness, and sore throat among patients with respiratory symptoms suggests that most patients suffered from upper respiratory tract infections. Other frequent symptoms were headaches and pain in various organs. Three percentage of patients were considered to have malaria, 29.8% of patients were prescribed antibiotics and 2.6% antimalarial drugs, and 1.5% of patients were hospitalized. Only one death was recorded. Preparedness of the medical infrastructure should target these syndromic features, in terms of diagnostic tools and specific treatments, including pediatric formulations. It is also essential to improve the quality and rapid availability of data to enable real-time analysis of medical events at the GMT and to implement a rapid response, if necessary.
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Affiliation(s)
- Cheikh Sokhna
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Ndiaw Goumballa
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Van Thuan Hoang
- Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam.,IHU-Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | | | | | | | - Aldiouma Diallo
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Didier Raoult
- Aix Marseille University, IRD, AP-HM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
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31
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Uyeki TM, Bernstein HH, Bradley JS, Englund JA, File TM, Fry AM, Gravenstein S, Hayden FG, Harper SA, Hirshon JM, Ison MG, Johnston BL, Knight SL, McGeer A, Riley LE, Wolfe CR, Alexander PE, Pavia AT. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clin Infect Dis 2020; 68:e1-e47. [PMID: 30566567 DOI: 10.1093/cid/ciy866] [Citation(s) in RCA: 332] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 12/19/2022] Open
Abstract
These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.
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Affiliation(s)
- Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Henry H Bernstein
- Division of General Pediatrics, Cohen Children's Medical Center, New Hyde Park, New York
| | - John S Bradley
- Division of Infectious Diseases, Rady Children's Hospital.,University of California, San Diego
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle Children's Hospital
| | - Thomas M File
- Division of Infectious Diseases Summa Health, Northeast Ohio Medical University, Rootstown
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stefan Gravenstein
- Providence Veterans Affairs Medical Center and Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island
| | - Frederick G Hayden
- Division of Infectious Diseases and International Health, University of Virginia Health System, Charlottesville
| | - Scott A Harper
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jon Mark Hirshon
- Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Michael G Ison
- Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - B Lynn Johnston
- Department of Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Canada
| | - Shandra L Knight
- Library and Knowledge Services, National Jewish Health, Denver, Colorado
| | - Allison McGeer
- Division of Infection Prevention and Control, Sinai Health System, University of Toronto, Ontario, Canada
| | - Laura E Riley
- Department of Maternal-Fetal Medicine, Massachusetts General Hospital, Boston
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Paul E Alexander
- McMaster University, Hamilton, Ontario, Canada.,Infectious Diseases Society of America, Arlington, Virginia
| | - Andrew T Pavia
- Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City
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The Impact of Mass Gatherings on Emergency Department Patient Presentations with Communicable Diseases Related to Syndromic Indicators: An Integrative Review. Prehosp Disaster Med 2020; 35:206-211. [PMID: 32070453 DOI: 10.1017/s1049023x20000151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Mass-gathering events (MGEs) are commonly associated with a higher than average rate of morbidity. Spectators, workers, and the substantial number of MGE attendees can increase the spread of communicable diseases. During an MGE, emergency departments (EDs) play an important role in offering health care services to both residents of the local community and event attendees. Syndromic indicators (SIs) are widely used in an ED surveillance system for early detection of communicable diseases. AIM This literature review aimed to develop an understanding of the effect of MGEs on ED patient presentations with communicable diseases and their corresponding SIs. METHOD An integrative literature review methodology was used. Online databases were searched to retrieve relevant academic articles that focused on MGEs, EDs, and SIs. Inclusion/exclusion criteria were applied to screen articles. The Standard Quality Assessment Criteria for Evaluating Primary Research (QualSyst) assessment tool was used to assess the quality of included papers. RESULTS Eleven papers were included in this review; all discussed the impact of an MGE on patient presentations with communicable diseases at EDs/hospitals. Most included studies used the raw number of patients who presented or were admitted to EDs/hospitals to determine impact. Further, the majority of studies focused on either respiratory infections (n = 4) or gastrointestinal infections (n = 2); two articles reported on both. Eight articles mentioned SIs; however, such information was limited. The quality of evidence (using QualSyst) ranged from 50% to 90%. CONCLUSIONS Limited research exists on the impact of MGEs on ED presentations with communicable diseases and related SIs. Recommendations for future MGE studies include assessing differences in ED presentations with communicable diseases regarding demographics, clinical characteristics, and outcomes before, during, and after the event. This would benefit health care workers and researchers by offering more comprehensive knowledge for application into practice.
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Bokhary H, Rashid H, Hill-Cawthorne GA, Abd El Ghany M. The Rise of Antimicrobial Resistance in Mass Gatherings. HANDBOOK OF HEALTHCARE IN THE ARAB WORLD 2020:1-16. [DOI: 10.1007/978-3-319-74365-3_47-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/15/2019] [Indexed: 09/01/2023]
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Abd El Ghany M, Fouz N, Hill-Cawthorne GA. Human Movement and Transmission of Antimicrobial-Resistant Bacteria. THE HANDBOOK OF ENVIRONMENTAL CHEMISTRY 2020:311-344. [DOI: 10.1007/698_2020_560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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35
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Gautret P, Angelo KM, Asgeirsson H, Duvignaud A, van Genderen PJJ, Bottieau E, Chen LH, Parker S, Connor BA, Barnett ED, Libman M, Hamer DH. International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study. Travel Med Infect Dis 2019; 32:101504. [PMID: 31707112 PMCID: PMC7110217 DOI: 10.1016/j.tmaid.2019.101504] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Travelers to international mass gatherings may be exposed to conditions which increase their risk of acquiring infectious diseases. Most existing data come from single clinical sites seeing returning travelers, or relate to single events. METHODS Investigators evaluated ill travelers returning from a mass gathering, and presenting to a GeoSentinel site between August 2015 and April 2019, and collected data on the nature of the event and the relation between final diagnoses and the mass gathering. RESULTS Of 296 ill travelers, 51% were female and the median age was 54 years (range: 1-88). Over 82% returned from a religious mass gathering, most frequently Umrah or Hajj. Only 3% returned from the Olympics in Brazil or South Korea. Other mass gatherings included other sporting events, cultural or entertainment events, and conferences. Respiratory diseases accounted for almost 80% of all diagnoses, with vaccine preventable illnesses such as influenza and pneumonia accounting for 26% and 20% of all diagnoses respectively. This was followed by gastrointestinal illnesses, accounting for 4.5%. Sixty-three percent of travelers reported having a pre-travel encounter with a healthcare provider. CONCLUSIONS Despite this surveillance being limited to patients presenting to GeoSentinel sites, our findings highlight the importance of respiratory diseases at mass gatherings, the need for pre-travel consultations before mass gatherings, and consideration of vaccination against influenza and pneumococcal disease.
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Affiliation(s)
- Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France and IHU-Méditerranée Infection, Marseille, France.
| | - Kristina M Angelo
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, GA, USA
| | - Hilmir Asgeirsson
- Department of Infectious Diseases, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Alexandre Duvignaud
- Department of Infectious Diseases and Tropical Medicine, Division of Tropical Medicine and Clinical International Health, CHU Bordeaux, Bordeaux, France
| | - Perry J J van Genderen
- Department of Medical Microbiology and Infectious Diseases, University Hospital Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital and Harvard Medical School, MA, USA
| | - Salim Parker
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Bradley A Connor
- Weill Cornell Medical College, New York, USA; New York Center for Travel and Tropical Medicine, New York, USA
| | | | - Michael Libman
- J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Canada
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, MA, USA; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, MA, USA
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Beaulieu-Prévost D, Cormier M, Heller SM, Nelson-Gal D, McRae K. Welcome to Wonderland? A Population Study of Intimate Experiences and Safe Sex at a Transformational Mass Gathering (Burning Man). ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2055-2073. [PMID: 31325119 DOI: 10.1007/s10508-019-01509-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
Transformational festivals are socially immersive artistic mass gatherings that are said to promote a strong feeling of belonging and experiences of personal transformation. The purposes of the present study were (1) to investigate the social and intimate experiences of Burning Man participants and (2) to study the factors predicting safe sex practices in the context of that transformational festival. The study was based on data from two consecutive cycles (2013 and 2014) of the yearly post-event online survey done in collaboration with the Burning Man Project. Participants consisted of people who attended the event (N = 19,512). The results were weighted based on the sociodemographic characteristics of the population. A typology of social and intimate experiences was created using a k-means cluster analysis. Predictors of having had unprotected sex with someone met during the event were identified using a nested logistic regression. Five profiles of social and intimate experiences were identified. Profiles with high levels of emotionally and physically intimate experiences were associated with a strong feeling of belonging and a high proportion of personal transformation. Predictive analyses showed that unprotected sex was mainly predicted by variables associated with one of three factors: (1) a lower lever of preparation and practice in using protection, (2) sex education and/or subcultures, and (3) the perceived costs and benefits associated with protection. The results also indirectly suggest a positive effect of the event on safe sex. Implications in terms of public health intervention are discussed.
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Affiliation(s)
- Dominic Beaulieu-Prévost
- Département de sexologie, Université du Québec à Montréal, C.P. 8888, succ. Centre-ville, Montréal, QC, H3C 3P8, Canada.
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.
| | - Mélanie Cormier
- Département de sexologie, Université du Québec à Montréal, C.P. 8888, succ. Centre-ville, Montréal, QC, H3C 3P8, Canada
| | - S Megan Heller
- Department of Anthropology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Kateri McRae
- Department of Psychology, University of Denver, Denver, CO, USA
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Al-Tawfiq JA, Memish ZA. The Hajj 2019 Vaccine Requirements and Possible New Challenges. J Epidemiol Glob Health 2019; 9:147-152. [PMID: 31529930 PMCID: PMC7310822 DOI: 10.2991/jegh.k.190705.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 01/02/2023] Open
Abstract
Each year millions of pilgrims perform the annual Hajj from more than 180 countries around the world. This is one of the largest mass gathering events and may result in the occurrence and spread of infectious diseases. As such, there are mandatory vaccinations for the pilgrims such as meningococcal vaccines. The 2019 annual Hajj will take place during August 8-13, 2019. Thus, we review the recommended and mandated vaccinations for the 2019 Hajj and Umrah. The mandatory vaccines required to secure the visa include the quadrivalent meningococcal vaccine for all pilgrims, while yellow fever, and poliomyelitis vaccines are required for pilgrims coming from countries endemic or with disease activity. The recommended vaccines are influenza, pneumococcal, in addition to full compliance with basic vaccines for all pilgrims against diphtheria, tetanus, pertussis, polio, measles, and mumps. It is imperative to continue surveillance for the spread of antimicrobial resistance and occurrence of all infectious diseases causing outbreaks across the globe in the last year, like Zika virus, MDR-Typhoid, Nipah, Ebola, cholera, chikungunya and Middle East Respiratory Syndrome Coronavirus.
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Affiliation(s)
- Jaffar A. Al-Tawfiq
- Infectious Disease Section, Specialty Medicine Department, Johns Hopkins Aramco Healthcare, Dhahran, Kingdom of Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ziad A. Memish
- Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Infectious Diseases Division, Department of Medicine, Prince Mohammed Bin Abdulaziz Hospital (PMAH), Ministry of Health, Riyadh, Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Collender PA, Morris C, Glenn-Finer R, Acevedo A, Chang HH, Trostle JA, Eisenberg JNS, Remais JV. Mass Gatherings and Diarrheal Disease Transmission Among Rural Communities in Coastal Ecuador. Am J Epidemiol 2019; 188:1475-1483. [PMID: 31094412 DOI: 10.1093/aje/kwz102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 12/17/2022] Open
Abstract
Mass gatherings exacerbate infectious disease risks by creating crowded, high-contact conditions and straining the capacity of local infrastructure. While mass gatherings have been extensively studied in the context of epidemic disease transmission, the role of gatherings in incidence of high-burden, endemic infections has not been previously studied. Here, we examine diarrheal incidence among 17 communities in Esmeraldas, Ecuador, in relation to recurrent gatherings characterized using ethnographic data collected during and after the epidemiologic surveillance period (2004-2007). Using distributed-lag generalized estimating equations, adjusted for seasonality, trend, and heavy rainfall events, we found significant increases in diarrhea risk in host villages, peaking 2 weeks after an event's conclusion (incidence rate ratio, 1.21; confidence interval, adjusted for false coverage rate of ≤0.05: 1.02, 1.43). Stratified analysis revealed heightened risks associated with events where crowding and travel were most likely (2-week-lag incidence rate ratio, 1.51; confidence interval, adjusted for false coverage rate of ≤0.05: 1.09, 2.10). Our findings suggest that community-scale mass gatherings might play an important role in endemic diarrheal disease transmission and could be an important focus for interventions to improve community health in low-resource settings.
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Affiliation(s)
- Philip A Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Christa Morris
- Joint Medical Program of University of California, Berkeley, Berkeley, California, and University of California, San Francisco, San Francisco, California
| | - Rose Glenn-Finer
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Andrés Acevedo
- Instituto de Microbiología, Universidad de San Francisco de Quito, Quito, Ecuador
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - James A Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut
| | | | - Justin V Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
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Braga JM, Nhantumbo L, Nhambomba A, Cossa E, Nhabomba C, Dimas T, Nunes D, Salomão C, Langa JP, Baltazar C, Brant J. Epidemiological profile of health consultations during the Mozambique 9 th National Cultural Festival, August 2016. Pan Afr Med J 2019; 33:52. [PMID: 31448015 PMCID: PMC6689826 DOI: 10.11604/pamj.2019.33.52.15534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/18/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction The use of mass gatherings as spaces to practice health surveillance has been growing in recent years. In Mozambique, the 9th National Festival of Culture in 2016 was selected for this practice. A specific public health surveillance system to facilitate rapid detection of outbreaks and other health-related events was implemented for this event with real time data collection and analysis Methods A descriptive epidemiological evaluation of all the health consultations that occurred in fixed posts prepared for the event was conducted. The data were collected through electronic mobile system (tablets) in real time, with the aid of a form designed for this purpose and sent directly to the incident command system (ICS) Results During the event, a total of 355 patients were assisted, 52.3% were female, 87.0% were from Beira city and the artists were the group that most frequently sought health care at 59.4%. The largest number of visits took place on the third day (36.4%). People over 45 years of age were the age group that most frequently sought health care (30.8%). The main provisional diagnoses of those who were attended to during the festival was arterial hypertension (20.3%), followed by febrile syndrome (19.0%), with falls being the most frequent causes of trauma during the festival (60.0%). Conclusion The system of monitoring in real time using mobile technologies proved to be efficient for the monitoring of the main health events during the mass gatherings. This profile of health consultations encourages the health sector to plan strategies and actions geared to the reality of care for this type of event.
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Affiliation(s)
- Judite Monteiro Braga
- Mozambique Field Epidemiology Training Program (Moz FELTP), Mozambique.,Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | - Lucas Nhantumbo
- Mozambique Field Epidemiology Training Program (Moz FELTP), Mozambique
| | - António Nhambomba
- Department of Epidemiology, National Directorate of Public Health, Ministry of Health, Maputo, Mozambique
| | - Esmeralda Cossa
- Mozambique Field Epidemiology Training Program (Moz FELTP), Mozambique.,Centro de Investigação Operacional de Beira (CIOB), INS, Beira, Mozambique
| | | | - Tomas Dimas
- Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | - Daniele Nunes
- Associação Brasileira de Profissionais de Epidemiologia de Campo (ProEpi), Brazil
| | | | | | | | - Jonas Brant
- Associação Brasileira de Profissionais de Epidemiologia de Campo (ProEpi), Brazil
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Godbole G, McCann N, Jones SM, Dallman TJ, Brown M. Ceftriaxone-resistant Salmonella Typhi in a traveller returning from a mass gathering in Iraq. THE LANCET. INFECTIOUS DISEASES 2019; 19:467. [DOI: 10.1016/s1473-3099(19)30176-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 03/20/2019] [Indexed: 12/11/2022]
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Uyeki TM, Bernstein HH, Bradley JS, Englund JA, File TM, Fry AM, Gravenstein S, Hayden FG, Harper SA, Hirshon JM, Ison MG, Johnston BL, Knight SL, McGeer A, Riley LE, Wolfe CR, Alexander PE, Pavia AT. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clin Infect Dis 2019; 68. [PMID: 30566567 PMCID: PMC6653685 DOI: 10.1093/cid/ciy866 10.1093/cid/ciz044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.
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Affiliation(s)
- Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Henry H Bernstein
- Division of General Pediatrics, Cohen Children's Medical Center, New Hyde Park, New York
| | - John S Bradley
- Division of Infectious Diseases, Rady Children's Hospital
- University of California, San Diego
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle Children's Hospital
| | - Thomas M File
- Division of Infectious Diseases Summa Health, Northeast Ohio Medical University, Rootstown
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stefan Gravenstein
- Providence Veterans Affairs Medical Center and Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island
| | - Frederick G Hayden
- Division of Infectious Diseases and International Health, University of Virginia Health System, Charlottesville
| | - Scott A Harper
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jon Mark Hirshon
- Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Michael G Ison
- Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - B Lynn Johnston
- Department of Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Canada
| | - Shandra L Knight
- Library and Knowledge Services, National Jewish Health, Denver, Colorado
| | - Allison McGeer
- Division of Infection Prevention and Control, Sinai Health System, University of Toronto, Ontario, Canada
| | - Laura E Riley
- Department of Maternal-Fetal Medicine, Massachusetts General Hospital, Boston
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Paul E Alexander
- McMaster University, Hamilton, Ontario, Canada
- Infectious Diseases Society of America, Arlington, Virginia
| | - Andrew T Pavia
- Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City
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Abstract
A mass gathering is “any occasion, either organized or spontaneous, that attracts sufficient numbers of people to strain the planning and response resources of the community, city, or nation hosting the event.”2 Often the existing infrastructure (e.g., public health, health care, or emergency services) is inadequate for the disproportionate sudden surge in demand, hence careful planning is required. Although infectious diseases are most feared due to the potential for rapid international spread, noncommunicable diseases, accidents, and stampedes are more frequent. Mass gatherings may lead to three potential infectious disease public health threats: the risk of importation of infectious diseases usually not seen in the country of the gathering; the amplification of transmission during the event; and the international spread of infectious disease through global mobility networks. Mass gatherings are the temporary collection of large numbers of people at one site or location for a common purpose. Mass gatherings present some of the most complex management challenges faced by governments and organizers. Mass gatherings may lead to three potential infectious disease public health threats: the risk of importation of infectious diseases usually not seen in the country of the gathering; the amplification of transmission during the event; and the international spread of infectious disease through global mobility networks. While infectious diseases may be of greater global public health relevance, noncommunicable diseases, accidents, and stampede usually have a higher local impact with respect to morbidity and mortality during mass gatherings.
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Acevedo R, Bai X, Borrow R, Caugant DA, Carlos J, Ceyhan M, Christensen H, Climent Y, De Wals P, Dinleyici EC, Echaniz-Aviles G, Hakawi A, Kamiya H, Karachaliou A, Lucidarme J, Meiring S, Mironov K, Sáfadi MAP, Shao Z, Smith V, Steffen R, Stenmark B, Taha MK, Trotter C, Vázquez JA, Zhu B. The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations. Expert Rev Vaccines 2018; 18:15-30. [PMID: 30526162 DOI: 10.1080/14760584.2019.1557520] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The 2018 Global Meningococcal Initiative (GMI) meeting focused on evolving invasive meningococcal disease (IMD) epidemiology, surveillance, and protection strategies worldwide, with emphasis on emerging antibiotic resistance and protection of high-risk populations. The GMI is comprised of a multidisciplinary group of scientists and clinicians representing institutions from several continents. AREAS COVERED Given that the incidence and prevalence of IMD continually varies both geographically and temporally, and surveillance systems differ worldwide, the true burden of IMD remains unknown. Genomic alterations may increase the epidemic potential of meningococcal strains. Vaccination and (to a lesser extent) antimicrobial prophylaxis are the mainstays of IMD prevention. Experiences from across the globe advocate the use of conjugate vaccines, with promising evidence growing for protein vaccines. Multivalent vaccines can broaden protection against IMD. Application of protection strategies to high-risk groups, including individuals with asplenia, complement deficiencies and human immunodeficiency virus, laboratory workers, persons receiving eculizumab, and men who have sex with men, as well as attendees at mass gatherings, may prevent outbreaks. There was, however, evidence that reduced susceptibility to antibiotics was increasing worldwide. EXPERT COMMENTARY The current GMI global recommendations were reinforced, with several other global initiatives underway to support IMD protection and prevention.
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Affiliation(s)
- Reinaldo Acevedo
- a Biologic Evaluation Department , Finlay Institute of Vaccines , Havana , Cuba
| | - Xilian Bai
- b Meningococcal Reference Unit , Public Health England , Manchester , UK
| | - Ray Borrow
- b Meningococcal Reference Unit , Public Health England , Manchester , UK
| | - Dominique A Caugant
- c Division of Infection Control and Environmental Health , Norwegian Institute of Public Health , Oslo , Norway
| | - Josefina Carlos
- d Department of Pediatrics, College of Medicine , University of the East - Ramon Magsaysay Memorial Medical Center , Quezon City , Philippines
| | - Mehmet Ceyhan
- e Faculty of Medicine, Department of Pediatric Infectious Diseases , Hacettepe University , Ankara , Turkey
| | - Hannah Christensen
- f Population Health Sciences, Bristol Medical School , University of Bristol , Bristol , UK
| | - Yanet Climent
- a Biologic Evaluation Department , Finlay Institute of Vaccines , Havana , Cuba
| | - Philippe De Wals
- g Department of Social and Preventive Medicine , Laval University , Quebec City , QC , Canada
| | - Ener Cagri Dinleyici
- h Department of Paediatrics , Eskisehir Osmangazi University Faculty of Medicine , Eskisehir , Turkey
| | - Gabriela Echaniz-Aviles
- i Center for Research on Infectious Diseases , Instituto Nacional de Salud Pública , Cuernavaca , México
| | - Ahmed Hakawi
- j Infectious Diseases Control , Ministry of Health , Riyadh , Saudi Arabia
| | - Hajime Kamiya
- k Infectious Disease Surveillance Center , National Institute of Infectious Diseases , Tokyo , Japan
| | | | - Jay Lucidarme
- b Meningococcal Reference Unit , Public Health England , Manchester , UK
| | - Susan Meiring
- m Division of Public Health Surveillance and Response , National Institute for Communicable Diseases , Johannesburg , South Africa
| | - Konstantin Mironov
- n Central Research Institute of Epidemiology , Moscow , Russian Federation
| | - Marco A P Sáfadi
- o Department of Pediatrics , FCM Santa Casa de São Paulo School of Medical Sciences , São Paulo , Brazil
| | - Zhujun Shao
- p National Institute for Communicable Disease Control and Prevention , Chinese Centre for Disease Control and Prevention , Beijing , China
| | - Vinny Smith
- q Meningitis Research Foundation , Bristol , UK
| | - Robert Steffen
- r Department of Epidemiology and Prevention of Infectious Diseases , WHO Collaborating Centre for Travellers' Health, University of Zurich , Zurich , Switzerland
| | - Bianca Stenmark
- s Department of Laboratory Medicine , Örebro University Hospital , Örebro , Sweden
| | - Muhamed-Kheir Taha
- t Institut Pasteur , National Reference Centre for Meningococci , Paris , France
| | - Caroline Trotter
- l Department of Veterinary Medicine , University of Cambridge , Cambridge , UK
| | - Julio A Vázquez
- u National Centre of Microbiology , Institute of Health Carlos III , Madrid , Spain
| | - Bingqing Zhu
- p National Institute for Communicable Disease Control and Prevention , Chinese Centre for Disease Control and Prevention , Beijing , China
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Karampourian A, Ghomian Z, Khorasani-Zavareh D. Exploring challenges of health system preparedness for communicable diseases in Arbaeen mass gathering: a qualitative study. F1000Res 2018; 7:1448. [PMID: 30473777 PMCID: PMC6234742 DOI: 10.12688/f1000research.15290.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Infectious diseases are common problems in mass gatherings, especially when there is a lack of health system preparedness. Since Iran is one of the most important countries on the walking path of Arbaeen and has a vital role in providing health services to pilgrims, the experiences of health challenges by participants is of key importance. The aim of this study is to explore stakeholders' experiences on the health system's preparedness and challenges, and to provide suggestions for preventing infectious diseases during the Arbaeen mass gathering. Methods: A qualitative research method was used with a conventional content analysis approach. The number of participants was 17, including 13 executive managers and 4 health policymakers who entered the study among participants. Semi-structured interviews were used to generate the data. Interviews were analyzed by means of content analysis after face-to-face interviews. Results: Data analysis resulted in the extraction of four main themes and 11 sub-themes. Health infrastructure defects in Iraq has three sub-themes (health abandonment in Iraq, the weaknesses in health culture and problems related to the health system); poor control of the causative factors of infectious diseases has three sub-themes (the underlying factors of the prevalence of contagious diseases, health system response to communicable diseases and ignoring the risks of the Arbaeen ceremony); the low perception of risk in pilgrims has three sub-themes (lack of awareness in pilgrims, fatalism in pilgrims and unhygienic belief in pilgrims); and the ineffectiveness of health education has two sub-themes (training shortage in the targeted group and educational content problems) that shows participant's experiences of the health system's challenges for coping with infectious diseases during the Arbaeen ceremony. Conclusion: Pilgrim-based training, planning and controlling other challenges may change these threats to opportunities and improve the health of participants of the mass gathering of Arbaeen in the region.
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Affiliation(s)
- Arezou Karampourian
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
| | - Zohreh Ghomian
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
| | - Davoud Khorasani-Zavareh
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
- Department of Clinical Sciences and Education, Karolinska Institute, Stockholm, 202100-2973, Sweden
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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. Summary 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.
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Affiliation(s)
- Van-Thuan Hoang
- IRD, AP-HM, SSA, VITROME, Institut Hospitalo-Universitaire Méditerranée Infection, Aix Marseille University, 19-21 Boulevard Jean Moulin, 13385, Marseille Cedex 05, France.,Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Philippe Gautret
- IRD, AP-HM, SSA, VITROME, Institut Hospitalo-Universitaire Méditerranée Infection, Aix Marseille University, 19-21 Boulevard Jean Moulin, 13385, Marseille Cedex 05, France.
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Pshenichnaya N, Petersen E, Patel D, Gautret P, Schlagenhauf P. Football fever in Russia: Infectious disease risks and the FIFA world cup 2018. Travel Med Infect Dis 2018; 24:4-6. [PMID: 29908327 DOI: 10.1016/j.tmaid.2018.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 11/23/2022]
Affiliation(s)
- Natalia Pshenichnaya
- Department of Infectious Diseases, Rostov State Medical University, Rostov-on-Don, Russia; Department of Infectious Diseases and Parasitology, Rostov Scientific Research Institute of Microbiology and Parasitology, Rostov-on-Don, Russia.
| | - Eskild Petersen
- Institute for Clinical Medicine, University of Aarhus, Denmark and Department of Infectious Diseases, The Royal Hospital, Muscat, Oman
| | - Dipti Patel
- National Travel Health Network and Centre (NaTHNaC), UCLH NHS Foundation Trust, London NW1 2PG, UK
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Patricia Schlagenhauf
- University of Zurich Centre for Travel Medicine, WHO Collaborating for Travellers' Health, Department of Public Health, Institute for Epidemiology, Biostatistics and Prevention, Hirschengraben 84, 8001 Zurich, Switzerland
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Epidemiology of vaccine-preventable diseases in Japan: considerations for pre-travel advice for the 2019 Rugby World Cup and 2020 Summer Olympic and Paralympic Games. Western Pac Surveill Response J 2018; 9:26-33. [PMID: 30057855 PMCID: PMC6053105 DOI: 10.5365/wpsar.2017.8.4.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction In 2019 and 2020, Japan will host two international sporting events estimated to draw a combined 22 million visitors. Mass gatherings like these ones increase the risk of spread of infectious disease outbreaks and international transmission. Pre-travel advice reduces that risk. Methods To assist ministries of health and related organizations in developing pre-travel advice, we summarized national surveillance data in Japan (2000-2016, to the extent available) for rubella, invasive pneumococcal disease, measles, non-A and non-E viral hepatitis, hepatitis A, invasive Haemophilus influenzae disease, tetanus, typhoid fever, invasive meningococcal disease, Japanese encephalitis, influenza, varicella, mumps and pertussis by calculating descriptive statistics of reported cases and reviewing trends. (See Annex A for details of reviewed diseases.). Results Our findings showed notable incidences of rubella (1.78 per 100 000 person-years), influenza (243.5 cases per sentinel site), and mumps (40.1 per sentinel site); seasonal increases for influenza (November-May) and Japanese encephalitis (August-November); and a geographical concentration of Japanese encephalitis in western Japan. Measles cases decreased from 11 013 in 2008 to 35 in 2015, but outbreaks (n = 165 cases) associated with importation occurred in 2016. Though invasive meningococcal disease incidence was only 0.03 per 100 000, international transmission occurred at a mass gathering in Japan in 2015. Discussion Ministries of health and related organizations should use these findings to develop targeted pre-travel advice for travellers to the 2019 Rugby World Cup and the 2020 Summer Olympic and Paralympic Games, especially for mumps, measles, rubella, influenza, and meningitis. Travellers with increased exposure risk should also be advised about hepatitis A and Japanese encephalitis.
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Abd El Ghany M, Alsomali M, Almasri M, Regalado EP, Naeem R, Tukestani A, Asiri A, Hill-Cawthorne GA, Pain A, Memish ZA. Enteric Infections Circulating during Hajj Seasons, 2011-2013. Emerg Infect Dis 2018; 23. [PMID: 28930004 PMCID: PMC5621540 DOI: 10.3201/eid2310.161642] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Foodborne-associated bacteria with increased incidence of antimicrobial drug resistance were the most common cause. Hajj, the annual Muslim pilgrimage to Mecca, Saudi Arabia, is a unique mass gathering event that raises public health concerns in the host country and globally. Although gastroenteritis and diarrhea are common among Hajj pilgrims, the microbial etiologies of these infections are unknown. We collected 544 fecal samples from pilgrims with medically attended diarrheal illness from 40 countries during the 2011–2013 Hajj seasons and screened the samples for 16 pathogens commonly associated with diarrheal infections. Bacteria were the main agents detected, in 82.9% of the 228 positive samples, followed by viral (6.1%) and parasitic (5.3%) agents. Salmonella spp., Shigella/enteroinvasive Escherichia coli, and enterotoxigenic E. coli were the main pathogens associated with severe symptoms. We identified genes associated with resistance to third-generation cephalosporins ≈40% of Salmonella- and E. coli–positive samples. Hajj-associated foodborne infections pose a major public health risk through the emergence and transmission of antimicrobial drug–resistant bacteria.
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Hopkins N, Reicher SD. Social identity and health at mass gatherings. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2017. [DOI: 10.1002/ejsp.2288] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nick Hopkins
- School of Social Sciences; University of Dundee; Dundee UK
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Al-Tawfiq JA, Gautret P, Memish ZA. Expected immunizations and health protection for Hajj and Umrah 2018 -An overview. Travel Med Infect Dis 2017; 19:2-7. [PMID: 29037978 PMCID: PMC7110709 DOI: 10.1016/j.tmaid.2017.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The annual Hajj and Umrah are one of the largest recurring religious mass gatherings across the globe drawing pilgrims from more than 185 countries. The living circumstances and activities of the pilgrims may create an environment for the occurrence and spread of communicable diseases. Each year, the Health authority of the Kingdom of Saudi Arabia, in coordination with international health authorities, updates health requirements for pilgrims. The Hajj for 2017 took place from August 24 to September 5, 2017. Here, we review the expected obligations for immunizations for the 2018 Hajj and Umrah. RESULTS The Hajj and Umrah vaccine requirements include mandatory vaccinations against yellow fever, quadrivalent meningococcal polysaccharide (every 3 years) or conjugated (every 5 years) vaccines and poliomyelitis vaccine. Influenza vaccine utilizing the 2016 (Southern Hemisphere vaccine to all pilgrims) was recommended but was not obligatory for pilgrims. Ciprofloxacin is required for individuals >12 years excluding pregnant women as chemoprophylaxis to be given at the port of entry for Pilgrims coming from the meningitis belt. With the ongoing outbreaks of measles in Europe, it is recommended that all pilgrims have an updated immunization against vaccine-preventable diseases (diphtheria, tetanus, pertussis, polio, measles and mumps). CONCLUSION The mandatory vaccines remain the same with continued vigilance for the development of any new or emerging infectious diseases. Continuing surveillance for Zika virus, cholera and MERS-CoV are ongoing.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Philippe Gautret
- Unité de Recherche sur Les Maladies Infectieuses et Tropicales émergentes (URMITE) CNRS-IRD UMR 6236, Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Ziad A Memish
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital ("PMAH"), Ministry of Health, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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