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Ebikeme C. How Paris is preparing for the health threats of the Olympic Games. BMJ 2024; 385:q1263. [PMID: 38918027 DOI: 10.1136/bmj.q1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
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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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Alahmari AA, Khan AA, Alamri FA, Almuzaini YS, Habash AK, Jokhdar H. Healthcare policies, precautionary measures and outcomes of mass gathering events in the era of COVID-19 pandemic: Expedited review. J Infect Public Health 2024; 17 Suppl 1:27-33. [PMID: 37059635 PMCID: PMC10049799 DOI: 10.1016/j.jiph.2023.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/14/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Abstract
With the onset of the COVID-19 pandemic in early 2020, several countries suspended or restricted mass gathering (MG) events to mitigate the risk of superspreading events. Prohibiting MGs aimed to lessen the likelihood of highly infectious persons coming into close contact with many others. Now that the world has opened its doors wide and removed most of precautionary measures, many questions arise. In this review, we aimed to summarize the current evidence regarding the policies and regulations that were implemented for the safe return of MG events. Besides, we highlighted the impact of the return of MG events during 2021 on the trajectory of COVID-19 spread. Canceling MG events can carry religious, societal, economic, and public negative consequences necessitating the safe return of these events. The experience with the COVID-19 pandemic was the foundation for the recommendations for the safe conduction of MG events during the pandemic by international public health bodies. When policymakers adequately applied precautionary measures and strategic approaches, we witnessed the safe holding of huge MG events without aggravating the COVID-19 situation or increasing the number of new cases beyond the capacity and readiness of the national healthcare system.
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Affiliation(s)
- Ahmed A Alahmari
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Saudi Arabia
| | - Anas A Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Saudi Arabia
| | - Fahad A Alamri
- Global Centre of Mass Gatherings Medicine, Family Medicine, Primary Health Centre, Ministry of Health, Riyadh, Saudi Arabia.
| | - Yasir S Almuzaini
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Saudi Arabia
| | - Alia K Habash
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Saudi Arabia
| | - Hani Jokhdar
- Deputyship of Public Health, Ministry of Health, Riyadh, Saudi Arabia
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4
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Meurice L, Filleul L, Fischer A, Burbaud A, Delvallez G, Diancourt L, Belichon S, Clouzeau B, Malvy D, Oliva-Labadie M, Bragança C, Wilking H, Franca R, Martin G, Godbole G, Tourdjman M, Jourdan-Da Silva N. Foodborne botulism outbreak involving different nationalities during the Rugby World Cup: critical role of credit card data and rapid international cooperation, France, September 2023. Euro Surveill 2023; 28:2300624. [PMID: 37997664 PMCID: PMC10668258 DOI: 10.2807/1560-7917.es.2023.28.47.2300624] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/23/2023] [Indexed: 11/25/2023] Open
Abstract
In September 2023, a severe outbreak of type B botulism with fifteen cases was linked to consumption of canned sardines at a restaurant in Bordeaux, France, during the Rugby World Cup. The cases were from seven countries. One death was recorded. Outbreak investigation using credit card data, rapid communication between health authorities of the affected countries and broad media communication allowed identification of cases and exposed persons and prevented further severe outcomes.
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Affiliation(s)
- Laure Meurice
- Santé publique France, Regional office in Nouvelle-Aquitaine, Bordeaux, France
| | - Laurent Filleul
- Santé publique France, Regional office in Nouvelle-Aquitaine, Bordeaux, France
| | - Aurélie Fischer
- Regional health agency Nouvelle-Aquitaine (ARS Nouvelle-Aquitaine), Bordeaux, France
| | - Annie Burbaud
- Regional health agency Nouvelle-Aquitaine (ARS Nouvelle-Aquitaine), Bordeaux, France
| | - Gauthier Delvallez
- National Reference Center for Anaerobic Bacteria and Botulism, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laure Diancourt
- National Reference Center for Anaerobic Bacteria and Botulism, Institut Pasteur, Université Paris Cité, Paris, France
| | | | | | | | | | - Coralie Bragança
- Poison control center, Bordeaux Hospital Center, Bordeaux, France
| | - Hendrik Wilking
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Rafaela Franca
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Greg Martin
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Gauri Godbole
- United Kingdom Health Security Agency, Gastrointestinal Pathogens and Food Safety (One Health) Division, London, United Kingdom
| | - Mathieu Tourdjman
- Santé publique France, Department of Infectious Disease, Saint-Maurice, France
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Huo D, Shen Y, Zhou T, Yu T, Lyu R, Tong Y, Gao T, Wang Q. Case study of the Beijing 2022 Olympic Winter Games: Implications for global mass gathering events amidst the COVID-19 pandemic. Front Public Health 2023; 11:1068023. [PMID: 36815167 PMCID: PMC9939634 DOI: 10.3389/fpubh.2023.1068023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
Objective This study aimed to evaluate the public health countermeasures against coronavirus disease 2019 (COVID-19) that are important for organizing mass gathering events (MGEs) during a pandemic and to identify the practices suitable for application at future MGEs. Methods This study analyzed data from the Beijing 2022 Olympic Winter Games. The aforementioned analysis was conducted from the viewpoints of overseas stakeholders and Chinese residents. The comprehensive set of countermeasures established to prevent the transmission of the COVID-19 pandemic comprised the bubble strategy, the three-layer testing strategy (pre-departure testing, testing at the airport, and daily screening), the mandatory wearing of N95 masks, and mandatory vaccination. Findings A total of 437 positive cases within the bubble were reported during the Games, of which 60.6% were detected through screening at the airport and 39.4% were detected through routine screening. Nearly, 92.0% of the positive cases were detected within 7 days of arrival in China, and 80.8% of the cases had already been identified before the Opening Ceremony of the Games. Outside the bubble, no Games stakeholders were infected and no spectator contracted COVID-19. The bubble strategy, the three-layer testing strategy, the mandatory wearing of N95 masks, and mandatory vaccination are promising countermeasures to prevent the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during MGEs. Conclusion Public health countermeasures introduced during the Beijing 2022 Olympic Winter Games were proven to be useful. The success in delivering and organizing the Games instills confidence and leaves a public health legacy for future MGEs amid the pandemic of COVID-19 or future emerging infectious diseases.
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Affiliation(s)
- Da Huo
- Beijing Center for Disease Prevention and Control, Beijing, China,Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China,School of Public Health, Capital Medical University, Beijing, China,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Ying Shen
- Beijing Center for Disease Prevention and Control, Beijing, China,Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China,*Correspondence: Ying Shen ✉
| | - Tao Zhou
- Beijing Center for Disease Prevention and Control, Beijing, China,Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China
| | - Tong Yu
- Beijing Center for Disease Prevention and Control, Beijing, China,Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China
| | - Ruoran Lyu
- Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China,Beijing Economic-Technological Development Area Center for Disease Prevention and Control, Beijing, China
| | - Ying Tong
- Beijing Center for Disease Prevention and Control, Beijing, China,Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China
| | - Ting Gao
- Beijing Center for Disease Prevention and Control, Beijing, China,Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Beijing, China,Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing, China
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Alhussaini NWZ, Elshaikh UAM, Hamad NA, Nazzal MA, Abuzayed M, Al-Jayyousi GF. A scoping review of the risk factors and strategies followed for the prevention of COVID-19 and other infectious diseases during sports mass gatherings: Recommendations for future FIFA World Cups. Front Public Health 2023; 10:1078834. [PMID: 36726622 PMCID: PMC9885104 DOI: 10.3389/fpubh.2022.1078834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Objective Sports mass gatherings of people pose particular concerns and place an additional burden on the host countries and the countries of origin of the travelers. It is imperative to identify how countries dealt with various communicable diseases in the context of previous world cups and identify possible advice for protection from outbreaks. Methods A scoping review was employed in this study and a PRISMA extension for scoping reviews was employed to guide the reporting of this study. A systematic search was performed using PubMed, Embase, Web of Science, SCOPUS, SportDiscus, and Google scholar. The search strategy included two main strings viz "communicable disease" AND "sport" AND "setting" as keywords for each string. A total of 34 studies were included in this review. Results Information on risk factors for infectious diseases during FIFA, and recommendations for disease prevention in various stages of the event: pre-event, during, and post-event were charted. These strategies can be achieved with the empowerment of the public by enhancing their social responsibility and the coordination between the healthcare system, the ministry of public health, and other stakeholders. Conclusion The findings will support planning for protection strategies to prevent any outbreak while having the FIFA World Cup or any other sports gatherings. A model was constructed to present the findings and recommendations from this review.
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Affiliation(s)
| | | | - Noor Ahmed Hamad
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maisa Ayman Nazzal
- Department of Infection Control Unit, Ibn Sina Specialized Hospital, West Bank, Palestine
| | - Manal Abuzayed
- Health Promotion Division, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | - Ghadir Fakhri Al-Jayyousi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar,*Correspondence: Ghadir Fakhri Al-Jayyousi ✉
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7
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Tsuzuki S, Asai Y, Ibuka Y, Nakaya T, Ohmagari N, Hens N, Beutels P. Social contact patterns in Japan in the COVID-19 pandemic during and after the Tokyo Olympic Games. J Glob Health 2022; 12:05047. [DOI: 10.7189/jogh.12.05047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Yusuke Asai
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoko Ibuka
- Faculty of Economics, Keio University, Tokyo, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Niel Hens
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Patel SS, Neylan JH, Bavaro K, Chai PR, Goralnick E, Erickson TB. Chemical, biological, radiological, nuclear, and explosives (CBRNEs) preparedness for sporting event mass gatherings: A systematic review of the literature. Am J Disaster Med 2022; 17:57-74. [PMID: 35913184 DOI: 10.5055/ajdm.2022.0420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Sporting events often constitute mass gatherings (MGs) featuring large crowds of spectators and participants. Our objective is to understand the current state of emergency preparedness for sporting events by examining past MG sporting events to evaluate mitigation, preparedness, response, and recovery against chemical, biological, radiological, nuclear, and explosive (CBRNE) events. METHODS In accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was carried out among 10 literature databases. The quality and risk of bias in each reviewed publication was assessed using the Mixed Methods Appraisal Tool. RESULTS A total of 5,597 publications were identified. Of these, 81 papers were selected for full text reads and 25 publications were accepted. The included articles documented sporting events worldwide, ranging from incidents occurring from 1972 to 2020. Cross-cutting themes found in best practices and recommendations were strategic communication, surveillance, planning and preparedness, and training and response. CONCLUSION More evidence-based guidelines are needed to ensure best practices in response and recovery for CBRNE incidents at sporting events. Public health risks as well as implementation barriers and opportunities to prepare for potential CBRNE threats at sporting event MGs require further investigation.
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Affiliation(s)
- Sonny S Patel
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts; Transcultural Conflict and Violence Initiative, Georgia State University, Atlanta, Georgia. ORCID: https://orcid.org/0000-0002-9810-0055
| | - Julian H Neylan
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts
| | - Katerina Bavaro
- Health Studies Program, University College, University of Toronto - St. George, Toronto, Canada
| | - Peter R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
| | - Eric Goralnick
- Ariadne Labs, Brigham and Women's Hospital, Boston, Massachusetts; Harvard T.H. Chan School of Public Health Boston, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Timothy B Erickson
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts; Division of Medical Toxicology, Department of Emergency Medicine, Brigham Health, Harvard Medical School, Boston, Massachusetts
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Guo C, Hu X, Xu C, Zheng X. Association between Olympic Games and children's growth: evidence from China. Br J Sports Med 2022; 56:bjsports-2021-104844. [PMID: 35241433 PMCID: PMC9484364 DOI: 10.1136/bjsports-2021-104844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To estimate the association between the 2008 Beijing Olympic Games (BOG) and growth of children in China. METHODS A total sample of 6 951 children aged 3-10 years were included, among which 3 201 were interviewed in 2014 and 3 750 were interviewed in 2018. The BOG was used as a natural experiment. Exposure to the BOG was established by triple differences measured by age group, survey period and whether child participants were living in BOG areas or not, respectively. Children's growth was assessed by binary variables of stunting, underweight, overweight and obesity. The difference-in-difference-in-differences (DDD) method was used to estimate the association between the BOG and children's growth. RESULTS DDD estimates showed that the BOG was significantly associated with decreased risks of children's underweight (OR 0.12; 95% CI 0.02 to 0.69) and overweight (OR 0.43; 95% CI 0.19 to 0.98) after controlling for multiple covariates in fractional polynomial models. There was significant sex heterogeneity with regard to the association between BOG and obesity, that is, lower odds of obesity (OR 0.24; 95% CI 0.06 to 0.94) were found in female children but not in male children. CONCLUSION The BOG was positively associated with healthier growth of children including decreased risks of both undernutrition and overnutrition. More attention should be given to the improvement of health surveillance and services before and after sporting events so that the active role of such mega-events in the lasting well-being of the public can be determined in more detail.
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Affiliation(s)
- Chao Guo
- Institute of Population Research, Peking University, Beijing, China
- APEC Health Science Academy (HeSAY), Peking University, Beijing, China
| | - Xiyuan Hu
- Institute of Population Research, Peking University, Beijing, China
| | - Chaofan Xu
- Institute of Population Research, Peking University, Beijing, China
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, Beijing, China
- APEC Health Science Academy (HeSAY), Peking University, Beijing, China
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Parasuraman G, Muthappan S, Ponnaiah M, Virumbhi V, Thangaraj JV, Muthuperumal P, Venkatasamy V, Murhekar M. Syndromic surveillance during religious mass gatherings, southern India 2015-2018. Travel Med Infect Dis 2022; 47:102290. [PMID: 35247579 DOI: 10.1016/j.tmaid.2022.102290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/31/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Viduthalai Virumbhi
- Department of Public Health and Preventive Medicine, Government of Tamil Nadu, India
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11
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Easy Access to Antibiotics; Spread of Antimicrobial Resistance and Implementation of One Health Approach in India. J Epidemiol Glob Health 2021; 11:444-452. [PMID: 34734384 PMCID: PMC8477994 DOI: 10.1007/s44197-021-00008-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 09/14/2021] [Indexed: 11/01/2022] Open
Abstract
Antimicrobial resistance (AMR) is a global public health concern because of its fast spread. India, one of the world's top consumer of antibiotics and second most populated country has its unique constraints of social, cultural and economic strata. The continual self-medication, use of antibiotics for the growth promotion in animals, and accumulation of residual antibiotics in the environment challenge the implementation of AMR containment policy. Hence, the present review attempts to delineate the influence of antibiotics abuse on the human, animal and environmental health under the realm of one health. It was based on the literature search using public databases to highlight the rapid surge in the burden of AMR in India affecting various sectors and/or ecosystems in India. It was found that the irrational and overuse of antibiotics in different sectors have led to the emergence of extended antimicrobial resistance wherein the environment acts as a reservoir of antibiotic resistance genes (ARGs); completing the cycle of contamination and recontamination. There are efforts by government policy makers to reduce the burden of AMR in the country to reduce the health risks, through the One Health approach. Parallel efforts in educating healthcare professionals, strict legislation for pharmacies and pharmaceutical companies should be prioritize. At the same time surveillance of newly emerged AMR pathogens, prioritising research focusing on AMR, and awareness camps or programs among the local population is critical while addressing the consequences of spared of AMR in India.
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Khan AA, Sabbagh AY, Ranse J, Molloy MS, Ciottone GR. Mass Gathering Medicine in Soccer Leagues: A Review and Creation of the SALEM Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199973. [PMID: 34639274 PMCID: PMC8508246 DOI: 10.3390/ijerph18199973] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/05/2022]
Abstract
Potential risks for public health incidents, outbreaks, and casualties are inferred at association football events, especially if event organizers have not taken appropriate preventative measures. This review explores the potential risks imposed by mass gathering (MG) football events, with particular emphasis on tools and methodologies to manage the risks of football MG events. Effective planning and implementation of MGs along with the mitigation of risks related to people’s health require special attention to all potential threats, especially in frequent and recurring MG events such as football leagues. The well-being of all participants can be compromised by ignoring a single risk. Healthcare systems should cooperate with all stakeholders and organizations who are involved in MG management and response. Provision of services during MG or a disaster must be performed by trained personnel or entities that have full access to available resources in accessible publicly known locations at the MG event site. Several MG assessment tools were developed worldwide; however, to adapt to the Saudi context, SALEM tool was developed to provide a guide for MG planning and assessment. SALEM assesses the risks of MG events with scores that help to categorize the risk of MG events by offering recommendations for required resources.
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Affiliation(s)
- Anas A. Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh 12372, Saudi Arabia
- Correspondence: ; Tel.: +966-11-806-6590
| | | | - Jamie Ranse
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4215, Australia;
- Department of Emergency Medicine, Gold Coast Health, Gold Coast 4215, Australia
| | - Michael S. Molloy
- University College Dublin School of Medicine and Medical Science, D04 V1W8 Dublin, Ireland;
- Faculty Sports and Exercise Medicine, Royal College of Surgeons in Ireland, RCSI House 121 St. Stephen’s Green, D02 H903 Dublin, Ireland
- Disaster Medicine Fellowship, Beth Israel Deaconess Medical Center, 457 Brookline Ave., Boston, MA 02215, USA
- Wexford General Hospital, Ireland East Hospital Group, Carricklawn, Y35 Y17D Wexford, Ireland
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14
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Annear M, Kidokoro T, Shimizu Y. Existential threats to the Summer Olympic and Paralympic Games? a review of emerging environmental health risks. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:159-166. [PMID: 34981705 DOI: 10.1515/reveh-2020-0141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/22/2020] [Indexed: 06/14/2023]
Abstract
This review highlights two intersecting environmental phenomena that have significantly impacted the Tokyo Summer Olympic and Paralympic Games: infectious disease outbreaks and anthropogenic climate change. Following systematic searches of five databases and the gray literature, 15 studies were identified that addressed infectious disease and climate-related health risks associated with the Summer Games and similar sports mega-events. Over two decades, infectious disease surveillance at the Summer Games has identified low-level threats from vaccine-preventable illnesses and respiratory conditions. However, the COVID-19 pandemic and expansion of vector-borne diseases represent emerging and existential challenges for cities that host mass gathering sports competitions due to the absence of effective vaccines. Ongoing threats from heat injury among athletes and spectators have also been identified at international sports events from Asia to North America due to a confluence of rising Summer temperatures, urban heat island effects and venue crowding. Projections for the Tokyo Games and beyond suggest that heat injury risks are reaching a dangerous tipping point, which will necessitate relocation or mitigation with long-format and endurance events. Without systematic change to its format or staging location, the Summer Games have the potential to drive deleterious health outcomes for athletes, spectators and host communities.
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Affiliation(s)
- Michael Annear
- Faculty of Sport Sciences, Waseda University, 2-7-5 Higashi-Fushimi, Nishitokyo city, Tokyo202-0021, Japan
| | - Tetsuhiro Kidokoro
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Hachioji, Tokyo, Japan
| | - Yasuo Shimizu
- Division of Arts & Sciences, International Christian University, Mitaka, Tokyo, Japan
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15
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Mountjoy M, Moran J, Ahmed H, Bermon S, Bigard X, Doerr D, Lacoste A, Miller S, Weber A, Foster J, Budgett R, Engebretsen L, Burke LM, Gouttebarge V, Grant ME, McCloskey B, Piccininni P, Racinais S, Stuart M, Zideman D. Athlete health and safety at large sporting events: the development of consensus-driven guidelines. Br J Sports Med 2020; 55:191-197. [PMID: 33184113 DOI: 10.1136/bjsports-2020-102771] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 11/04/2022]
Abstract
All sport events have inherent injury and illness risks for participants. Healthcare services for sport events should be planned and delivered to mitigate these risks which is the ethical responsibility of all sport event organisers. The objective of this paper was to develop consensus-driven guidelines describing the basic standards of services necessary to protect athlete health and safety during large sporting events. By using the Knowledge Translation Scheme Framework, a gap in International Federation healthcare programming for sport events was identified. Event healthcare content areas were determined through a narrative review of the scientific literature. Content experts were systematically identified. Following a literature search, an iterative consensus process was undertaken. The outcome document was written by the knowledge translation expert writing group, with the assistance of a focus group consisting of a cohort of International Federation Medical Chairpersons. Athletes were recruited to review and provide comment. The Healthcare Guidelines for International Federation Events document was developed including content-related to (i) pre-event planning (eg, sport medical risk assessment, public health requirements, environmental considerations), (ii) event safety (eg, venue medical services, emergency action plan, emergency transport, safety and security) and (iii) additional considerations (eg, event health research, spectator medical services). We developed a generic standardised template guide to facilitate the planning and delivery of medical services at international sport events. The organisers of medical services should adapt, evaluate and modify this guide to meet the sport-specific local context.
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Affiliation(s)
- Margo Mountjoy
- Bureau-Sport Medicine Liaison, McMaster University Michael G DeGroote School of Medicine, Hamilton, Ontario, Canada .,Medical and Scientific Commission-Games Group-Sport Medicine, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Jane Moran
- Medical and Scientific Commission-Games Group-Sport Medicine, International Olympic Committee, Lausanne, Vaud, Switzerland.,Medical Commission, International Skating Union, Victoria, British Columbia, Canada
| | - Hosny Ahmed
- ADU, International Handball Federation, Basel, Switzerland
| | | | - Xavier Bigard
- Sport Medicine, Union Cycliste Internationale, Aigle, Vaud, Switzerland
| | - Dominik Doerr
- International Weightlifting Federation (IWF), Budapest, Hungary
| | - Alain Lacoste
- Sports Medicine, World Rowing, Lausanne, Vaud, Switzerland
| | - Stuart Miller
- Science & Technical Department, International Tennis Federation, Roehampton, UK
| | | | - Jeremy Foster
- Association of Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Louise M Burke
- Nutrition Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Vincent Gouttebarge
- Mental Health Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Marie-Elaine Grant
- Medical and Scientific Commission Games Group-Physiotherapy, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Brian McCloskey
- Medical and Scientific Commission-Games Group-Public Health, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Paul Piccininni
- Medical and Scientific Commission-Dental, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Sebastien Racinais
- Medical and Scientific Commission-Games Group Sport Science: adverse weather impact, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Mark Stuart
- Medical and Scientific Commission Games Group-Pharmacy, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - David Zideman
- Medical and Scientific Commission-Games Group Anaesthesiologist and Emergency Pre-Hospital Care Consultant, International Olympic Committee, Lausanne, Vaud, Switzerland
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16
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Scerri M, Grech V. WITHDRAWN: Sports and sportsmen as role models - or otherwise - in the COVID-19 era. Early Hum Dev 2020:105254. [PMID: 33221030 DOI: 10.1016/j.earlhumdev.2020.105254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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17
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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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18
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The Impact of Postponing 2020 Tokyo Olympics on the Happiness of O-MO-TE-NA-SHI Workers in Tourism: A Consequence of COVID-19. SUSTAINABILITY 2020. [DOI: 10.3390/su12198168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The 2020 Tokyo Olympics have been postponed due to the novel coronavirus (COVID-19) pandemic. The implications for industries related to the Olympics—tourism, hotels and restaurants, and others—are expected to be affected by reduced demand. Japanese workers in these industries were prepared to offer their hospitality to visitors from around the world. They would be benefited not only by an increase in income but also in offering visitors a taste of Tokyo’s great hospitality if the Olympics had been held in 2020. However, postponement of the sporting event is likely to have a significant impact on their happiness level. We independently collected individual-level panel data from March to April 2020. In the survey, the respondents were asked about their happiness levels by choosing from 11 categories: 1 (very unhappy) and 11 (very happy). They were also asked about expected income changes from 2020 to 2021. Based on this, we examined the effect of postponement on happiness level and expected income change. The sample was divided into sub-samples of areas including and excluding Tokyo. We found that the happiness level of workers in the tourism and restaurant sectors declined drastically after the announcement of the postponement. Only two weeks later, their happiness level did not alter from the pre-announcement level. This tendency was strongly observed in Tokyo and the surrounding prefectures, but not in other prefectures. However, workers engaged in the tourism and restaurant sectors did not predict a decrease in their income even after the postponement. Combined, these findings indicate that loss of extending hospitality, rather than reduction in income, temporarily reduces the happiness level of workers.
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19
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Abstract
PURPOSE OF REVIEW Mass gathering events bring people from across all continents increasing the risk of spread of aerosol transmissible respiratory tract infections. Respiratory tract infections for instance in pilgrims attending the world's largest recurring annual pilgrimage, the Hajj are common. We review recent literature on viral and bacterial infectious diseases with special focus on the Hajj. RECENT FINDINGS The prevalence of bacterial and viral infections continue to increase, because of the acquisition of rhinovirus, coronaviruses (229E, HKU1, OC43), influenza A H1N1, Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus during Hajj. Whilst MERS-CoV continues to circulate in the Middle East, no cases of MERS-CoV have yet been identified in pilgrims during Hajj. SUMMARY Respiratory tract infections are a major cause of morbidity in pilgrims attending mass gathering events. The management of severe respiratory infections should consider investigation and empirical coverage for the most likely agents based on syndromic surveillance data from hosting country and /or other relevant exposure history during events. Pneumococcal and Pertussis vaccines should be recommended for Hajj pilgrims.
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20
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Mann RH, Clift BC, Boykoff J, Bekker S. Athletes as community; athletes in community: covid-19, sporting mega-events and athlete health protection. Br J Sports Med 2020; 54:1071-1072. [PMID: 32303522 PMCID: PMC7497562 DOI: 10.1136/bjsports-2020-102433] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Robert H Mann
- Children's Health and Exercise Research Centre, Department of Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Bryan C Clift
- Centre for Qualitative Research, University of Bath, Bath, UK
| | - Jules Boykoff
- Politics and Government, Pacific University, Forest Grove, Oregon, USA
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21
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McCloskey B, Zumla A, Ippolito G, Blumberg L, Arbon P, Cicero A, Endericks T, Lim PL, Borodina M. Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma. Lancet 2020; 395:1096-1099. [PMID: 32203693 PMCID: PMC7138150 DOI: 10.1016/s0140-6736(20)30681-4] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Brian McCloskey
- Centre on Global Health Security, Chatham House, Royal Institute of International Affairs, London SW1Y 4LE, UK.
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, UK; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases-Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Lucille Blumberg
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Paul Arbon
- Flinders University, Adelaide, SA, Australia
| | - Anita Cicero
- Johns Hopkins Center for Health Security, Baltimore, MD, USA
| | | | - Poh Lian Lim
- National Centre for Infectious Diseases and Tan Tock Seng Hospital, Singapore
| | - Maya Borodina
- Academy of Postgraduate Education, Federal Medical Biological Agency of Russia, Moscow, Russia
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22
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Affiliation(s)
- Daniel Parnell
- University of Liverpool Management School, University of Liverpool, Liverpool, UK
| | - Paul Widdop
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Alex Bond
- Sport Business Group, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Rob Wilson
- Sheffield Business School, Sheffield Hallam University, Sheffield, UK
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23
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Abstract
Syndromic surveillance is a form of surveillance that generates information for public health action by collecting, analysing and interpreting routine health-related data on symptoms and clinical signs reported by patients and clinicians rather than being based on microbiologically or clinically confirmed cases. In England, a suite of national real-time syndromic surveillance systems (SSS) have been developed over the last 20 years, utilising data from a variety of health care settings (a telehealth triage system, general practice and emergency departments). The real-time systems in England have been used for early detection (e.g. seasonal influenza), for situational awareness (e.g. describing the size and demographics of the impact of a heatwave) and for reassurance of lack of impact on population health of mass gatherings (e.g. the London 2012 Olympic and Paralympic Games).We highlight the lessons learnt from running SSS, for nearly two decades, and propose questions and issues still to be addressed. We feel that syndromic surveillance is an example of the use of ‘big data’, but contend that the focus for sustainable and useful systems should be on the added value of such systems and the importance of people working together to maximise the value for the public health of syndromic surveillance services.
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24
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Tavan A, Tafti AD, Nekoie-Moghadam M, Ehrampoush M, Vafaei Nasab MR, Tavangar H, Fallahzadeh H. Risks threatening the health of people participating in mass gatherings: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:209. [PMID: 31807599 PMCID: PMC6852309 DOI: 10.4103/jehp.jehp_214_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 05/14/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Mass gatherings (MGs) are established for different religious, social, political, cultural, and sport motivations. Many risks threaten the participants' health in MGs for different reasons. One duty of health-care system is to identify the risks and manage them to reduce the participants' injuries in MGs. This study aimed to identify and classify the risks threatening the health of participants in MGs and review related articles systematically. SUBJECTS AND METHODS In this study, we investigated electronic databases including Science Direct, PubMed, Ovid, ProQuest, Web of Science, Scopus, and Google Scholar. This systematic review investigated those health articles which studied MGs published after 2000. Keywords that were searched included (Mass gathering OR Crowd) AND (Assessment OR Evaluation) AND (Disaster OR Emergencies) AND (Injuries OR Stamped). The final full text articles were assessed qualitatively by STROBE article assessment checklist, and then the data extracted from the results of the articles were analyzed and reported. RESULTS Initially, a total of 1874 articles were found, qualitative exclusion and inclusion criteria were applied, and finally 29 full-text articles were selected for the analysis. More than forty health-related risks were recognized. In order to better understand the risks and use of the results more efficiently, the risks were classified and reported into the following five domains: environmental risks, individual risks, psychological risks, public health risks, and management risks. CONCLUSION Many risks threaten the health of participants in MGs. Recognizing and managing the risks are considered the primary and basic essentials of health sector for the better management of MGs.
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Affiliation(s)
- Asghar Tavan
- Department of Health in Disasters and Emergencies, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abbasali Dehghani Tafti
- Department of Health in Disasters and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Nekoie-Moghadam
- Department of Health Services Management, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohmmadhasan Ehrampoush
- Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Reza Vafaei Nasab
- Department of Physical Medicine and Rehabilitation, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Tavangar
- Department of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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25
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Ishikawa H, Shimogawara R. Risk Assessment of Dengue Autochthonous Infections in Tokyo during Summer, Especially in the Period of the 2020 Olympic Games. Jpn J Infect Dis 2019; 72:399-406. [PMID: 31366859 DOI: 10.7883/yoken.jjid.2019.094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An outbreak of autochthonous dengue fever occurred in the summer of 2014 in Tokyo, Japan. Numerous participants and spectators from abroad are expected to visit Tokyo in the summer of 2020. This study aims to analyze the risk of autochthonous dengue infections in Tokyo in summer and also assess the additional risk in the Olympiad using a mathematical model. A stochastic transmission model was developed with the cooperation of seasonal factors that greatly influence the transmission cycle of dengue virus, and stochastic simulations were conducted for each scenario provided adequately. This study found that (i) the incidence of dengue autochthonous infections is predicted to occur in a small number of cases; (ii) the local climate greatly influences the scale of dengue autochthonous infections; (iii) the incidence reaches its peak in August and early September; and (iv) the possibility of progressing to dengue outbreak is rare. In the Olympiad to be held in the summer of 2020, an additional risk of dengue autochthonous infections will amount to double compared with that in other years.
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Affiliation(s)
- Hirofumi Ishikawa
- Department of Environmental parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Rieko Shimogawara
- Department of Environmental parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences.,Department of Parasitology, National Institute of Infectious Diseases
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26
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Huot C, Paradis A, Hammond-Collins K, Bélair MA, Villeneuve J, Brousseau N, Goupil-Sormany I, Riffon J. A public health enhanced surveillance system for a mass gathering event. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2019; 45. [PMID: 31355825 PMCID: PMC6615436 DOI: 10.45745/ccdr.v45i78a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health. OBJECTIVE To assess three additional monitoring strategies to detect public health threats during a mass gathering event. INTERVENTION In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues. RESULTS Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period. CONCLUSION The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.
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Affiliation(s)
- C Huot
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC,Correspondence:
| | - A Paradis
- Département de médecine sociale et préventive, Université Laval, Québec, QC
| | - K Hammond-Collins
- Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - MA Bélair
- Centre for Emergency Preparedness and Response, Public Health Agency of Canada, Whitehorse, YK
| | - J Villeneuve
- Institut national de santé publique du Québec, Québec, QC
| | - N Brousseau
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC
| | - I Goupil-Sormany
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC,Département de médecine sociale et préventive, Université Laval, Québec, QC
| | - J Riffon
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC
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27
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A public health enhanced surveillance system for a mass gathering event. ACTA ACUST UNITED AC 2019; 45:212-224. [PMID: 31355825 DOI: 10.14745/ccdr.v45i78a05] [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: 11/08/2022]
Abstract
Background From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health. Objective To assess three additional monitoring strategies to detect public health threats during a mass gathering event. Intervention In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues. Results Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period. Conclusion The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.
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28
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Memish ZA, Steffen R, White P, Dar O, Azhar EI, Sharma A, Zumla A. Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events. Lancet 2019; 393:2073-2084. [PMID: 31106753 PMCID: PMC7159069 DOI: 10.1016/s0140-6736(19)30501-x] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/19/2019] [Accepted: 02/27/2019] [Indexed: 12/14/2022]
Abstract
Mass gathering events are associated with major public health challenges. The 2014 Lancet Series on the new discipline of mass gatherings medicine was launched at the World Health Assembly of Ministers of Health in Geneva in May, 2014. The Series covered the planning and surveillance systems used to monitor public health risks, public health threats, and experiences of health-care providers from mass gathering events in 2012 and 2013. This follow-up Review focuses on the main public health issues arising from planned mass gathering events held between 2013 and 2018. We highlight public health and research data on transmission of infectious diseases and antibiotic-resistant bacteria, mass casualty incidents, and non-communicable diseases, including thermal disorders. In the events discussed in this Review, the combination of a large influx of people, many from countries with outbreak-prone infectious diseases, with a high degree of crowd interactions imposed substantial burdens on host countries' health systems. The detection and transmission of antibiotic-resistant bacteria in pilgrims attending the Kumbh Mela and the Hajj raise concern of possible globalisation from mass-gathering religious events. Priorities for further investments and opportunities for research into prevention, surveillance, and management of these public health issues are discussed.
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Affiliation(s)
- Ziad A Memish
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Infectious Diseases Division, Department of Medicine and Research, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers' Health, University of Zurich, Zurich, Switzerland; Division of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA
| | - Paul White
- Commonwealth of the Northern Mariana Islands, Epidemiology and Laboratory Capacity Program, Public Health & Hospital Emergency Preparedness Program, Commonwealth Health Care Corporation, Saipan, Northern Mariana Islands, USA
| | - Osman Dar
- Public Health England and Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK
| | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Saudi Arabia; Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Avinash Sharma
- National Centre for Microbial Resource, Pune, Maharashtra, India; National Centre for Cell Science, Pune, Maharashtra, India
| | - Alimuddin Zumla
- Division of Infection, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
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29
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Bigouette JP, Owen EC, Greenleaf J, James SL, Strasser NL. Injury Surveillance and Evaluation of Medical Services Utilized During the 2016 Track and Field Olympic Trials. Orthop J Sports Med 2018; 6:2325967118816300. [PMID: 30627590 PMCID: PMC6311600 DOI: 10.1177/2325967118816300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Injury surveillance systems have been implemented at world championships, yet no previous work has determined the burden of injuries during the United States Track and Field Olympic Trials. Additionally, the type of medical service providers utilized throughout the meet has not been reported, leaving it unclear whether optimal staffing needs are being met. Purpose: To describe the incidence of injuries presenting to the medical team at the 2016 US Track and Field Olympic Trials (Eugene, Oregon) by event type and competitor demographics. Study Design: Descriptive epidemiology study. Methods: A retrospective review was performed of all documented injuries and treatments recorded from June 28 through July 10, 2016. Descriptive statistics and the prevalence of newly incurred injuries were calculated for registered athletes and nonathlete (ie, support) staff. The incidence of acute injuries was analyzed for registered athletes, as stratified by athlete sex and event type. Results: A total of 514 individuals were seen during the trials: 89% were athletes and 11% were supporting staff. Physicians treated 71 injuries and 14 illnesses. Of diagnosed injuries, 85% (n = 60) occurred among athletes, with hamstring strains (16.7%, n = 10) being the most prevalent. A mean of 124 medical services (median, 137; interquartile range, 65.5-179.5) were provided each day of the trials. Among medical services, 41.8% were attributed to massage therapists for athletes, while chiropractic services were the most utilized service (47.1%) by the support staff. There was an overall incidence of 59.7 injuries per 1000 registered athletes, with jumpers (109.4 per 1000) and long-distance athletes (90.4 per 1000) being the most commonly seen athletes. Conclusion: Throughout the trials, athletes participating in jumping and long-distance events were the most commonly seen by physicians, creating the potential need for an increase in staffing of physicians during meet periods when these events occur. The provided medical services appeared to follow the number of athletes competing during the trials and the need for recovery treatments after competition. Findings from this study should inform future strategy for staffing and policy development at Olympic Trials and other elite-level track and field events in the United States.
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Affiliation(s)
- John Paul Bigouette
- Slocum Research & Education Foundation, Eugene, Oregon, USA.,School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Erin C Owen
- Slocum Research & Education Foundation, Eugene, Oregon, USA
| | | | - Stanley L James
- Slocum Center for Orthopedics & Sports Medicine, Eugene, Oregon, USA
| | - Nicholas L Strasser
- Slocum Research & Education Foundation, Eugene, Oregon, USA.,Slocum Center for Orthopedics & Sports Medicine, Eugene, Oregon, USA
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30
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Yanagisawa N, Wada K, Spengler JD, Sanchez-Pina R. Health preparedness plan for dengue detection during the 2020 summer Olympic and Paralympic games in Tokyo. PLoS Negl Trop Dis 2018; 12:e0006755. [PMID: 30235211 PMCID: PMC6147396 DOI: 10.1371/journal.pntd.0006755] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/14/2018] [Indexed: 11/29/2022] Open
Abstract
Background Participants in mass gathering events are at risk of acquiring imported and locally endemic infectious diseases. The 2014 dengue outbreak in Tokyo gathered attention since it was the first time in 70 years for Japan to experience an autochthonous transmission. Preparation for emerging infectious threats is essential even in places where these outbreaks have been largely unknown. The aim of this study is to identify strategies for early detection and prevention of dengue infection during the 2020 summer Olympics and Paralympics in Tokyo. Methodology/Principal findings We modified and adapted the failure mode and effect analysis (FMEA) methodology, generally used in industrial manufacturing, to examine the current controls for dengue detection and assessment. Information on existing controls were obtained from publicly available resources. Our analysis revealed that the national infectious disease control system to detect dengue in Japan is robust. However, in the case of large assemblies of international visitors for special events when the spread of communicable and vector-borne diseases increases, there are three main gaps that could be reinforced. First, cyclical training or a certification program on tropical disease management is warranted for physicians, especially those working in non-infectious disease-designated hospitals or clinics. Second, multi-language communication methods need to be strengthened especially in the health and hospitality sector. Third, owners of accommodations should consider incorporating a formal tropical disease-training program for their staff members and have a contingency plan for infectious disease-suspected travelers. Conclusions/Significance Our findings may facilitate physicians and public health officials where new controls would be beneficial for the 2020 summer Olympics and Paralympics. The FMEA framework has the potential to be applied to other infectious diseases, not just dengue. Dengue is a mosquito-borne disease that is most prevalent among the emerging arboviruses. Most patients recover from dengue without complications, but a small portion of cases may progress to severe dengue which carries a high mortality rate if left untreated. In 2014, a dengue outbreak unexpectedly occurred in Tokyo, which was the first time in 70 years for Japan to experience an autochthonous transmission. Thus, preparation for dengue and other emerging infectious threats is essential even in places where these outbreaks have been largely unknown. Tokyo will be hosting the Olympic and Paralympic games in 2020, and interventions are warranted to mitigate the risks. We modified and adapted the failure mode effect analysis (FMEA) methodology to test the vulnerability and resiliency of the current controls. Although the FMEA methodology is generally used in industrial manufacturing, it has the potential to be utilized for health preparedness for other infectious diseases as well. Our analysis identifies three strategies to reinforce early detection of dengue infection and prevent further transmission during the Olympic and Paralympic Games.
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Affiliation(s)
- Naoki Yanagisawa
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Koji Wada
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | - John D. Spengler
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ramon Sanchez-Pina
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
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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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Khan Y, Leung GJ, Belanger P, Gournis E, Buckeridge DL, Liu L, Li Y, Johnson IL. Comparing Twitter data to routine data sources in public health surveillance for the 2015 Pan/Parapan American Games: an ecological study. Canadian Journal of Public Health 2018; 109:419-426. [PMID: 29981081 PMCID: PMC6964588 DOI: 10.17269/s41997-018-0059-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/31/2017] [Indexed: 11/17/2022]
Abstract
Objectives This study examined Twitter for public health surveillance during a mass gathering in Canada with two objectives: to explore the feasibility of acquiring, categorizing and using geolocated Twitter data and to compare Twitter data against other data sources used for Pan Parapan American Games (P/PAG) surveillance. Methods Syndrome definitions were created using keyword categorization to extract posts from Twitter. Categories were developed iteratively for four relevant syndromes: respiratory, gastrointestinal, heat-related illness, and influenza-like illness (ILI). All data sources corresponded to the location of Toronto, Canada. Twitter data were acquired from a publicly available stream representing a 1% random sample of tweets from June 26 to September 10, 2015. Cross-correlation analyses of time series data were conducted between Twitter and comparator surveillance data sources: emergency department visits, telephone helpline calls, laboratory testing positivity rate, reportable disease data, and temperature. Results The frequency of daily tweets that were classified into syndromes was low, with the highest mean number of daily tweets being for ILI and respiratory syndromes (22.0 and 21.6, respectively) and the lowest, for the heat syndrome (4.1). Cross-correlation analyses of Twitter data demonstrated significant correlations for heat syndrome with two data sources: telephone helpline calls (r = 0.4) and temperature data (r = 0.5). Conclusion Using simple syndromes based on keyword classification of geolocated tweets, we found a correlation between tweets and two routine data sources for heat alerts, the only public health event detected during P/PAG. Further research is needed to understand the role for Twitter in surveillance. Electronic supplementary material The online version of this article (10.17269/s41997-018-0059-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yasmin Khan
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario, M5G 1V2, Canada. .,Department of Medicine, University of Toronto, Toronto, Canada. .,University Health Network, Toronto, Canada.
| | - Garvin J Leung
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario, M5G 1V2, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Paul Belanger
- KFL&A Public Health, Kingston, Canada.,Department of Geography and Planning, Queen's University, Kingston, Canada
| | - Effie Gournis
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Toronto Public Health, Toronto, Canada
| | - David L Buckeridge
- Surveillance Lab, McGill Clinical and Health Informatics, Montreal, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Li Liu
- KFL&A Public Health, Kingston, Canada
| | - Ye Li
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario, M5G 1V2, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ian L Johnson
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario, M5G 1V2, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Rattanaumpawan P, Boonyasiri A, Vong S, Thamlikitkul V. Systematic review of electronic surveillance of infectious diseases with emphasis on antimicrobial resistance surveillance in resource-limited settings. Am J Infect Control 2018; 46:139-146. [PMID: 29029814 DOI: 10.1016/j.ajic.2017.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/07/2017] [Accepted: 08/07/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Electronic surveillance of infectious diseases involves rapidly collecting, collating, and analyzing vast amounts of data from interrelated multiple databases. Although many developed countries have invested in electronic surveillance for infectious diseases, the system still presents a challenge for resource-limited health care settings. METHODS We conducted a systematic review by performing a comprehensive literature search on MEDLINE (January 2000-December 2015) to identify studies relevant to electronic surveillance of infectious diseases. Study characteristics and results were extracted and systematically reviewed by 3 infectious disease physicians. RESULTS A total of 110 studies were included. Most surveillance systems were developed and implemented in high-income countries; less than one-quarter were conducted in low-or middle-income countries. Information technologies can be used to facilitate the process of obtaining laboratory, clinical, and pharmacologic data for the surveillance of infectious diseases, including antimicrobial resistance (AMR) infections. These novel systems require greater resources; however, we found that using electronic surveillance systems could result in shorter times to detect targeted infectious diseases and improvement of data collection. CONCLUSIONS This study highlights a lack of resources in areas where an effective, rapid surveillance system is most needed. The availability of information technology for the electronic surveillance of infectious diseases, including AMR infections, will facilitate the prevention and containment of such emerging infectious diseases.
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Affiliation(s)
- Pinyo Rattanaumpawan
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Adhiratha Boonyasiri
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sirenda Vong
- World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Visanu Thamlikitkul
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Yoon PW, Ising AI, Gunn JE. Using Syndromic Surveillance for All-Hazards Public Health Surveillance: Successes, Challenges, and the Future. Public Health Rep 2018; 132:3S-6S. [PMID: 28692397 PMCID: PMC5676514 DOI: 10.1177/0033354917708995] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Paula W Yoon
- 1 Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amy I Ising
- 2 Carolina Center for Health Informatics, Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julia E Gunn
- 3 Communicable Disease Control Division, Infectious Disease Bureau, Boston Public Health Commission, Boston, MA, USA
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35
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Fleischauer AT, Gaines J. Enhancing Surveillance for Mass Gatherings: The Role of Syndromic Surveillance. Public Health Rep 2018; 132:95S-98S. [PMID: 28692398 DOI: 10.1177/0033354917706343] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Aaron T Fleischauer
- 1 Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA.,2 Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Joanna Gaines
- 3 Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
The mass gathering of people is a potential source for developing, propagating, and disseminating infectious diseases on a global scale. Of the illnesses associated with mass gatherings, respiratory tract infections are the most common, the most easily transmitted, and the most likely to be spread widely beyond the site of the meeting by attendees returning home. Many factors contribute to the spread of these infections during mass gatherings, including crowding, the health of the attendees, and the type and location of meetings. The annual Hajj in the Kingdom of Saudi Arabia is the largest recurring single mass gathering in the world. Every year more than 10 million pilgrims attend the annual Hajj and Umrah. Attendees assemble in confined areas for several days. People with a wide range of age, health, susceptibility to illness, and hygiene sophistication come in close contact, creating an enormous public health challenge. Controlling respiratory infections at the Hajj requires surveillance, rapid diagnostic testing, and containment strategies. Although the Hajj is without equal, other mass gatherings can generate similar hazards. The geographic colocalization of the Zika virus epidemic and the 2016 Summer Olympic Games in Brazil is a current example of great concern. The potential of international mass gatherings for local and global calamity calls for greater global attention and research.
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37
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van Dijk A, Dawson E, Moore KM, Belanger P. Risk Assessment During the Pan American and Parapan American Games, Toronto, 2015. Public Health Rep 2017; 132:106S-110S. [PMID: 28692399 PMCID: PMC5676513 DOI: 10.1177/0033354917708356] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
During the summer of 2015, the Pan American and Parapan American Games took place in the Greater Toronto area of Ontario, Canada, bringing together thousands of athletes and spectators from around the world. The Acute Care Enhanced Surveillance (ACES) system-a syndromic surveillance system that captures comprehensive hospital visit triage information from acute care hospitals across Ontario-monitored distinct syndromes throughout the games. We describe the creation and use of a risk assessment tool to evaluate alerts produced by ACES during this period. During the games, ACES generated 1420 alerts, 4 of which were considered a moderate risk and were communicated to surveillance partners for further action. The risk assessment tool was useful for public health professionals responsible for surveillance activities during the games. Next steps include integrating the tool within the ACES system.
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Affiliation(s)
- Adam van Dijk
- 1 Knowledge Management Division, Kingston, Frontenac and Lennox & Addington Public Health, Kingston, ON, Canada
| | - Emily Dawson
- 1 Knowledge Management Division, Kingston, Frontenac and Lennox & Addington Public Health, Kingston, ON, Canada
| | - Kieran Michael Moore
- 1 Knowledge Management Division, Kingston, Frontenac and Lennox & Addington Public Health, Kingston, ON, Canada
| | - Paul Belanger
- 1 Knowledge Management Division, Kingston, Frontenac and Lennox & Addington Public Health, Kingston, ON, Canada
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38
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Kajita E, Luarca MZ, Wu H, Hwang B, Mascola L. Harnessing Syndromic Surveillance Emergency Department Data to Monitor Health Impacts During the 2015 Special Olympics World Games. Public Health Rep 2017; 132:99S-105S. [PMID: 28692391 DOI: 10.1177/0033354917706956] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Mass gatherings that attract a large international presence may cause or amplify point-source outbreaks of emerging infectious disease. The Los Angeles County Department of Public Health customized its syndromic surveillance system to detect increased syndrome-specific utilization of emergency departments (EDs) and other medical encounters coincident to the 2015 Special Olympics World Games. MATERIALS AND METHODS We queried live databases containing data on ED visits, California Poison Control System calls, and Los Angeles County coroner-investigated deaths for increases in daily counts from July 19 to August 6, 2015. We chose syndrome categories based on the potential for disease outbreaks common to international travel and dormitory settings, morbidity amplified by high temperatures, and bioterrorism threats inherent to mass gatherings. We performed line-list reviews and trend analyses of total, syndrome-specific, and region-specific daily counts, using cumulative sum-based signals. We also piloted a novel strategy of requesting that ED registrars proactively tag Special Olympics attendees in chief complaint data fields. RESULTS The syndromic surveillance system showed that the 2015 Special Olympics did not generate large-scale acute morbidities leading to detectable stress on local EDs. We recruited 10 hospitals for proactive patient tagging, from which 16 Special Olympics attendees were detected; these patients reported various symptoms, such as injury, vomiting, and syncope. PRACTICE IMPLICATIONS As an enhancement to traditional syndromic surveillance, proactive patient tagging can illuminate potential epidemiologic links among patients in challenging syndromic surveillance applications, such as mass gatherings. Syndromic surveillance has the potential to enhance ED patient polling and reporting of exposure, symptom, and other epidemiologic case definition criteria to public health agencies in near-real time.
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Affiliation(s)
- Emily Kajita
- 1 Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Monica Z Luarca
- 1 Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Han Wu
- 1 Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Bessie Hwang
- 1 Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Laurene Mascola
- 1 Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
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A retrospective analysis of hypertension screening at a mass gathering in India: implications for non-communicable disease control strategies. J Hum Hypertens 2017; 31:750-753. [PMID: 28726795 DOI: 10.1038/jhh.2017.54] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 06/08/2017] [Accepted: 06/14/2017] [Indexed: 01/25/2023]
Abstract
Cardiovascular disease is the leading case of mortality from non-communicable diseases (NCD) in India. The government's National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke seeks to increase capacity building, screening, referral and management of NCDs across India, and includes community-based outreach and screening programmes. The government in India routinely provides basic care at religious mass gatherings. However, in 2015, at the Kumbh Mela in Nashik and Trimbakeshwar, the state government extended its services to include a hypertension screening programme. We examine here the value and implications of such opportunistic screening at mass gatherings. At the Kumbh, 5760 persons voluntarily opted for hypertension screening, and received a single blood pressure measurement. In all, 1783 (33.6%) screened positive, of whom, 1580 were previously unaware of their diagnosis. Of the 303 that had previously known hypertension, 240 (79%) were prescribed medications, and 160 were compliant (that is, 52.8% under treatment). Fifty-five (18%) had normal blood pressure readings (BP under control). The data also demonstrated higher prevalence (39%) of hypertension among tobacco users compared to non-users (28%) (P<0.001). Poor recording of phone numbers (0.01%) precluded any phone-based follow-up. The low rates of hypertension awareness, treatment and control underscore the ongoing challenge of both hypertension screening and management in India.
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40
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Abstract
Background Public health surveillance for previous Olympic and Paralympic Games have been described in the literature, but surveillance for regional, multisport events on a smaller scale have rarely been explored. Objective To describe the public health surveillance planning, implementation, results, and lessons learned from the 2015 Pan/Parapan American Games in Toronto, Ontario, Canada. Intervention Public health surveillance planning for the Games began two years in advance and involved local, provincial and federal partners, primarily focusing on infectious disease. From June to August, 2015, enhanced public health surveillance was conducted to support situational awareness and to facilitate the detection of infectious diseases and outbreaks, environmental health hazards and impacts and other major health events. Outcomes No major public health incidents occurred that were associated with or a result of hosting the Games. There were two cases of reportable infectious diseases associated with the Games, and 18 public health investigations involving Games-accredited individuals (six related to vaccine-preventable diseases and 12 related to gastrointestinal illnesses or food/water safety violations). Enhanced communication mechanisms, rather than routine and syndromic surveillance systems, were the primary sources of initial notification to surveillance partners on investigations. Conclusion Working with its partners, Ontario created a robust public health surveillance system for the 2015 Pan/Parapan American Games. Lessons learned, as well as the relationships and capacity developed through this experience, will be applied towards public health surveillance planning for future events.
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McCloskey B, Endericks T. The rise of Zika infection and microcephaly: what can we learn from a public health emergency? Public Health 2017. [PMID: 28651111 PMCID: PMC7118743 DOI: 10.1016/j.puhe.2017.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives To consider why Zika was declared a Public Health Emergency of International Concern (PHEIC), why it stopped being one and what we can learn from this for the future. Study design This paper reviews the sequence of events and evidence base for the decision to declare Zika a PHEIC, the global response to this, the challenges in maintaining an evidence-based approach to outbreak response and identifies learning outcomes. Methods Evidence review, all published articles in reputable UK and international journals were identified. Results The association between Zika virus infection and congenital malformations including microcephaly became a PHEIC on 1st February 2016 and was declared to be no longer an emergency in November 2016. This shaped the global response led by WHO in the first global emergency since Ebola in West Africa. Conclusion The response to Zika highlights important issues and lessons for future outbreaks that might pose an international risk. Particular challenges arose in trying to maintain an evidence-based approach to public risk communication when the evidence is unclear or still evolving. The Zika incident also demonstrates the importance of public health practitioners and agencies understanding the political context in which outbreaks must be managed and understanding the competing factors that shape the political response. Declaring Zika a public health emergency was based on the association with microcephaly, not on the clinical illness. Maintaining an evidence-based approach to public communication when the evidence is evolving is challenging. Preplanning for significant international outbreaks had not considered infections that cause congenital abnormalities. Sexual transmission should be considered as possible in emerging infections. All outbreaks have a political context and public health practitioners need to understand and respect this context.
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Affiliation(s)
- B McCloskey
- Global Public Health, Public Health England, UK.
| | - T Endericks
- WHO Collaborating Centre on Mass Gatherings and Global Health Security, Global Public Health, Public Health England, UK
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42
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Alotaibi BM, Yezli S, Bin Saeed AAA, Turkestani A, Alawam AH, Bieh KL. Strengthening health security at the Hajj mass gatherings: characteristics of the infectious diseases surveillance systems operational during the 2015 Hajj. J Travel Med 2017; 24:3053462. [PMID: 28355612 PMCID: PMC7107526 DOI: 10.1093/jtm/taw087] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hajj is one of the largest and the most ethnically and culturally diverse mass gatherings worldwide. The use of appropriate surveillance systems ensures timely information management for effective planning and response to infectious diseases threats during the pilgrimage. The literature describes infectious diseases prevention and control strategies for Hajj but with limited information on the operations and characteristics of the existing Hajj infectious diseases surveillance systems. METHOD We reviewed documents, including guidelines and reports from the Saudi Ministry of Health's database, to describe the characteristics of the infectious diseases surveillance systems that were operational during the 2015 Hajj, highlighting best practices and gaps and proposing strategies for strengthening and improvement. Using Pubmed and Embase online search engines and a combination of search terms including, 'mass gatherings' 'Olympics' 'surveillance' 'Hajj' 'health security', we explored the existing literature and highlighted some lessons learnt from other international mass gatherings. RESULTS A regular indicator-based infectious disease surveillance system generates routine reports from health facilities within the Kingdom to the regional and central public health directorates all year round. During Hajj, enhanced indicator-based notifiable diseases surveillance systems complement the existing surveillance tool to ensure timely reporting of event information for appropriate action by public health officials. CONCLUSION There is need to integrate the existing Hajj surveillance data management systems and to implement syndromic surveillance as an early warning system for infectious disease control during Hajj. International engagement is important to strengthen Hajj infectious diseases surveillance and to prevent disease transmission and globalization of infectious agents which could undermine global health security.
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Affiliation(s)
- Badriah M Alotaibi
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Saber Yezli
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdul-Aziz A Bin Saeed
- Public Health Deputyship, Ministry of Health, Riyadh, Saudi Arabia.,Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Amnah H Alawam
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Kingsley L Bieh
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia
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Zumla A, Alagaili AN, Cotten M, Azhar EI. Infectious diseases epidemic threats and mass gatherings: refocusing global attention on the continuing spread of the Middle East Respiratory syndrome coronavirus (MERS-CoV). BMC Med 2016; 14:132. [PMID: 27604081 PMCID: PMC5015245 DOI: 10.1186/s12916-016-0686-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 09/06/2016] [Indexed: 01/09/2023] Open
Abstract
Media and World Health Organization (WHO) attention on Zika virus transmission at the 2016 Rio Olympic Games and the 2015 Ebola virus outbreak in West Africa diverted the attention of global public health authorities from other lethal infectious diseases with epidemic potential. Mass gatherings such as the annual Hajj pilgrimage hosted by Kingdom of Saudi Arabia attract huge crowds from all continents, creating high-risk conditions for the rapid global spread of infectious diseases. The highly lethal Middle Eastern respiratory syndrome coronavirus (MERS-CoV) remains in the WHO list of top emerging diseases likely to cause major epidemics. The 2015 MERS-CoV outbreak in South Korea, in which 184 MERS cases including 33 deaths occurred in 2 months, that was imported from the Middle East by a South Korean businessman was a wake-up call for the global community to refocus attention on MERS-CoV and other emerging and re-emerging infectious diseases with epidemic potential. The international donor community and Middle Eastern countries should make available resources for, and make a serious commitment to, taking forward a "One Health" global network for proactive surveillance, rapid detection, and prevention of MERS-CoV and other epidemic infectious diseases threats.
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Affiliation(s)
- Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK. .,NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.
| | - Abdulaziz N Alagaili
- KSU Mammals Research Chair, Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Matthew Cotten
- Viroscience Department, Erasmus Medical Center, Rotterdam, Netherlands
| | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia.,Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Epidemiology of Sexually Transmitted Infections in Visitors for the London 2012 Olympic Games: A Review of Attendees at Sexual Health Services. Sex Transm Dis 2016; 42:710-6. [PMID: 26562702 DOI: 10.1097/olq.0000000000000370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mass gatherings and large sporting events, such as the Olympics, may potentially pose a risk of increased sexually transmitted infection (STI) transmission and increase burden on local STI services. The objectives of this analysis were to assess whether the STI profile of Olympic visitors differed from that of the local STI clinic population and to investigate what impact these visitors had on local STI services. METHODS Self-administered questionnaires (completed by 29,292 patients) were used to determine the visitor status of patients attending 20 STI clinics, between July 20, 2012, and September 16, 2012, in the host cities, London and Weymouth. Using routine surveillance data from the Genitourinary Medicine Clinic Activity Dataset version 2, Olympic visitors were compared with usual attendees (local residents and non-Olympic visitors) in terms of their demographic characteristics, services utilized, and STIs diagnosed using univariate and multivariate methods. RESULTS Compared with usual attendees, Olympic visitors were more likely to be heterosexual males (56.0% vs. 34.9%, P = 0.001), aged between 15 and 24 years of age (47.1% vs. 34.0%, P = 0.001), of white ethnicity (81.9% vs. 66.4%, P = 0.001), and born in Australasia, Asia, North America, or South America (18.8% vs. 12.0%, P = 0.006). Olympic visitors constituted 1% of new clinic attendances and were less likely to be diagnosed as having a new STI (adjusted odds ratio, 0.69; 95% confidence interval, 0.48-0.98; P = 0.040). CONCLUSIONS In this first multisite study to examine the effect of Olympic visitors on local sexual health services, the 2012 Olympic Games was found to have minimal impact. This suggests that a "business as usual" approach would have been sufficient.
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Rainey JJ, Phelps T, Shi J. Mass Gatherings and Respiratory Disease Outbreaks in the United States - Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System. PLoS One 2016; 11:e0160378. [PMID: 27536770 PMCID: PMC4990208 DOI: 10.1371/journal.pone.0160378] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/18/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Because mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings during a moderate or severe pandemic. Despite these recommendations, limited empirical information exists on the frequency and characteristics of mass gathering-related respiratory disease outbreaks occurring in the United States. METHODS We conducted a systematic literature review to identify articles about mass gathering-related respiratory disease outbreaks occurring in the United States from 2005 to 2014. A standard form was used to abstract information from relevant articles identified from six medical, behavioral and social science literature databases. We also analyzed data from the National Outbreaks Reporting System (NORS), maintained by the Centers for Disease Control and Prevention since 2009, to estimate the frequency of mass gathering-related respiratory disease outbreaks reported to the system. RESULTS We identified 21 published articles describing 72 mass gathering-related respiratory disease outbreaks. Of these 72, 40 (56%) were associated with agriculture fairs and Influenza A H3N2v following probable swine exposure, and 25 (35%) with youth summer camps and pandemic Influenza A H1N1. Outbreaks of measles (n = 1) and mumps (n = 2) were linked to the international importation of disease. Between 2009 and 2013, 1,114 outbreaks were reported to NORS, including 96 respiratory disease outbreaks due to Legionella. None of these legionellosis outbreaks was linked to a mass gathering according to available data. CONCLUSION Mass gathering-related respiratory disease outbreaks may be uncommon in the United States, but have been reported from fairs (zoonotic transmission) as well as at camps where participants have close social contact in communal housing. International importation can also be a contributing factor. NORS collects information on certain respiratory diseases and could serve as a platform to monitor mass gathering-related respiratory outbreaks in the future.
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Affiliation(s)
- Jeanette J. Rainey
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Tiffani Phelps
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Jianrong Shi
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Blumberg L, Regmi J, Endricks T, McCloskey B, Petersen E, Zumla A, Barbeschi M. Hosting of mass gathering sporting events during the 2013-2016 Ebola virus outbreak in West Africa: experience from three African countries. Int J Infect Dis 2016; 47:38-41. [PMID: 27321960 PMCID: PMC7110551 DOI: 10.1016/j.ijid.2016.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/08/2016] [Indexed: 11/29/2022] Open
Abstract
Mass gatherings at sporting events attract millions of international and national host-country travellers, who may put themselves at risk of acquiring local endemic infectious diseases. The 2013–2016 Ebola virus disease (EVD) outbreak in West Africa that resulted in over 28 637 cases and 11 315 deaths required that countries holding these events put in place public health programmes for enhanced surveillance and specific response plans for any suspected cases of EVD. Three major sports events were held in Africa during the EVD outbreak, attended by athletes from numerous African countries including Liberia, Sierra Leone, and Guinea, the three countries most affected by EVD: the African Youth Games (Botswana), Africa Cup of Nations (Equatorial Guinea), and All-Africa Games (Republic of Congo). A large range of infectious diseases other than EVD were considered with respect to the differential diagnosis of acute febrile illnesses and for the provision of laboratory diagnostics and treatment options. The experience from these three mass gathering events during the Ebola epidemic illustrates that these events can be held safely provided that countries put measures in place for enhanced surveillance and response systems for communicable diseases.
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Affiliation(s)
- Lucille Blumberg
- National Institute for Communicable Diseases, Division of Public Health Surveillance and Response, 1 Modderfontein Rd, Sandringham, Johannesburg, 2192, South Africa.
| | - Jetri Regmi
- World Health Organization WHO/HSE/GCR, Geneva, Switzerland
| | - Tina Endricks
- Global Health Department, Public Health England, London, UK
| | | | - Eskild Petersen
- Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark; The Royal Hospital, Muscat, Sultanate of Oman
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
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Shafi S, Dar O, Khan M, Khan M, Azhar EI, McCloskey B, Zumla A, Petersen E. The annual Hajj pilgrimage-minimizing the risk of ill health in pilgrims from Europe and opportunity for driving the best prevention and health promotion guidelines. Int J Infect Dis 2016; 47:79-82. [PMID: 27343984 PMCID: PMC7110525 DOI: 10.1016/j.ijid.2016.06.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/08/2016] [Indexed: 01/08/2023] Open
Abstract
Mass gatherings at religious events can pose major public health challenges, particularly the transmission of infectious diseases. Every year the Kingdom of Saudi Arabia (KSA) hosts the Hajj pilgrimage, the largest gathering held on an annual basis where over 2 million people come to KSA from over 180 countries. Living together in crowded conditions exposes the pilgrims and the local population to a range infectious diseases. Respiratory and gastrointestinal tract bacterial and viral infections can spread rapidly and affect attendees of mass gatherings. Lethal infectious disease outbreaks were common during Hajj in the 19th and 20th centuries although they have now been controlled to a great extent by the huge investments made by the KSA into public health prevention and surveillance programs. The KSA provides regular updated Hajj travel advice and health regulations through international public health agencies such as the WHO, Public Health England, the Centers for Disease Control and Prevention, and Hajj travel agencies. During the Hajj, an additional 25 000 health workers are deployed; there are eight hospitals in Makkah and Mina complete with state-of-the-art surgical wards and intensive care units made specifically available for pilgrims. All medical facilities offer high quality of care, and services are offered free to Hajj pilgrims to ensure the risks of ill health to all pilgrims and KSA residents are minimal. A summary of the key health issues that arise in pilgrims from Europe during Hajj and of the KSA Hajj guidelines, together with other factors that may play a role in reducing the risks to pilgrims and to wider global health security, is provided herein.
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Affiliation(s)
- Shuja Shafi
- Muslim Council of Great Britain, London, UK.
| | - Osman Dar
- Public Health England, London, UK; Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK
| | - Mishal Khan
- London School of Hygiene and Tropical Medicine, London, UK; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Eskild Petersen
- Institute of Clinical Medicine, University of Aarhus, Denmark; The Royal Hospital, Muscat, Oman
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Aitsi-Selmi A, Murray V, Heymann D, McCloskey B, Azhar EI, Petersen E, Zumla A, Dar O. Reducing risks to health and wellbeing at mass gatherings: the role of the Sendai Framework for Disaster Risk Reduction. Int J Infect Dis 2016; 47:101-4. [PMID: 27062983 PMCID: PMC7110506 DOI: 10.1016/j.ijid.2016.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 12/05/2022] Open
Abstract
Reducing the health risks of mass gatherings and seizing the opportunities for health improvement that mass gatherings may offer requires a broader approach to the underlying determinants of risk similar to the comprehensive social determinants of health approach. One of the largest regular mass gatherings in the world is the Hajj. It is the annual mass gathering of over two million Muslims from all over the world and presents challenges to the authorities in Saudi Arabia. The battle against the spread of travel-related infections and other risks facilitated by globalization that arise from mass gatherings is a shared responsibility between different countries, sectors, and disciplines that can help to reduce risk. The Sendai Framework offers a unique opportunity to move beyond simply responding to emergencies to a more comprehensive, prevention-based approach to mass gathering management through the use of science and technical capabilities. It puts the protection of people's health, lives, and livelihoods at its centre.
Mass gatherings of people at religious pilgrimages and sporting events are linked to numerous health hazards, including the transmission of infectious diseases, physical injuries, and an impact on local and global health systems and services. As with other forms of disaster, mass gathering-related disasters are the product of the management of different hazards, levels of exposure, and vulnerability of the population and environment, and require comprehensive risk management that looks beyond single hazards and response. Incorporating an all-hazard, prevention-driven, evidence-based approach that is multisectoral and multidisciplinary is strongly advocated by the Sendai Framework for Disaster Risk Reduction 2015–2030. This paper reviews some of the broader impacts of mass gatherings, the opportunity for concerted action across policy sectors and scientific disciplines offered by the year 2015 (including through the Sendai Framework), and the elements of a 21st century approach to mass gatherings.
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Affiliation(s)
- Amina Aitsi-Selmi
- Public Health England, 133-155 Waterloo Road, London, SE1 8UG, England, UK; Epidemiology and Public Health Department, University College London, London, UK
| | - Virginia Murray
- Public Health England, 133-155 Waterloo Road, London, SE1 8UG, England, UK; UNISDR Scientific and Technical Advisory Group, Geneva, Switzerland
| | - David Heymann
- Public Health England, 133-155 Waterloo Road, London, SE1 8UG, England, UK; Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK
| | - Brian McCloskey
- Public Health England, 133-155 Waterloo Road, London, SE1 8UG, England, UK
| | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eskild Petersen
- The Royal Hospital, Muscat, Oman; Aarhus University, Aarhus, Denmark
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre (AZ), UCL Hospitals NHS Foundation Trust, London, UK
| | - Osman Dar
- Public Health England, 133-155 Waterloo Road, London, SE1 8UG, England, UK; Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK.
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Gautret P, Steffen R. Communicable diseases as health risks at mass gatherings other than Hajj: what is the evidence? Int J Infect Dis 2016; 47:46-52. [PMID: 26987476 DOI: 10.1016/j.ijid.2016.03.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/07/2016] [Accepted: 03/09/2016] [Indexed: 01/06/2023] Open
Abstract
Mass gatherings are characterized by the concentration of people temporally and spatially, and may lead to the emergence of infectious diseases due to enhanced transmission between attendees. This is well-demonstrated in the context of the Hajj and Umrah pilgrimages in Saudi Arabia. The goal of this review was to present the available evidence on outbreaks associated with a variety of pathogens, or also the lack thereof, as assessed by thorough surveillance at any mass gatherings with the exception of those in Saudi Arabia. A systematic search for relevant articles in the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixty-eight studies were identified. Although outbreaks have not been reported frequently in or after mass gatherings outside the Hajj and Umrah pilgrimages, they have sometimes occurred at Muslim, Christian, and Hindu religious events, at sports events, and at large-scale open air festivals. In this review it was found that the most common outbreaks at these mass gatherings involved vaccine preventable diseases, mainly measles and influenza, but also mumps and hepatitis A. Meningococcal disease has rarely been recorded. Additionally it was found that the transmission of various communicable diseases that may not be prevented by vaccination has been recorded in association with mass gatherings. These were mainly gastrointestinal infections, caused by a variety of pathogens. It was also noted that some outbreaks occurring at mass gatherings have resulted in the international spread of communicable diseases.
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Affiliation(s)
- Philippe Gautret
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, F-13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, World Health Organization Collaborating Centre for Traveller's Health, University of Zurich, Zurich, Switzerland
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National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014. Disaster Med Public Health Prep 2016; 10:562-9. [PMID: 26883318 DOI: 10.1017/dmp.2015.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). METHODS We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting data with all ED visits in all 50 states and Washington, DC. RESULTS Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. CONCLUSIONS NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. (Disaster Med Public Health Preparedness. 2016;10:562-569).
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