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McCloskey B, Saito T, Shimada S, Ikenoue C, Endericks T, Mullen L, Mota P, Kumar CK, Laxminarayan R, Budgett R, Heymann D, Zumla A. The Tokyo 2020 and Beijing 2022 Olympic Games held during the COVID-19 pandemic: planning, outcomes, and lessons learnt. Lancet 2024; 403:493-502. [PMID: 38244561 DOI: 10.1016/s0140-6736(23)02635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 01/22/2024]
Abstract
The COVID-19 pandemic profoundly affected all mass gatherings for sporting and religious events, causing cancellation, postponement, or downsizing. On March 24, 2020, the Japanese Government, the Tokyo Organising Committee of the Olympic and Paralympic Games, and the International Olympic Committee decided to postpone the Tokyo 2020 Olympic and Paralympic Games until the summer of 2021. With the emergence of SARS-CoV-2, the potential creation of a superspreading event that would overwhelm the Tokyo health system was perceived as a risk. Even with a delayed start date, an extensive scale of resources, planning, risk assessment, communication, and SARS-CoV-2 testing were required for the Games to be held during the COVID-19 pandemic. The effectiveness of various mitigation and control measures, including the availability of vaccines and the expansion of effective testing options, allowed event organisers and the Japanese Government to successfully host the rescheduled 2020 Tokyo Olympic Games from July 23 to Aug 8, 2021 with robust safety plans in place. In February and March, 2022, Beijing hosted the 2022 Winter Olympic Games as scheduled, built on the lessons learnt from the Tokyo Games, and developed specific COVID-19 countermeasure plans in the context of China's national framework for the plan called Zero COVID. Results from the testing programmes at both the Tokyo and Beijing Games show that the measures put in place were effective at preventing the spread of COVID-19 within the Games, and ensured that neither event became a COVID-19-spreading event. The extensive experience from the Tokyo and Beijing Olympic Games highlights that it is possible to organise mass gatherings during a pandemic, provided that appropriate risk assessment, risk mitigation, and risk communication arrangements are in place, leaving legacies for future mass gatherings, public health, epidemic preparedness, and wider pandemic response.
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Affiliation(s)
- Brian McCloskey
- Global Health Programme, Chatham House, Royal Institute of International Affairs, London, UK; Epidemiology of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Tomoya Saito
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satoshi Shimada
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan; Infectious Diseases Control Centre, The Tokyo 2020 Organising Committee of the Olympic and Paralympic Games, Tokyo, Japan
| | - Chiaki Ikenoue
- Infectious Diseases Control Centre, The Tokyo 2020 Organising Committee of the Olympic and Paralympic Games, Tokyo, Japan; Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tina Endericks
- Department of Global Public Health, UK Health Security Agency, London, UK
| | - Lucia Mullen
- Johns Hopkins Center for Health Security, Baltimore, MD, USA; Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Epidemiology of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Pau Mota
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | | | | | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - David Heymann
- Epidemiology of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals National Health Service Foundation Trust, London, UK
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Azhar EI, Velavan TP, Rungsung I, Traore T, Hui DS, McCloskey B, El-Kafrawy SA, Zumla A. Middle East respiratory syndrome coronavirus-a 10-year (2012-2022) global analysis of human and camel infections, genomic sequences, lineages, and geographical origins. Int J Infect Dis 2023; 131:87-94. [PMID: 36996998 PMCID: PMC10050196 DOI: 10.1016/j.ijid.2023.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/19/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES The World Health Organization priority zoonotic pathogen Middle East respiratory syndrome (MERS) coronavirus (CoV) has a high case fatality rate in humans and circulates in camels worldwide. METHODS We performed a global analysis of human and camel MERS-CoV infections, epidemiology, genomic sequences, clades, lineages, and geographical origins for the period January 1, 2012 to August 3, 2022. MERS-CoV Surface gene sequences (4061 bp) were extracted from GenBank, and a phylogenetic maximum likelihood tree was constructed. RESULTS As of August 2022, 2591 human MERS cases from 26 countries were reported to the World Health Organization (Saudi Arabia, 2184 cases, including 813 deaths [case fatality rate: 37.2%]) Although declining in numbers, MERS cases continue to be reported from the Middle East. A total of 728 MERS-CoV genomes were identified (the largest numbers were from Saudi Arabia [222: human = 146, camels = 76] and the United Arab Emirates [176: human = 21, camels = 155]). A total of 501 'S'-gene sequences were used for phylogenetic tree construction (camels [n = 264], humans [n = 226], bats [n = 8], other [n=3]). Three MERS-CoV clades were identified: clade B, which is the largest, followed by clade A and clade C. Of the 462 clade B lineages, lineage 5 was predominant (n = 177). CONCLUSION MERS-CoV remains a threat to global health security. MERS-CoV variants continue circulating in humans and camels. The recombination rates indicate co-infections with different MERS-CoV lineages. Proactive surveillance of MERS-CoV infections and variants of concern in camels and humans worldwide, and development of a MERS vaccine, are essential for epidemic preparedness.
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Affiliation(s)
- Esam I Azhar
- Special Infectious Agents Unit Biosafety Level-3, King Fahd Medical Research Center and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Ikrormi Rungsung
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Tieble Traore
- Emergency Preparedness and Response Program, World Health Organization Regional Office for Africa, Dakar Hub, Senegal
| | - David S Hui
- Department of Medicine and Therapeutics, Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Brian McCloskey
- Global Health Program, Chatham House, Royal Institute of International Affairs, London, United Kingdom
| | - Sherif A El-Kafrawy
- Special Infectious Agents Unit Biosafety Level-3, King Fahd Medical Research Center and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, United Kingdom; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom
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Azhar EI, Hui DS, McCloskey B, El-Kafrawy SA, Sharma A, Maeurer M, Lee SS, Zumla A. The Qatar FIFA World Cup 2022 and camel pageant championships increase risk of MERS-CoV transmission and global spread. Lancet Glob Health 2023; 11:e189-e190. [PMID: 36525983 DOI: 10.1016/s2214-109x(22)00543-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Esam I Azhar
- King Fahd Medical Research Center and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21362, Saudi Arabia.
| | - David S Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Brian McCloskey
- Global Health Program, Royal Institute of International Affairs, London, UK
| | - Sherif A El-Kafrawy
- King Fahd Medical Research Center and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21362, Saudi Arabia
| | - Avinash Sharma
- Department of Biotechnology, National Centre for Cell Science, Pune, India
| | - Markus Maeurer
- Immunotherapy Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal; I Medical Clinic, University of Mainz, Mainz, Germany
| | - Shui-Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London Royal Free Campus, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
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Mountjoy M, McCloskey B, Bahr R, Hull JH, Kemp J, Thornton JS, Patricios J. Hosting international sporting events during the COVID-19 pandemic: lessons learnt and looking forward. Br J Sports Med 2023; 57:3-4. [PMID: 35985809 PMCID: PMC9811077 DOI: 10.1136/bjsports-2022-106096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada,International Olympic Committee Games Group, Lausanne, Switzerland
| | - B McCloskey
- International Olympic Committee Games Group, Lausanne, Switzerland,Chatam House, Senior Consulting Fellow Global Health Programme, London, UK
| | - R Bahr
- International Olympic Committee Games Group, Lausanne, Switzerland,Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - James H Hull
- Institute of Sport, Exercise and Health (ISEH), Division of Surgery, UCL, London, UK
| | - Joanne Kemp
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Jane S Thornton
- Western Centre for Public Health and Family Medicine, University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Jon Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
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Sharma A, McCloskey B, Hui DS, Rambia A, Zumla A, Traore T, Shafi S, El-Kafrawy SA, Azhar EI, Zumla A, Rodriguez-Morales AJ. Global mass gathering events and deaths due to crowd surge, stampedes, crush and physical injuries - Lessons from the Seoul Halloween and other disasters. Travel Med Infect Dis 2022; 52:102524. [PMID: 36516965 DOI: 10.1016/j.tmaid.2022.102524] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Affiliation(s)
| | - Brian McCloskey
- Global Health Program, Chatham House, Royal Institute of International Affairs, London, UK
| | - David S Hui
- Department of Medicine & Therapeutics and Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China
| | | | - Adam Zumla
- Accident and Emergency Department, Royal Albert Edward Infirmary, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom
| | - Tieble Traore
- Emergency Preparedness and Response Programme, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Shuja Shafi
- Mass Gatherings and Global Health Network, London, UK
| | - Sherif A El-Kafrawy
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Esam I Azhar
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London; and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas - Institución Universitaria Vision de Las Americas, Pereira, Risaralda, Colombia; Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, P.O. Box 36, Lebanon.
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6
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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7
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Adami PE, Cianca J, McCloskey B, Derman W, Steinacker JM, O'Connor F, Migliorini S, Budgett R, Yamasawa F, Lereim I, Bigard X, Troyanos C, Garrandes F, Bermon S. Infectious Diseases Outbreak Management Tool for endurance mass participation sporting events: an international effort to counteract the COVID-19 spread in the endurance sport setting. Br J Sports Med 2020; 55:181-182. [PMID: 32819919 DOI: 10.1136/bjsports-2020-103091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Paolo Emilio Adami
- Health and Science, World Athletics, Monaco .,Sport, Human and Health sciences, HUniversità degli Studi di Roma 'Foro Italico', Roma, Lazio, Italy
| | - John Cianca
- International Institute for Race Medicine, Plymouth, Massachusetts, USA.,Human Performance Center, Houston, Texas, USA
| | - Brian McCloskey
- Centre on Global Health Security, Chatham House, London, UK.,Co-chair WHO Expert Group on COVID-19 and Mass Gatherings, World Health Organization, Geneva, Switzerland
| | - Wayne Derman
- Institute of Sports and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Tygerberg, South Africa.,International Olympic Committee Research Centre, Cape Town, South Africa.,International Paralympic Committee, Bonn, Germany
| | - Juergen Michael Steinacker
- Sport- und Rehabilitationsmedizin, Universitat Ulm, Ulm, Germany.,Sports Medicine Commission, World Rowing Federation, Lausanne, Switzerland
| | - Francis O'Connor
- International Institute for Race Medicine, Plymouth, Massachusetts, USA.,Consortium for Health and Military Performance (CHAMP), Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Sergio Migliorini
- Medical Committee, International Triathlon Union, ITU, Lausanne, Switzerland
| | | | - Fumihiro Yamasawa
- Health and Science, World Athletics, Monaco.,International Institute for Race Medicine, Plymouth, Massachusetts, USA.,Marubeni Health Promotion Center, Tokyo, Japan
| | - Inggard Lereim
- Neuroscience Department, Norwegian University of Science and Technology, Trondheim, Norway.,Medical Committee, International Ski Federation, Oberhofen/Thunersee, Switzerland
| | - Xavier Bigard
- Val-de-Grace Medical School, Paris, France.,Medical Department, International Cycling Union, Aigle, Switzerland
| | - Chris Troyanos
- International Institute for Race Medicine, Plymouth, Massachusetts, USA
| | | | - Stephane Bermon
- Health and Science, World Athletics, Monaco.,LAMHESS, Université Côte d'Azur, Nice, France
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McCloskey B, Zumla A, Lim PL, Endericks T, Arbon P, Cicero A, Borodina M. A risk-based approach is best for decision making on holding mass gathering events. Lancet 2020; 395:1256-1257. [PMID: 32247321 PMCID: PMC7195068 DOI: 10.1016/s0140-6736(20)30794-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 12/22/2022]
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
| | - Poh Lian Lim
- National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore
| | | | - Paul Arbon
- Flinders University, Adelaide, SA, Australia
| | - Anita Cicero
- Johns Hopkins Center for Health Security, Baltimore, MD, USA
| | - Maria Borodina
- Academy of Postgraduate Education, Federal Medical Biological Agency of Russia, Moscow, Russia
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Petersen E, McCloskey B, Hui DS, Kock R, Ntoumi F, Memish ZA, Kapata N, Azhar EI, Pollack M, Madoff LC, Hamer DH, Nachega JB, Pshenichnaya N, Zumla A. COVID-19 travel restrictions and the International Health Regulations - Call for an open debate on easing of travel restrictions. Int J Infect Dis 2020; 94:88-90. [PMID: 32305518 PMCID: PMC7162781 DOI: 10.1016/j.ijid.2020.04.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 02/03/2023] Open
Affiliation(s)
- Eskild Petersen
- Institute for Clinical Medicine, Faculty of Health Sciences, University of Aarhus, Denmark, and Directorate General for Disease Surveillance and Control, Ministry of Healyh, Muscat, Oman, and European Society for Clinical Microbiology and Infectious Diseases [ESCMID] Task Force for Emerging Infections, Basel, Switzerland.
| | - Brian McCloskey
- Centre on Global Health Security, Chatham House, Royal Institute of International Affairs, London, United Kingdom.
| | - David S Hui
- Department of Medicine & Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China.
| | - Richard Kock
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, United Kingdom.
| | - Francine Ntoumi
- Université Marien Gouabi, Fondation Congolaise pour la Recherche Médicale, Brazzaville, Congo; University of Tübingen, Germany.
| | - Ziad A Memish
- Research Centre, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Nathan Kapata
- National Public health Institute, Ministry of Health, Lusaka, Zambia.
| | - Esam I Azhar
- King Fahd Medical Research Center [KFMRC], Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | | | - Larry C Madoff
- International Society for Infectious Diseases, Boston, MA, USA; University of Massachusetts, Division of Infectious Diseases, Worcester, MA, USA
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Disease, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Jean B Nachega
- Department of Medicine and Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa; University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - N Pshenichnaya
- National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia; Rostov State Medical University, Rostov-on-Don, Russia
| | - Alimuddin Zumla
- Center for Clinical Microbiology, Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom.
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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: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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11
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Smith GE, Elliot AJ, Ibbotson S, Morbey R, Edeghere O, Hawker J, Catchpole M, Endericks T, Fisher P, McCloskey B. Novel public health risk assessment process developed to support syndromic surveillance for the 2012 Olympic and Paralympic Games. J Public Health (Oxf) 2018; 39:e111-e117. [PMID: 27451417 DOI: 10.1093/pubmed/fdw054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Syndromic surveillance aims to provide early warning and real time estimates of the extent of incidents; and reassurance about lack of impact of mass gatherings. We describe a novel public health risk assessment process to ensure those leading the response to the 2012 Olympic Games were alerted to unusual activity that was of potential public health importance, and not inundated with multiple statistical 'alarms'. Methods Statistical alarms were assessed to identify those which needed to result in 'alerts' as reliably as possible. There was no previously developed method for this. We identified factors that increased our concern about an alarm suggesting that an 'alert' should be made. Results Between 2 July and 12 September 2012, 350 674 signals were analysed resulting in 4118 statistical alarms. Using the risk assessment process, 122 'alerts' were communicated to Olympic incident directors. Conclusions Use of a novel risk assessment process enabled the interpretation of large number of statistical alarms in a manageable way for the period of a sustained mass gathering. This risk assessment process guided the prioritization and could be readily adapted to other surveillance systems. The process, which is novel to our knowledge, continues as a legacy of the Games.
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Affiliation(s)
- Gillian E Smith
- Real-Time Syndromic Surveillance Team, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK
| | - Alex J Elliot
- Real-Time Syndromic Surveillance Team, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK
| | - Sue Ibbotson
- Public Health England Centre, West Midlands, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK
| | - Roger Morbey
- Real-Time Syndromic Surveillance Team, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK
| | - Obaghe Edeghere
- Field Epidemiology Service, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK
| | - Jeremy Hawker
- Field Epidemiology Service, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK
| | - Mike Catchpole
- Public Health England Centre for Infectious Disease Surveillance and Control, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Tina Endericks
- Department of Global Health, Wellington House, 133 to 155 Waterloo Road, London SE1 8UG, UK
| | - Paul Fisher
- Real-Time Syndromic Surveillance Team, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK
| | - Brian McCloskey
- Department of Global Health, Wellington House, 133 to 155 Waterloo Road, London SE1 8UG, UK
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Hughes HE, Hughes TC, Haile A, Smith GE, McCloskey B, Elliot AJ. Syndromic Surveillance Revolution? Public Health Benefits of Modernizing the Emergency Care Patient Health Record in England. Public Health Rep 2018; 132:12S-15S. [PMID: 28692387 DOI: 10.1177/0033354917706955] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Helen E Hughes
- 1 Real-time Syndromic Surveillance Team, National Infection Service, Public Health England, Birmingham, United Kingdom.,2 The Farr Institute, Health e-Research Centre, University of Liverpool, Liverpool, United Kingdom
| | - Thomas C Hughes
- 3 John Radcliffe Hospital, Oxford, United Kingdom.,4 The Royal College of Emergency Medicine, London, United Kingdom
| | - Aaron Haile
- 4 The Royal College of Emergency Medicine, London, United Kingdom
| | - Gillian E Smith
- 1 Real-time Syndromic Surveillance Team, National Infection Service, Public Health England, Birmingham, United Kingdom
| | - Brian McCloskey
- 5 Global Health, Health Protection, Public Health England, London, United Kingdom
| | - Alex J Elliot
- 1 Real-time Syndromic Surveillance Team, National Infection Service, Public Health England, Birmingham, United Kingdom
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13
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Yezli S, Assiri A, Nabulsi H, Awam A, Blumberg L, Endericks T, Stergachis A, Reicher S, McCloskey B, Petersen E, Alotaibi B. From mass gatherings medicine to mass gatherings health: Conclusions from the 3rd International Conference on Mass Gatherings Medicine, Riyadh, Kingdom of Saudi Arabia. Int J Infect Dis 2018; 66:128-130. [PMID: 29287699 DOI: 10.1016/j.ijid.2017.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- S Yezli
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia.
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- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - A Assiri
- Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia
| | - H Nabulsi
- Directorate of Civil Defense in Makkah Region, Ministry of Interior, Kingdom of Saudi Arabia
| | - A Awam
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
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- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - L Blumberg
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - T Endericks
- Global Health Security Department, Public Health England, UK
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- Global Health Security Department, Public Health England, UK
| | - A Stergachis
- School of Pharmacy, University of Washington, Seattle, USA; School of Public Health, University of Washington, Seattle, WA, USA
| | | | - S Reicher
- School of Psychology, University of St Andrews, UK
| | - B McCloskey
- Global Health Security Department, Public Health England, UK
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- Global Health Security Department, Public Health England, UK
| | - E Petersen
- Institute of Clinical Medicine, University of Aarhus, Denmark; The Royal Hospital, Muscat, Oman
| | - B Alotaibi
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
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- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
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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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15
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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16
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Zumla A, McCloskey B, Bin Saeed AA, Dar O, Al Otabi B, Perlmann S, Gautret P, Roy N, Blumberg L, Azhar EI, Barbeschi M, Memish Z, Petersen E. What is the experience from previous mass gathering events? Lessons for Zika virus and the Olympics 2016. Int J Infect Dis 2016; 47:1-4. [PMID: 27321962 PMCID: PMC7110488 DOI: 10.1016/j.ijid.2016.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/08/2016] [Indexed: 01/15/2023] Open
Abstract
All previous experiences from different mass gathering show that vaccine preventable diseases is the most important infections like influemza, hepatitis A, polio and meningitis. Three mass gathering held in Africa during the Ebola outbreak accepted participants from West Africa and was able to handle the theoretical risk without any incident. Therefore we believe that the Olympc games in Rio de Janeiro should not be canceled. The number of visitors to the games is a tine fraction (1%) of other visitors to Zika endemic con tries and it will have no measurable effect on the risk of spreading Zika virus, if the games was cancelled.
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Affiliation(s)
- A Zumla
- Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - B McCloskey
- Global Health Department, Public Health England, London, UK
| | - A A Bin Saeed
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - O Dar
- Public Health England, London, UK
| | - B Al Otabi
- WHO Collaborating Centre for Mass Gatherings Medicine, Office of the Deputy Minister for Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - S Perlmann
- Department of Microbiology, University of Iowa, Iowa, USA
| | - P Gautret
- Infectious Diseases and Tropical Medicine Unit, North Hospital, Marseille, France
| | - N Roy
- Environmental Health Resource Hub, School of Habitat Studies, Tata Institute of Social Sciences, Deonar, Mumbai, India
| | - L Blumberg
- National Institute for Communicable Diseases, Division of Public Health Surveillance and Response, Sandringham, Johannesburg, South Africa
| | - E I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M Barbeschi
- World Health Organization, Geneva, Switzerland
| | - Z Memish
- Ministry of Health, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - E Petersen
- Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark; Department of Infectious Diseases, The Royal Hospital, Muscat, Sultanate of Oman.
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17
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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18
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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19
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Zumla A, Saeed AB, Alotaibi B, Yezli S, Dar O, Bieh K, Bates M, Tayeb T, Mwaba P, Shafi S, McCloskey B, Petersen E, Azhar EI. Tuberculosis and mass gatherings-opportunities for defining burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage. Int J Infect Dis 2016; 47:86-91. [PMID: 26873277 DOI: 10.1016/j.ijid.2016.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 02/01/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022] Open
Abstract
Tuberculosis (TB) is now the most common infectious cause of death worldwide. In 2014, an estimated 9.6 million people developed active TB. There were an estimated three million people with active TB including 360000 with multidrug-resistant TB (MDR-TB) who were not diagnosed, and such people continue to fuel TB transmission in the community. Accurate data on the actual burden of TB and the transmission risk associated with mass gatherings are scarce and unreliable due to the small numbers studied and methodological issues. Every year, an estimated 10 million pilgrims from 184 countries travel to the Kingdom of Saudi Arabia (KSA) to perform the Hajj and Umrah pilgrimages. A large majority of pilgrims come from high TB burden and MDR-TB endemic areas and thus many may have undiagnosed active TB, sub-clinical TB, and latent TB infection. The Hajj pilgrimage provides unique opportunities for the KSA and the 184 countries from which pilgrims originate, to conduct high quality priority research studies on TB under the remit of the Global Centre for Mass Gatherings Medicine. Research opportunities are discussed, including those related to the definition of the TB burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage. The associated data are required to develop international recommendations and guidelines for TB management and control at mass gathering events.
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Affiliation(s)
- Alimuddin Zumla
- Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK; Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia; Global Health Department, Public Health England, London, UK; University of Zambia-University College London Medical School Research and Training Project University Teaching Hospital, Lusaka, Zambia; Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Abdulaziz Bin Saeed
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia
| | - Badriah Alotaibi
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia
| | - Saber Yezli
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia
| | - Osman Dar
- Global Health Department, Public Health England, London, UK
| | - Kingsley Bieh
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia
| | - Matthew Bates
- Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK; University of Zambia-University College London Medical School Research and Training Project University Teaching Hospital, Lusaka, Zambia
| | - Tamara Tayeb
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia
| | - Peter Mwaba
- University of Zambia-University College London Medical School Research and Training Project University Teaching Hospital, Lusaka, Zambia
| | - Shuja Shafi
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia; Muslim Council of Great Britain, London, UK
| | - Brian McCloskey
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia; Global Health Department, Public Health England, London, UK
| | - Eskild Petersen
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia; The Royal Hospital, Muscat, Oman; Aarhus University, Aarhus, Denmark
| | - Esam I Azhar
- Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia; Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdul Aziz University, Jeddah, Saudi Arabia.
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20
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Petersen E, Wilson ME, Touch S, McCloskey B, Mwaba P, Bates M, Dar O, Mattes F, Kidd M, Ippolito G, Azhar EI, Zumla A. Rapid Spread of Zika Virus in The Americas--Implications for Public Health Preparedness for Mass Gatherings at the 2016 Brazil Olympic Games. Int J Infect Dis 2016; 44:11-5. [PMID: 26854199 DOI: 10.1016/j.ijid.2016.02.001] [Citation(s) in RCA: 236] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/02/2016] [Indexed: 11/26/2022] Open
Abstract
Mass gatherings at major international sporting events put millions of international travelers and local host-country residents at risk of acquiring infectious diseases, including locally endemic infectious diseases. The mosquito-borne Zika virus (ZIKV) has recently aroused global attention due to its rapid spread since its first detection in May 2015 in Brazil to 22 other countries and other territories in the Americas. The ZIKV outbreak in Brazil, has also been associated with a significant rise in the number of babies born with microcephaly and neurological disorders, and has been declared a 'Global Emergency by the World Health Organization. This explosive spread of ZIKV in Brazil poses challenges for public health preparedness and surveillance for the Olympics and Paralympics which are due to be held in Rio De Janeiro in August, 2016. We review the epidemiology and clinical features of the current ZIKV outbreak in Brazil, highlight knowledge gaps, and review the public health implications of the current ZIKV outbreak in the Americas. We highlight the urgent need for a coordinated collaborative response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events.
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Affiliation(s)
- Eskild Petersen
- The Royal Hospital, Muscat, Oman, and Insititute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Mary E Wilson
- School of Medicine, University of California, San Francisco, USA; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sok Touch
- Communicable Disease Control Department, Ministry of Health, Cambodia
| | - Brian McCloskey
- Global Health Department, Public Health England, London, United Kingdom
| | - Peter Mwaba
- UNZA-UCLMS Project, University Teaching Hospital, and Ministry of Health, Lusaka, Zambia
| | - Matthew Bates
- UNZA-UCLMS Project, University Teaching Hospital, and Ministry of Health, Lusaka, Zambia
| | - Osman Dar
- Global Health Department, Public Health England, London, United Kingdom
| | - Frank Mattes
- Dept of Virology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Mike Kidd
- Dept of Virology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy
| | - 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, Kingdom of Saudi Arabia
| | - Alimuddin Zumla
- Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
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21
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Zumla A, Azhar EI, Arabi Y, Alotaibi B, Rao M, McCloskey B, Petersen E, Maeurer M. Host-directed therapies for improving poor treatment outcomes associated with the middle east respiratory syndrome coronavirus infections. Int J Infect Dis 2015; 40:71-4. [PMID: 26365771 PMCID: PMC7128983 DOI: 10.1016/j.ijid.2015.09.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Three years after its first discovery in Jeddah Saudi Arabia, the novel zoonotic pathogen of humans, the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) continues to be a major threat to global health security.(1) Sporadic community acquired cases of MERS continue to be reported from the Middle East. The recent nosocomial outbreaks in hospitals in Seoul, Korea and at the National Guard Hospital in Riyadh, Saudi Arabia indicate the epidemic potential of MERS-CoV. Currently there are no effective anti-MERS-CoV anti-viral agents or therapeutics and MERS is associated with a high mortality rate (40%) in hospitalised patients. A large proportion of MERS patients who die have a range of pulmonary pathology ranging from pneumonia to adult respiratory distress syndrome with multi-organ failure, compounded by co-morbidities, reflecting a precarious balance of interactions between the host-immune system and MERS-CoV. Whilst we wait for new MERS-CoV specific drugs, therapeutics and vaccines to be developed, there is a need to advance a range of Host-Directed Therapies. A range of HDTs are available, including commonly used drugs with good safety profiles, which could augment host innate and adaptive immune mechanisms to MERS-CoV, modulate excessive inflammation and reduce lung tissue destruction. We discuss the rationale and potential of using Host-Directed Therapies for improving the poor treatment outcomes associated with MERS. Carefully designed randomized controlled trials will be needed to determine whether HDTs could benefit patients with MERS. The recurrent outbreaks of MERS-CoV infections at hospitals in the Middle East present unique opportunities to conduct randomized clinical trials. The time has come for a more coordinated global response to MERS and a multidisciplinary global MERS-CoV response group is required to take forward priority research agendas.
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Affiliation(s)
- Alimuddin Zumla
- Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom; Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - 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, Kingdom of Saudi Arabia.
| | - Yaseen Arabi
- Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, 11426, Kingdom of Saudi Arabia.
| | - Badriah Alotaibi
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
| | - Martin Rao
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, and Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden.
| | - Brian McCloskey
- Global Health Department, Public Health England, London, United Kingdom.
| | - Eskild Petersen
- Department of Infectious Diseases and Clinical Microbiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
| | - Markus Maeurer
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, and Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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22
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Zumla A, Perlman S, McNabb SJN, Shaikh A, Heymann DL, McCloskey B, Hui DS. Middle East respiratory syndrome in the shadow of Ebola. Lancet Respir Med 2015; 3:100-102. [PMID: 25592990 PMCID: PMC7129307 DOI: 10.1016/s2213-2600(14)70316-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Alimuddin Zumla
- Division of Infection and Immunity, UCL Royal Free Campus, University College London, Rowland Hill Street, London NW3 2PF, UK; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.
| | - Stanley Perlman
- Departments of Microbiology and Pediatrics, University of Iowa, IA, USA
| | | | | | | | | | - David S Hui
- Division of Respiratory Medicine and Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong
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23
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Elliot AJ, Bone A, Morbey R, Hughes HE, Harcourt S, Smith S, Loveridge P, Green HK, Pebody R, Andrews N, Murray V, Catchpole M, Bickler G, McCloskey B, Smith G. Using real-time syndromic surveillance to assess the health impact of the 2013 heatwave in England. Environ Res 2014; 135:31-6. [PMID: 25262071 DOI: 10.1016/j.envres.2014.08.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 08/20/2014] [Accepted: 08/23/2014] [Indexed: 05/12/2023]
Abstract
Heatwaves are a seasonal threat to public health. During July 2013 England experienced a heatwave; we used a suite of syndromic surveillance systems to monitor the impact of the heatwave. Significant increases in heatstroke and sunstroke were observed during 7-10 July 2013. Syndromic surveillance provided an innovative and effective service, supporting heatwave planning and providing early warning of the impact of extreme heat thereby improving the public health response to heatwaves.
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Affiliation(s)
- Alex J Elliot
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK.
| | - Angie Bone
- Extreme Events and Health Protection, Public Health England, London SE1 8UG, UK
| | - Roger Morbey
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
| | - Helen E Hughes
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
| | - Sally Harcourt
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
| | - Sue Smith
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
| | - Paul Loveridge
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
| | - Helen K Green
- Respiratory Diseases Department, Public Health England, London NW9 5EQ, UK
| | - Richard Pebody
- Respiratory Diseases Department, Public Health England, London NW9 5EQ, UK
| | - Nick Andrews
- Statistics and Modelling Economics Department, Public Health England, London NW9 5HT, UK
| | - Virginia Murray
- Extreme Events and Health Protection, Public Health England, London SE1 8UG, UK
| | - Mike Catchpole
- Centre for Infectious Disease Surveillance and Control, Public Health England, London NW9 5HT, UK
| | - Graham Bickler
- Operations Centre, Public Health England, Horsham RH12 1XA, UK
| | | | - Gillian Smith
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
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Abstract
Emerging infectious diseases are an important public health threat and infections with pandemic potential are a major global risk. Although much has been learned from previous events the evidence for mitigating actions is not definitive and pandemic preparedness remains a political and scientific challenge. A need exists to develop trust and effective meaningful collaboration between countries to help with rapid detection of potential pandemic infections and initiate public health actions. This collaboration should be within the framework of the International Health Regulations. Collaboration between countries should be encouraged in a way that acknowledges the benefits that derive from sharing biological material and establishing equitable collaborative research partnerships. The focus of pandemic preparedness should include upstream prevention through better collaboration between human and animal health sciences to enhance capacity to identify potential pathogens before they become serious human threats, and to prevent their emergence where possible. The one-health approach provides a means to develop this and could potentially enhance alignment of global health and trade priorities.
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Affiliation(s)
- Brian McCloskey
- Global Health and WHO Collaborating Centre on Mass Gatherings, and Public Health England, London, UK.
| | - Osman Dar
- Chatham House and London School of Hygiene & Tropical Medicine, London, UK
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Center, University College London Hospitals, London, UK
| | - David L Heymann
- Chatham House and London School of Hygiene & Tropical Medicine, London, UK
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25
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Affiliation(s)
- Alimuddin Zumla
- Division of Infection and Immunity, Royal Free Hospital Campus, University College London, UK; NIHR Biomedical Research Centre, University College London Hospital, London NW3 2PF, UK; Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
| | - David S Hui
- Division of Respiratory Medicine and Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong
| | - Jaffar A Al-Tawfiq
- John Hopkins Aramco healthcare, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indiana, USA
| | - Phillipe Gautret
- Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection & Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), Marseille, France
| | - Brian McCloskey
- Global Health and WHO Collaborating Centre on Mass Gatherings, Public Health England, London, UK; Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Ziad A Memish
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia; Ministry of Health and Al-Faisal University, Riyadh, Saudi Arabia
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26
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Hughes HE, Morbey R, Hughes TC, Locker TE, Shannon T, Carmichael C, Murray V, Ibbotson S, Catchpole M, McCloskey B, Smith G, Elliot AJ. Using an Emergency Department Syndromic Surveillance System to investigate the impact of extreme cold weather events. Public Health 2014; 128:628-35. [PMID: 25065517 DOI: 10.1016/j.puhe.2014.05.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 05/06/2014] [Accepted: 05/06/2014] [Indexed: 11/23/2022]
Abstract
This report describes the development of novel syndromic cold weather public health surveillance indicators for use in monitoring the impact of extreme cold weather on attendances at EDs, using data from the 2010-11 and 2011-12 winters. A number of new surveillance indicators were created specifically for the identification and monitoring of cold weather related ED attendances, using the diagnosis codes provided for each attendance in the Emergency Department Syndromic Surveillance System (EDSSS), the first national syndromic surveillance system of its kind in the UK. Using daily weather data for the local area, a time series analysis to test the sensitivity of each indicator to cold weather was undertaken. Diagnosis codes relating to a health outcome with a potential direct link to cold weather were identified and assigned to a number of 'cold weather surveillance indicators'. The time series analyses indicated strong correlations between low temperatures and cold indicators in nearly every case. The strongest fit with temperature was cold related fractures in females, and that of snowfall was cold related fractures in both sexes. Though currently limited to a small number of sentinel EDs, the EDSSS has the ability to give near real-time detail on the magnitude of the impact of weather events. EDSSS cold weather surveillance fits well with the aims of the Cold Weather Plan for England, providing information on those particularly vulnerable to cold related health outcomes severe enough to require emergency care. This timely information aids those responding to and managing the effects on human health, both within the EDs themselves and in the community as a whole.
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Affiliation(s)
- H E Hughes
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
| | - R Morbey
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK
| | - T C Hughes
- Emergency Department, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK; The College of Emergency Medicine, London, UK
| | - T E Locker
- The College of Emergency Medicine, London, UK; Emergency Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - T Shannon
- Emergency Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - C Carmichael
- Extreme Events and Health Protection, Public Health England, London, UK
| | - V Murray
- Extreme Events and Health Protection, Public Health England, London, UK
| | - S Ibbotson
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK
| | - M Catchpole
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - B McCloskey
- Global Health, Public Health England, London, UK
| | - G Smith
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK
| | - A J Elliot
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK
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27
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McCloskey B, Endericks T, Catchpole M, Zambon M, McLauchlin J, Shetty N, Manuel R, Turbitt D, Smith G, Crook P, Severi E, Jones J, Ibbotson S, Marshall R, Smallwood CAH, Isla N, Memish ZA, Al-Rabeeah AA, Barbeschi M, Heymann DL, Zumla A. London 2012 Olympic and Paralympic Games: public health surveillance and epidemiology. Lancet 2014; 383:2083-2089. [PMID: 24857700 PMCID: PMC7138022 DOI: 10.1016/s0140-6736(13)62342-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mass gatherings are regarded as potential risks for transmission of infectious diseases, and might compromise the health system of countries in which they are hosted. The evidence for increased transmission of infectious diseases at international sporting mass gatherings that attract many visitors from all over the world is not clear, and the evidence base for public health surveillance, epidemiology, and response at events such as the Olympics is small. However, infectious diseases are a recognised risk, and public health planning is, and should remain, a crucial part of the overall planning of sporting events. In this Series paper, we set out the planning and the surveillance systems that were used to monitor public health risks during the London 2012 Olympic and Paralympic Games in the summer of 2012, and draw attention to the public health issues-infectious diseases and chemical, radiation, and environmental hazards-that arose. Although the absolute risk of health-protection problems, including infectious diseases, at sporting mass gatherings is small, the need for reassurance of the absence of problems is higher than has previously been considered; this could challenge conventional public health surveillance systems. Recognition of the limitations of health-surveillance systems needs to be part of the planning for future sporting events.
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Affiliation(s)
- Brian McCloskey
- Global Center for Mass Gathering Medicine, Riyadh, Saudi Arabia; Global Health and WHO Collaborating Centre on Mass Gatherings, London, UK.
| | - Tina Endericks
- Global Health and WHO Collaborating Centre on Mass Gatherings, London, UK
| | - Mike Catchpole
- Centre for Infectious Disease Surveillance and Control, London, UK
| | | | - Jim McLauchlin
- Food, Water, and Environmental Microbiology Services, London, UK
| | | | | | | | | | | | - Ettore Severi
- European Programme for Intervention Epidemiology Training, London, UK
| | - Jane Jones
- Travel and Migrant Health Section, London, UK
| | | | | | | | - Nicolas Isla
- Global Preparedness, Surveillance and and Response, WHO, Geneva, Switzerland
| | - Ziad A Memish
- Global Center for Mass Gathering Medicine, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia; Al-Faisal University, Riyadh, Saudi Arabia
| | - Abdullah A Al-Rabeeah
- Global Center for Mass Gathering Medicine, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia
| | - Maurizio Barbeschi
- Global Center for Mass Gathering Medicine, Riyadh, Saudi Arabia; Global Capacities, Alert and Response, WHO, Geneva, Switzerland
| | - David L Heymann
- Global Center for Mass Gathering Medicine, Riyadh, Saudi Arabia; Public Health England, London, UK; Royal Institute of International Affairs, Chatham House, London, UK; London School of Hygiene and Tropical Medicine, London, UK
| | - Alimuddin Zumla
- Global Center for Mass Gathering Medicine, Riyadh, Saudi Arabia; Division of Infection and Immunity, University College London, London, UK; University College London Hospitals NHS Foundation Trust, London, UK
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28
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Smallwood CAH, Arbuthnott KG, Banczak-Mysiak B, Borodina M, Coutinho AP, Payne-Hallström L, Lipska E, Lyashko V, Miklasz M, Miskiewicz P, Nitzan D, Pokanevych I, Posobkiewicz M, Rockenschaub G, Sadkowska-Todys M, Sinelnik S, Smiley D, Tomialoic R, Yurchenko V, Memish ZA, Heymann D, Endericks T, McCloskey B, Zumla A, Barbeschi M. Euro 2012 European Football Championship Finals: planning for a health legacy. Lancet 2014; 383:2090-2097. [PMID: 24857705 DOI: 10.1016/s0140-6736(13)62384-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The revised international health regulations offer a framework that can be used by host countries to organise public health activities for mass gatherings. From June 8, to July 1, 2012, Poland and Ukraine jointly hosted the Union of European Football Associations European Football Championship Finals (Euro 2012). More than 8 million people from around the world congregated to watch the games. Host countries and international public health agencies planned extensively to assess and build capacity in the host countries and to develop effective strategies for dissemination of public health messages. The effectiveness of public health services was maximised through rapid sharing of information between parties, early use of networks of experienced individuals, and the momentum of existing national health programmes. Organisers of future mass gatherings for sporting events should share best practice and their experiences through the WHO International Observer Program. Research about behaviour of large crowds is needed for crowd management and the evidence base translated into practice. A framework to measure and evaluate the legacy of Euro 2012 is needed based on the experiences and the medium-term and long-term benefits of the tournament.
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Affiliation(s)
| | | | | | - Mariya Borodina
- WHO Virtual Inter-disciplinary Advisory Group on Mass Gatherings, Geneva, Switzerland
| | - Ana Paula Coutinho
- Alert and Response Operations, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Lara Payne-Hallström
- Surveillance and Response Support Unit, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | | | - Miroslaw Miklasz
- Country Office in Poland, WHO, Ministry of Health, Warsaw, Poland
| | | | | | | | | | - Gerald Rockenschaub
- Country Emergency Preparedness, WHO Regional Office for Europe, Copenhagen, Denmark
| | | | | | - Daniel Smiley
- WHO Virtual Inter-disciplinary Advisory Group on Mass Gatherings, Geneva, Switzerland
| | - Rysard Tomialoic
- European Programme for Intervention Epidemiology Training, Stockholm, Sweden
| | | | | | - David Heymann
- Chatham House, London, UK; London School of Hygiene & Tropical Medicine, London, UK; Public Health England, London, UK
| | - Tina Endericks
- WHO Collaborating Centre on Mass Gatherings, Public Health England, London, UK
| | - Brian McCloskey
- WHO Collaborating Centre on Mass Gatherings, Public Health England, London, UK
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK; University College London Hospitals NHS Foundation Trust, London, UK
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29
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Affiliation(s)
- Ziad A Memish
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh 11176, Saudi Arabia; Al-Faisal University, Riyadh, Saudi Arabia.
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, and University College London Hospitals, London, UK
| | - Brian McCloskey
- Global Health and WHO Collaborating Centre on Mass Gatherings, Public Health England, London, UK
| | - David Heymann
- Chatham House, London, UK; London School of Hygiene & Tropical Medicine, London, UK
| | - Abdullah A Al Rabeeah
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh 11176, Saudi Arabia
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30
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Memish ZA, Zumla A, Alhakeem RF, Assiri A, Turkestani A, Al Harby KD, Alyemni M, Dhafar K, Gautret P, Barbeschi M, McCloskey B, Heymann D, Al Rabeeah AA, Al-Tawfiq JA. Hajj: infectious disease surveillance and control. Lancet 2014; 383:2073-2082. [PMID: 24857703 PMCID: PMC7137990 DOI: 10.1016/s0140-6736(14)60381-0] [Citation(s) in RCA: 205] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Religious festivals attract a large number of pilgrims from worldwide and are a potential risk for the transmission of infectious diseases between pilgrims, and to the indigenous population. The gathering of a large number of pilgrims could compromise the health system of the host country. The threat to global health security posed by infectious diseases with epidemic potential shows the importance of advanced planning of public health surveillance and response at these religious events. Saudi Arabia has extensive experience of providing health care at mass gatherings acquired through decades of managing millions of pilgrims at the Hajj. In this report, we describe the extensive public health planning, surveillance systems used to monitor public health risks, and health services provided and accessed during Hajj 2012 and Hajj 2013 that together attracted more than 5 million pilgrims from 184 countries. We also describe the recent establishment of the Global Center for Mass Gathering Medicine, a Saudi Government partnership with the WHO Collaborating Centre for Mass Gatherings Medicine, Gulf Co-operation Council states, UK universities, and public health institutions globally.
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Affiliation(s)
- Ziad A Memish
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; WHO Collaborating Centre for Mass Gatherings Medicine, Riyadh, Saudi Arabia; Al-Faisal University, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia.
| | - Alimuddin Zumla
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Division of Infection and Immunity, University College London, London, UK; University College London Hospitals NHS Foundation Trust, London, UK
| | - Rafat F Alhakeem
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia
| | | | | | | | | | | | - Philippe Gautret
- Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Inserm, and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Maurizio Barbeschi
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Preparedness, Surveillance and Response, Global Capacity Alert and Response, World Health Organization, Geneva, Switzerland
| | - Brian McCloskey
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; WHO Collaborating Centre on Mass Gatherings and High Visibility/High Consequence Events, London, UK
| | - David Heymann
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Chatham House, London, UK; London School of Hygiene & Tropical Medicine, London, UK
| | - Abdullah A Al Rabeeah
- Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indianapolis, IN, USA
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Elliot AJ, Hughes HE, Hughes TC, Locker TE, Brown R, Sarran C, Clewlow Y, Murray V, Bone A, Catchpole M, McCloskey B, Smith GE. The impact of thunderstorm asthma on emergency department attendances across London during July 2013. Emerg Med J 2013; 31:675-8. [PMID: 24099832 DOI: 10.1136/emermed-2013-203122] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND This study illustrates the potential of using emergency department attendance data, routinely accessed as part of a national syndromic surveillance system, to monitor the impact of thunderstorm asthma. METHODS The Emergency Department Syndromic Surveillance System (EDSSS) routinely monitors anonymised attendance data on a daily basis across a sentinel network of 35 emergency departments. Attendance data for asthma, wheeze and difficulty breathing are analysed on a daily basis. RESULTS A statistically significant spike in asthma attendances in two EDSSS emergency departments in London was detected on 23 July 2013, coinciding with a series of large violent thunderstorms across southern England. There was also an increase in the reported severity of these attendances. CONCLUSIONS This preliminary report illustrates the potential of the EDSSS to monitor the impact of thunderstorms on emergency department asthma attendances. Further work will focus on how this system can be used to quantify the impact on emergency departments, thus potentially improving resource planning and also adding to the thunderstorm asthma evidence-base.
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Affiliation(s)
- A J Elliot
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK
| | - H E Hughes
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK
| | - T C Hughes
- Emergency Department, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK The College of Emergency Medicine, London, UK
| | - T E Locker
- The College of Emergency Medicine, London, UK Emergency Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - R Brown
- Emergency Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | | | | | - V Murray
- Extreme Events and Health Protection, Public Health England, London, UK
| | - A Bone
- Extreme Events and Health Protection, Public Health England, London, UK
| | - M Catchpole
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - B McCloskey
- Department of Global Health, Public Health England, London, UK
| | - G E Smith
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK
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32
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Dhamija A, Dhamija A, Hancock J, McCloskey B, Kim AW, Detterbeck FC, Boffa DJ. Minimally invasive oesophagectomy more expensive than open despite shorter length of stay. Eur J Cardiothorac Surg 2013; 45:904-9. [DOI: 10.1093/ejcts/ezt482] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Elliot AJ, Morbey RA, Hughes HE, Harcourt SE, Smith S, Loveridge P, Edeghere O, Ibbotson S, McCloskey B, Catchpole M, Smith GE. Syndromic surveillance – a public health legacy of the London 2012 Olympic and Paralympic Games. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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34
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Elliot AJ, Morbey RA, Hughes HE, Harcourt SE, Smith S, Loveridge P, Edeghere O, Ibbotson S, McCloskey B, Catchpole M, Smith GE. Syndromic surveillance - a public health legacy of the London 2012 Olympic and Paralympic Games. Public Health 2013; 127:777-81. [PMID: 23870845 DOI: 10.1016/j.puhe.2013.05.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/14/2013] [Accepted: 05/16/2013] [Indexed: 11/17/2022]
Affiliation(s)
- A J Elliot
- Real-time Syndromic Surveillance Team, Public Health England, London, UK.
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35
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Affiliation(s)
- Brian McCloskey
- WHO Collaborating Centre on Mass Gatherings and Health Protection Agency, UK
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK
| | - Gwen Stephens
- WHO Collaborating Centre for Mass Gathering Medicine, Ministry of Health, Saudi Arabia
| | - David L Heymann
- Centre on Global Health Security Chatham House, and London School of Hygiene and Tropical Medicine, London, UK
| | - Ziad A Memish
- WHO Collaborating Centre for Mass Gathering Medicine, Ministry of Health, Saudi Arabia
- Al-Faisal University, Riyadh, Saudi Arabia
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36
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Harcourt SE, Fletcher J, Loveridge P, Bains A, Morbey R, Yeates A, McCloskey B, Smyth B, Ibbotson S, Smith GE, Elliot AJ. Developing a new syndromic surveillance system for the London 2012 Olympic and Paralympic Games. Epidemiol Infect 2012; 140:2152-6. [PMID: 22892324 PMCID: PMC9152336 DOI: 10.1017/s0950268812001781] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 07/24/2012] [Accepted: 07/24/2012] [Indexed: 11/06/2022] Open
Abstract
Syndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.
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Affiliation(s)
- S E Harcourt
- Health Protection Agency, Real-time Syndromic Surveillance Team, Birmingham, UK.
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37
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38
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Elliot AJ, Hughes HE, Hughes TC, Locker TE, Shannon T, Heyworth J, Wapling A, Catchpole M, Ibbotson S, McCloskey B, Smith GE. Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic Games. Emerg Med J 2012; 29:954-60. [PMID: 22366039 DOI: 10.1136/emermed-2011-200684] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The London 2012 Olympic and Paralympic Games is a mass gathering event that will present a major public health challenge. The Health Protection Agency, in collaboration with the College of Emergency Medicine, has established the Emergency Department Sentinel Syndromic Surveillance System (EDSSS) to support the public health surveillance requirements of the Games. METHODS This feasibility study assesses the usefulness of EDSSS in monitoring indicators of disease in the community. Daily counts of anonymised attendance data from six emergency departments across England were analysed by patient demographics (age, gender, partial postcode), triage coding and diagnosis codes. Generic and specific syndromic indicators were developed using aggregations of diagnosis codes recorded during each attendance. RESULTS Over 339,000 attendances were recorded (26 July 2010 to 25 July 2011). The highest attendances recorded on weekdays between 10:00 and 11:00 and on weekends between 12:00 and 13:00. The mean daily attendance per emergency department was 257 (range 38-435). Syndromic indicators were developed including: respiratory, gastrointestinal, cardiac, acute respiratory infection, gastroenteritis and myocardial ischaemia. Respiratory and acute respiratory infection indicators peaked during December 2010, concomitant with national influenza activity, as monitored through other influenza surveillance systems. CONCLUSIONS The EDSSS has been established to provide an enhanced surveillance system for the London 2012 Olympics. Further validation of the data will be required; however, the results from this initial descriptive study demonstrate the potential for identifying unusual and/or severe outbreaks of infectious disease, or other incidents with public health impact, within the community.
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Affiliation(s)
- Alex J Elliot
- HPA Real-time Syndromic Surveillance Team, 6th Floor 5 St Philips' Place, Birmingham B3 2PW, UK.
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Balasegaram S, Ogilvie F, Glasswell A, Anderson C, Cleary V, Turbitt D, McCloskey B. Patterns of early transmission of pandemic influenza in London - link with deprivation. Influenza Other Respir Viruses 2012; 6:e35-41. [PMID: 22236079 PMCID: PMC4941677 DOI: 10.1111/j.1750-2659.2011.00327.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Please cite this paper as: Balasegaram et al. (2012) Patterns of early transmission of pandemic influenza in London – link with deprivation. Influenza and Other Respiratory Viruses 6(3), e35–e41. Background During the early containment phase in England from April to June 2009, the national strategy for H1N1 pandemic influenza involved case investigation and treatment, and tracing and prophylaxis of contacts. Objective To describe the relationship between early transmission of H1N1 pandemic influenza in London and age and socio‐economic status. Methods Epidemiological data on cases of pandemic flu in London reported to the London Flu Response Centre were analysed to determine patterns of transmission. Results There were 3487 reported cases (2202 confirmed, 1272 presumed and 14 probable) from 20 April to 28 June 2009, during the ‘containment’ period. The highest report rate of 206 per 100 000 (95% CI 195–218) was seen in primary school–age children (5−11 years) followed by 129 (95% CI 119–139) in secondary school–age children (12–18 years). Reports of cases were initially concentrated in affluent areas but overall showed a clear trend with deprivation and risk ratio of 2·32 (95% CI 1·94–2·78) between the most deprived and the least deprived. Conclusion Early transmissions were highest amongst school‐aged children but linked with socio‐economic deprivation across all age groups.
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Bickler G, Ibbotson S, McCloskey B. Local authorities should be responsible for public health. BMJ 2011; 342:d3696. [PMID: 21672977 DOI: 10.1136/bmj.d3696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Balasegaram S, Glasswell A, Cleary V, Turbitt D, McCloskey B. From containment to community: Trigger points from the London pandemic (H1N1) 2009 influenza incident response. Public Health 2011; 125:72-8. [PMID: 21288544 DOI: 10.1016/j.puhe.2010.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 10/07/2010] [Accepted: 11/03/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE In the UK, during the first wave of pandemic (H1N1) 2009 influenza, a national 'containment' strategy was employed from 25 April to 2 July 2009, with case finding, treatment of cases, contact tracing and prophylaxis of close contacts. The aim of the strategy was to delay the introduction and spread of pandemic flu in the UK, provide a better understanding of the course of the novel disease, and thereby allow more time for the development of treatment and vaccination options. STUDY DESIGN Descriptive study of the management of the containment phase of pandemic (H1N1) 2009 influenza. METHODS Analysis of data reported to the London Flu Response Centre (LFRC). RESULTS The average number of telephone calls and faxes per day from health professionals before 15 June 2009 was 188, but this started to rise from 363 on 12 June, to 674 on 15 June, and peaked on 22 June at 2206 calls. The number of cases confirmed [by pandemic (H1N1) 2009 influenza specific H1 and N1 polymerase chain reaction] in London rose to a peak of 200 cases per day. There were widespread school outbreaks reporting large numbers of absences with influenza-like illnesses. Activity in the LFRC intensified to a point where London was declared a 'hot spot' for pandemic (H1N1) 2009 influenza on 19 June 2009 because of sustained community transmission. The local incident response was modified to the 'outbreak management phase' of the containment phase. CONCLUSIONS The sharp rise in the number of telephone calls and the rise in school outbreaks appeared to be trigger points for community transmission. These indicators should inform decisions on modifying public health strategy in pandemic situations.
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Affiliation(s)
- S Balasegaram
- Health Protection Agency, 2nd Floor, Buckingham Palace Road, London, SW1W 9SZ, UK
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Elliot AJ, Singh N, Loveridge P, Harcourt S, Smith S, Pnaiser R, Kavanagh K, Robertson C, Ramsay CN, McMenamin J, Kibble A, Murray V, Ibbotson S, Catchpole M, McCloskey B, Smith GE. Syndromic surveillance to assess the potential public health impact of the Icelandic volcanic ash plume across the United Kingdom, April 2010. Euro Surveill 2010; 15:19583. [PMID: 20546694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
The Health Protection Agency and Health Protection Scotland used existing syndromic surveillance systems to monitor community health in the UK following the volcanic eruption in Iceland in April 2010.
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Affiliation(s)
- A J Elliot
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom.
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Elliot AJ, Singh N, Loveridge P, Harcourt S, Smith S, Pnaiser R, Kavanagh K, Robertson C, Ramsay CN, McMenamin J, Kibble A, Murray V, Ibbotson S, Catchpole M, McCloskey B, Smith GE. Syndromic surveillance to assess the potential public health impact of the Icelandic volcanic ash plume across the United Kingdom, April 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.23.19583-en] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- A J Elliot
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - N Singh
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - P Loveridge
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - S Harcourt
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - S Smith
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - R Pnaiser
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
- Health Protection Scotland, Glasgow, United Kingdom
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
- Health Protection Scotland, Glasgow, United Kingdom
| | - C N Ramsay
- Health Protection Scotland, Glasgow, United Kingdom
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - A Kibble
- Centre for Radiation, Chemicals and Environmental Hazards, Health Protection Agency, Birmingham, United Kingdom
| | - V Murray
- Centre for Radiation, Chemicals and Environmental Hazards, Health Protection Agency, London, United Kingdom
| | - S Ibbotson
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - M Catchpole
- Centre for Infections, Health Protection Agency, London, United Kingdom
| | - B McCloskey
- London Regional Director’s Office, Health Protection Agency, London, United Kingdom
| | - G E Smith
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
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Cleary V, Balasegaram S, McCloskey B, Keeling D, Turbitt D. Pandemic (H1N1) 2009: setting up a multi-agency regional response centre--a toolkit for other public health emergencies. J Bus Contin Emer Plan 2010; 4:154-164. [PMID: 20494880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The H1N1 pandemic emerged from Mexico in April 2009. In the UK, local Health Protection Units were quickly overwhelmed with calls from health professionals seeking public health advice on this novel virus. The Health Protection Agency (HPA) led the initial response and established regional flu response centres (FRCs). In London, the HPA's flu response moved swiftly from four in-house emergency operations centres to a fully functional multiagency response centre in rented office space, working with a new database, IT and telephone systems to provide a regional response. Surge capacity was sought from the National Health Service (NHS) and other agencies. The London FRC transferred to NHS leadership supported by the existing management team to assist the NHS in London prior to the opening of the National Pandemic Flu Service. Structured debriefs were undertaken, identifying lessons for future evolving incidents. This paper gives an overview of the activation, resilience and decommissioning of the London FRC, incorporating the lessons identified and key recommendations into a toolkit for future emergency evolving incidents that adopt a regional response centre model.
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Affiliation(s)
- Vivien Cleary
- North East and North Central London HPU, London, UK.
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Anaraki S, Addiman S, Nixon G, Krahé D, Ghosh R, Brooks T, Lloyd G, Spencer R, Walsh A, McCloskey B, Lightfoot N. Investigations and control measures following a case of inhalation anthrax in East London in a drum maker and drummer, October 2008. Euro Surveill 2008; 13:19076. [PMID: 19094916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
The patient is believed to have acquired the infection from making animal hide drums. Environmental investigations identified one drum and two pieces of animal skins contaminated with anthrax spores.
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Affiliation(s)
- S Anaraki
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
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Anaraki S, Addiman S, Nixon G, Krahé D, Ghosh R, Brooks T, Lloyd G, Spencer R, Walsh A, McCloskey B, Lightfoot N. Investigations and control measures following a case of inhalation anthrax in East London in a drum maker and drummer, October 2008. Euro Surveill 2008. [DOI: 10.2807/ese.13.51.19076-en] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We discuss the investigations and control measures undertaken following the notification of a fatal case of inhalation anthrax in East London. The patient is believed to have acquired the infection from making animal hide drums. Environmental investigations identified one drum and two pieces of animal skins contaminated with anthrax spores.
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Affiliation(s)
- S Anaraki
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
| | - S Addiman
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
| | - G Nixon
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
| | - D Krahé
- Homerton University Hospital, London, United Kingdom
| | - R Ghosh
- Homerton University Hospital, London, United Kingdom
| | - T Brooks
- Laboratory for Novel and Dangerous Pathogens, Health Protection Agency, London, United Kingdom
| | - G Lloyd
- Laboratory for Novel and Dangerous Pathogens, Health Protection Agency, London, United Kingdom
| | - R Spencer
- Laboratory for Novel and Dangerous Pathogens, Health Protection Agency, London, United Kingdom
| | - A Walsh
- Centre for Infections, Health Protection Agency, London, United Kingdom
| | - B McCloskey
- London Regional Director’s Office, Health Protection Agency, London, United Kingdom
| | - N Lightfoot
- Health Protection Agency, Central Office, London, United Kingdom
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Metwally L, Fairley DJ, Coyle PV, Hay RJ, Hedderwick S, McCloskey B, O’Neill HJ, Webb CH, McMullan R. Comparison of serum and whole-blood specimens for the detection of Candida DNA in critically ill, non-neutropenic patients. J Med Microbiol 2008; 57:1269-1272. [DOI: 10.1099/jmm.0.2008/002444-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- L. Metwally
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - D. J. Fairley
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - P. V. Coyle
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - R. J. Hay
- Queen’s University of Belfast, School of Medicine and Dentistry, Belfast, Northern Ireland, UK
| | - S. Hedderwick
- Department of Infectious Diseases, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - B. McCloskey
- Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - H. J. O’Neill
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - C. H. Webb
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - R. McMullan
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
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McMullan R, Metwally L, Coyle PV, Hedderwick S, McCloskey B, O'Neill HJ, Patterson CC, Thompson G, Webb CH, Hay RJ. A Prospective Clinical Trial of a Real-Time Polymerase Chain Reaction Assay for the Diagnosis of Candidemia in Nonneutropenic, Critically Ill Adults. Clin Infect Dis 2008; 46:890-6. [DOI: 10.1086/528690] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Metwally L, Fairley DJ, Coyle PV, Hay RJ, Hedderwick S, McCloskey B, O'Neill HJ, Webb CH, Elbaz W, McMullan R. Improving molecular detection of Candida DNA in whole blood: comparison of seven fungal DNA extraction protocols using real-time PCR. J Med Microbiol 2008; 57:296-303. [DOI: 10.1099/jmm.0.47617-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The limitations of classical diagnostic methods for invasive Candida infections have led to the development of molecular techniques such as real-time PCR to improve diagnosis. However, the detection of low titres of Candida DNA in blood from patients with candidaemia requires the use of extraction methods that efficiently lyse yeast cells and recover small amounts of DNA suitable for amplification. In this study, a Candida-specific real-time PCR assay was used to detect Candida albicans DNA in inoculated whole blood specimens extracted using seven different extraction protocols. The yield and quality of total nucleic acids were estimated using UV absorbance, and specific recovery of C. albicans genomic DNA was estimated quantitatively in comparison with a reference (Qiagen kit/lyticase) method currently in use in our laboratory. The extraction protocols were also compared with respect to sensitivity, cost and time required for completion. The TaqMan PCR assay used to amplify the DNA extracts achieved high levels of specificity, sensitivity and reproducibility. Of the seven extraction protocols evaluated, only the MasterPure yeast DNA extraction reagent kit gave significantly higher total nucleic acid yields than the reference method, although nucleic acid purity was highest using either the reference or YeaStar genomic DNA kit methods. More importantly, the YeaStar method enabled C. albicans DNA to be detected with highest sensitivity over the entire range of copy numbers evaluated, and appears to be an optimal method for extracting Candida DNA from whole blood.
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Affiliation(s)
- L. Metwally
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland
| | - D. J. Fairley
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland
| | - P. V. Coyle
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland
| | - R. J. Hay
- Queen's University of Belfast, School of Medicine and Dentistry, Belfast, Northern Ireland
| | - S. Hedderwick
- Department of Infectious Diseases, Royal Victoria Hospital, Belfast, Northern Ireland
| | - B. McCloskey
- Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland
| | - H. J. O'Neill
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland
| | - C. H. Webb
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland
| | - W. Elbaz
- Department of Infectious Diseases, Royal Victoria Hospital, Belfast, Northern Ireland
| | - R. McMullan
- Department of Medical Microbiology, Royal Victoria Hospital, Belfast, Northern Ireland
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Metwally L, Coyle P, O'Neill H, Hogg G, Hedderwick S, Webb C, McCloskey B, Hay R, McMullan R. Rapid differentiation between fluconazole sensitive and resistant species of candida directly from positive blood culture bottles by real-time polymerase chain reaction (pcr). J Infect 2007. [DOI: 10.1016/j.jinf.2007.04.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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