Strengthening health security at the Hajj mass gatherings: characteristics of the infectious diseases surveillance systems operational during the 2015 Hajj

Abstract

There is need to integrate the existing Hajj surveillance data management systems and to implement syndromic surveillance as an early warning system for infectious disease control during Hajj. International engagement is important to strengthen Hajj infectious diseases surveillance and to prevent disease transmission and globalization of infectious agents which could undermine global health security.

Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events

“…These advances in realtime surveillance have improved public health security for the mass gatherings at the Hajj. 69 See Online for appendix…”

“…In the past 5 years, concern has grown with regard to the threat to global health security posed by several emerging and reemerging infectious diseases. Because of the Ebola outbreaks in West Africa (2013-16), 69 the cholera outbreak in Yemen (2015-18), 70 Zika virus in the Americas and southeast Asia (2016-18), [49][50][51] Lassa fever in Nigeria (2018), 71 diphtheria in Venezuela (2016-17) 72 and Yemen (2017-18), 73 Yellow fever in Latin America and Africa (2016-18), and Nipah virus in India and south Asia (2017-18), 74 concerns were expressed by the global public health fraternity regarding pilgrims from affected countries travelling to Saudi Arabia for the Hajj or Umrah. 70 The Saudi government implemented restrictions only to countries affected by the Ebola outbreak.…”

Health risk assessment at mass gatherings: a report of the camel festival in Saudi Arabia

“…The Saudi MoH has a regularly updated plan for the control and management of MERS in the country. Trained surveillance and response teams equipped with appropriate tools, including specialized ambulances for transfer of suspected cases of infectious diseases and personal protective equipment, are deployed across Saudi Arabia (2). The Saudi Ministry of Environment, Water and Agriculture (MEWA) coordinates the surveillance and response plan for animal infections in the country and has established a specialized team to be involved in the festival.…”

“…The World Health Organization (WHO) defines mass gatherings (MGs) as events attended by sufficient number of people to strain the planning and response resources of the community, state or nation (1). Saudi Arabia (KSA) hosts two major perennial international religious MGs; the Hajj and Umrah Muslim pilgrimages (2). In addition, Saudi Arabia regularly hosts other MGs including sporting and cultural events.…”

Syndromic Surveillance of Communicable Diseases in Mobile Clinics During the Arbaeenia Mass Gathering in Wassit Governorate, Iraq, in 2014: Cross-Sectional Study (Preprint)

“…The MG known as "Arbaeenia" is one of the largest annual mass gatherings in the world, during which individuals may walk up to 600km through Iraqi provinces to visit the Imam Hussein's shrine in Karbala to commemorate the 40 th day after his martyrdom [14] The use of appropriate surveillance systems ensures timely information management for effective planning and response to infectious diseases threats during the pilgrimage. [15].The influx of people places a strain on existing surveillance and response systems, and the media and political attention generated by MGs mean that the adverse consequences of any negative health event may be greatly magnified. [13] As part of the health services delivered to pilgrims, the Ministry of Health of Iraq (MOH) set up mobile clinics along the main roads leading to Karbala to provide immediate care to minor medical emergencies.…”