What is the experience from previous mass gathering events? Lessons for Zika virus and the Olympics 2016

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.

Indian Medical Mission at Hajj-2016: Mass-Gathering Medicine Perspectives, Challenges, and Opportunities in a Mission Posture

“…The Sendai Framework gives a mandate for disaster risk reduction (DRR) in mass gatherings. 10 The Indian Medical Mission executed an innovative Hajj medical mission for approximately 400 000 patients incorporating a patient-centric systems approach across the various operations of health intelligence, public-health measures, task forces, clinics, hospitals, evacuations, and Evacuation -lying patients 6 4 3 4 2…”

“…Interactions with multinational medical teams, the South Asian Moassasa (regional coordinating body), and Saudi Arabian hospitals were maintained. 5,10 Public health preparedness was ensured through pre-departure mandatory immunoprophylaxis for meningococcus, tetanus, and influenza. Patient education posters and advisories regarding hand hygiene, respiratory precautions, food-water safety, social distancing, avoidance of exertion, dehydration, heat exposure, injuries, and infections were disseminated.…”

“…1,15,18 Overcrowding increases the risk of transmission of respiratory pathogens such as human rhinovirus, respiratory syncytial virus, MERS and non-MERS Corona virus (229E, HKU1, NL63, OC43), influenza A H1N1, influenza B, adenovirus, multidrug resistant tuberculosis (MDRTB), and Streptococcus pneumoniae in an environment of "Hajj cough" in mass gathering Hajj rituals. 5,10,16,17,19,24 A significant difference has been seen in pre-and post-Hajj carriage rates of Influenza A and B, rhinovirus, and non-MERS coronaviruses. Five fatalities were reportedly caused by Influenza A H1N1 among less than one hundred patients during Hajj 2010.…”

“…17 Undiagnosed and untreated active, subclinical, and latent MDRTB cases from endemic high burden world regions remain serious health hazards as tuberculosis is the leading cause of mortality from an infectious disease worldwide. 5,10,[26][27][28] Neisseria meningitidis W135 outbreaks in 2000 and 2001 during Hajj were followed by a global spread, a risk existing for all MDR bacteria. 2,3,5,13,25,29,30 Hajj is the only mass gathering that has instituted mandatory immunoprophylaxis for pilgrims, pilgrim contacts, HCPs, and the local population.…”

“…[5][6][7][8] While the outbreak of El Tor cholera during the 1905 Hajj is historic, the international outbreak of meningitis following the Hajj pilgrimages in [1987][1988][1989][1990]1992, and 2000-2001 had serious repercussions. 2,9,10 Surging troupes led to stampedes in 1990,1994,1998,2001,, and 2015 and resulted in the trampling-induced deaths of approximately 5100 pilgrims and injuries to 550 pilgrims. Major fire accidents in 1975,1997, and 2011 led to 545 deaths and 1500 burn injuries.…”