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Kheimi AM, Bail JB, Parrillo SJ. Protection enhancement strategies of potential outbreaks during Hajj. Am J Disaster Med 2024; 19:71-77. [PMID: 38597649 DOI: 10.5055/ajdm.0454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study aimed to assist governments and organizers of mass gathering events in reviewing existing preventive measures for disease outbreaks to inform the adoption of enhanced strategies for risk reduction and impacts on public health. DESIGN A cross-sectional, quantitative, descriptive study. SETTING This study was conducted in a mass gathering of Hajj, an annual religious event in Mecca, Saudi Arabia. PARTICIPANTS A convenience sample of 70 personnel working in government ministries of Saudi Arabia (Ministry of Health, Ministry of Hajj, and Ministry of Interior) and the Saudi Red Crescent Authority involved in health management in Hajj, including policy formulation and implementation. MAIN OUTCOME MEASURES Perception and knowledge of health risks and outbreaks associated with Hajj. RESULTS The majority of the respondents (60 percent) expressed concern about the potential for infection transmission during Hajj. The respondents also reported having or knowing a colleague, a friend, or a family member with a history of infection during or after Hajj. However, the respondents' knowledge of the possible modes of infection of various diseases was limited. CONCLUSIONS Hajj is associated with various risks of outbreaks, and thus, better protection-enhancing measures are required. Training personnel involved in health management, including planners, coordinators, and healthcare providers, can help reduce the risks and prevent potential outbreaks.
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Affiliation(s)
- Abdulaiziz Mustafa Kheimi
- King Khalid University, College of Applied Medical Sciences, Saudi Ara-bia. ORCID: https://orcid.org/0009-0003-3869-4116
| | - Jean B Bail
- Disaster Medicine & Management Program Director, Thomas Jefferson University, Philadelphia, Pennsylvania. ORCID: https://orcid.org/0000-0002-7133-9357
| | - Steven J Parrillo
- Disaster Medicine & Management Program, Thomas Jefferson University, Philadelphia, Pennsylvania
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Grunnill M, Arino J, McCarthy Z, Bragazzi NL, Coudeville L, Thommes EW, Amiche A, Ghasemi A, Bourouiba L, Tofighi M, Asgary A, Baky-Haskuee M, Wu J. Modelling disease mitigation at mass gatherings: A case study of COVID-19 at the 2022 FIFA World Cup. PLoS Comput Biol 2024; 20:e1011018. [PMID: 38236838 PMCID: PMC10796029 DOI: 10.1371/journal.pcbi.1011018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/20/2023] [Indexed: 01/22/2024] Open
Abstract
The 2022 FIFA World Cup was the first major multi-continental sporting Mass Gathering Event (MGE) of the post COVID-19 era to allow foreign spectators. Such large-scale MGEs can potentially lead to outbreaks of infectious disease and contribute to the global dissemination of such pathogens. Here we adapt previous work and create a generalisable model framework for assessing the use of disease control strategies at such events, in terms of reducing infections and hospitalisations. This framework utilises a combination of meta-populations based on clusters of people and their vaccination status, Ordinary Differential Equation integration between fixed time events, and Latin Hypercube sampling. We use the FIFA 2022 World Cup as a case study for this framework (modelling each match as independent 7 day MGEs). Pre-travel screenings of visitors were found to have little effect in reducing COVID-19 infections and hospitalisations. With pre-match screenings of spectators and match staff being more effective. Rapid Antigen (RA) screenings 0.5 days before match day performed similarly to RT-PCR screenings 1.5 days before match day. Combinations of pre-travel and pre-match testing led to improvements. However, a policy of ensuring that all visitors had a COVID-19 vaccination (second or booster dose) within a few months before departure proved to be much more efficacious. The State of Qatar abandoned all COVID-19 related travel testing and vaccination requirements over the period of the World Cup. Our work suggests that the State of Qatar may have been correct in abandoning the pre-travel testing of visitors. However, there was a spike in COVID-19 cases and hospitalisations within Qatar over the World Cup. Given our findings and the spike in cases, we suggest a policy requiring visitors to have had a recent COVID-19 vaccination should have been in place to reduce cases and hospitalisations.
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Affiliation(s)
- Martin Grunnill
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
| | - Julien Arino
- Department of Mathematics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Zachary McCarthy
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
| | - Nicola Luigi Bragazzi
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
| | | | - Edward W. Thommes
- Modeling, Epidemiology and Data Science (MEDS), Sanofi, Lyon, France
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
| | | | - Abbas Ghasemi
- The Fluid Dynamics of Disease Transmission Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Mechanical and Industrial Engineering Department, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Lydia Bourouiba
- The Fluid Dynamics of Disease Transmission Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Mohammadali Tofighi
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
- Disaster & Emergency Management, York University, Toronto, Canada
| | - Ali Asgary
- Disaster & Emergency Management, York University, Toronto, Canada
- York Emergency Mitigation, Response, Engagement and Governance Institute, York University, Toronto, Ontario, Canada
| | | | - Jianhong Wu
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
- York Emergency Mitigation, Response, Engagement and Governance Institute, York University, Toronto, Ontario, Canada
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3
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Bokhary H, Rashid H, Hill-Cawthorne GA, Abd El Ghany M. The Rise of Antimicrobial Resistance in Mass Gatherings. HANDBOOK OF HEALTHCARE IN THE ARAB WORLD 2021:1199-1214. [DOI: 10.1007/978-3-030-36811-1_47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Bokhary H, Rashid H, Hill-Cawthorne GA, Abd El Ghany M. The Rise of Antimicrobial Resistance in Mass Gatherings. HANDBOOK OF HEALTHCARE IN THE ARAB WORLD 2020:1-16. [DOI: 10.1007/978-3-319-74365-3_47-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/15/2019] [Indexed: 09/01/2023]
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Antoine-Moussiaux N, Vandenberg O, Kozlakidis Z, Aenishaenslin C, Peyre M, Roche M, Bonnet P, Ravel A. Valuing Health Surveillance as an Information System: Interdisciplinary Insights. Front Public Health 2019; 7:138. [PMID: 31263687 PMCID: PMC6585471 DOI: 10.3389/fpubh.2019.00138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/15/2019] [Indexed: 12/13/2022] Open
Abstract
The economic evaluation of health surveillance systems and of health information is a methodological challenge, as for information systems in general. Main present threads are considering cost-effectiveness solutions, minimizing costs for a given technically required output, or cost-benefit analysis, balancing costs with economic benefits of duly informed public interventions. The latter option, following a linear command-and-control perspective, implies considering a main causal link between information, decision, action, and health benefits. Yet, valuing information, taking into account its nature and multiple sources, the modalities of its processing cycle, from production to diffusion, decentralized use and gradual building of a shared information capital, constitutes a promising challenge. This work proposes an interdisciplinary insight on the value of health surveillance to get a renewed theoretical framework integrating information and informatics theory and information economics. The reflection is based on a typological approach of value, basically distinguishing between use and non-use values. Through this structured discussion, the main idea is to expand the boundaries of surveillance evaluation, to focus on changes and trends, on the dynamic and networked structure of information systems, on the contribution of diverse data, and on the added value of combining qualitative and quantitative information. Distancing itself from the command-and-control model, this reflection considers the behavioral fundaments of many health risks, as well as the decentralized, progressive and deliberative dimension of decision-making in risk management. The framework also draws on lessons learnt from recent applications within and outside of health sector, as in surveillance of antimicrobial resistance, inter-laboratory networks, the use of big data or web sources, the diffusion of technological products and large-scale financial risks. Finally, the paper poses the bases to think the challenge of a workable approach to economic evaluation of health surveillance through a better understanding of health information value. It aims to avoid over-simplifying the range of health information benefits across society while keeping evaluation within the boundaries of what may be ascribed to the assessed information system.
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Affiliation(s)
- Nicolas Antoine-Moussiaux
- Fundamental and Applied Research for Animals and Health (FARAH), University of Liège, Liege, Belgium
| | - Olivier Vandenberg
- Research Centre on Environmental and Occupational Health, School of Public Health - Université Libre de Bruxelles, Brussels, Belgium
- Division of Infection and Immunity, Faculty of Medical Sciences - University College London, London, United Kingdom
| | - Zisis Kozlakidis
- Division of Infection and Immunity, Faculty of Medical Sciences - University College London, London, United Kingdom
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Cécile Aenishaenslin
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Marisa Peyre
- ASTRE, Univ. Montpellier, CIRAD, Inra, Montpellier, France
| | - Mathieu Roche
- TETIS, Univ. Montpellier, AgroParisTech, CIRAD, CNRS, Irstea, Montpellier, France
- Department Environments and Societies, CIRAD, Montpellier, France
| | - Pascal Bonnet
- Department Environments and Societies, CIRAD, Montpellier, France
| | - André Ravel
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC, Canada
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Leal Neto O, Dimech GS, Libel M, de Souza WV, Cesse E, Smolinski M, Oliveira W, Albuquerque J. Saúde na Copa: The World's First Application of Participatory Surveillance for a Mass Gathering at FIFA World Cup 2014, Brazil. JMIR Public Health Surveill 2017; 3:e26. [PMID: 28473308 PMCID: PMC5438444 DOI: 10.2196/publichealth.7313] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 02/23/2017] [Accepted: 03/20/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The 2005 International Health Regulations (IHRs) established parameters for event assessments and notifications that may constitute public health emergencies of international concern. These requirements and parameters opened up space for the use of nonofficial mechanisms (such as websites, blogs, and social networks) and technological improvements of communication that can streamline the detection, monitoring, and response to health problems, and thus reduce damage caused by these problems. Specifically, the revised IHR created space for participatory surveillance to function, in addition to the traditional surveillance mechanisms of detection, monitoring, and response. Participatory surveillance is based on crowdsourcing methods that collect information from society and then return the collective knowledge gained from that information back to society. The spread of digital social networks and wiki-style knowledge platforms has created a very favorable environment for this model of production and social control of information. OBJECTIVE The aim of this study was to describe the use of a participatory surveillance app, Healthy Cup, for the early detection of acute disease outbreaks during the Fédération Internationale de Football Association (FIFA) World Cup 2014. Our focus was on three specific syndromes (respiratory, diarrheal, and rash) related to six diseases that were considered important in a mass gathering context (influenza, measles, rubella, cholera, acute diarrhea, and dengue fever). METHODS From May 12 to July 13, 2014, users from anywhere in the world were able to download the Healthy Cup app and record their health condition, reporting whether they were good, very good, ill, or very ill. For users that reported being ill or very ill, a screen with a list of 10 symptoms was displayed. Participatory surveillance allows for the real-time identification of aggregates of symptoms that indicate possible cases of infectious diseases. RESULTS From May 12 through July 13, 2014, there were 9434 downloads of the Healthy Cup app and 7155 (75.84%) registered users. Among the registered users, 4706 (4706/7155, 65.77%) were active users who posted a total of 47,879 times during the study period. The maximum number of users that signed up in one day occurred on May 30, 2014, the day that the app was officially launched by the Minister of Health during a press conference. During this event, the Minister of Health announced the special government program Health in the World Cup on national television media. On that date, 3633 logins were recorded, which accounted for more than half of all sign-ups across the entire duration of the study (50.78%, 3633/7155). CONCLUSIONS Participatory surveillance through community engagement is an innovative way to conduct epidemiological surveillance. Compared to traditional epidemiological surveillance, advantages include lower costs of data acquisition, timeliness of information collected and shared, platform scalability, and capacity for integration between the population being served and public health services.
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Affiliation(s)
- Onicio Leal Neto
- EpitrackRecifeBrazil
- SingularityU Recife ChapterRecifeBrazil
- Aggeu Magalhães Research CenterDepartament of Health CollectiveRecifeBrazil
| | | | - Marlo Libel
- Skoll Global Threats FundPandemics TeamSan Francisco, CAUnited States
| | | | - Eduarda Cesse
- Aggeu Magalhães Research CenterDepartament of Public HealthRecifeBrazil
| | - Mark Smolinski
- Skoll Global Threats FundPandemics TeamSan Francisco, CAUnited States
| | - Wanderson Oliveira
- Brazil's Ministry of HealthGeneral Coordination of Public Health Emergencies ResponseBrasiliaBrazil
| | - Jones Albuquerque
- EpitrackRecifeBrazil
- Federal Rural University of PernambucoInformatics DepartamentRecifeBrazil
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Díaz-Menéndez M, Crespillo-Andújar C. Risk of Globalization of the Disease in Europe. ZIKA VIRUS INFECTION 2017. [PMCID: PMC7123135 DOI: 10.1007/978-3-319-59406-4_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Risk of dissemination of ZIKV disease is based on multiple factors, including environmental (climate, socioeconomically, deforestation or industrialization) and travel/traveller factors. Both the disease (viremic travellers) and vector movement to mosquito-free area contributes to the introduction and establishment of autochthonous ZIKV transmission. Mass gathering events can contribute to magnify transmission due to close crowd life in a confined area. Also, multitudinary events can promote the introduction of an infectious disease to a previously naïve area when returning home. Although mathematical models estimate a low risk for introduction of ZIKV in Europe, specific European regions (mainly Portuguese Island of Madeira) account with suitable and efficient vector and opportune climate conditions to harbour the disease. Clinicians should be aware to enable early detection of autochthonous ZIKV cases. International and local guidelines can help clinicians on how to handle suspicious cases, how to confirm the infection and how to report suspected and confirmed cases. In case of autochthonous ZIKV detection, public authorities should perform surveillance and provide adequate resources to sustain enhanced mosquito control.
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Affiliation(s)
- Marta Díaz-Menéndez
- Tropical Medicine Department, Hospital Universitario La Paz-Carlos III, Madrid, Spain
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8
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Alqahtani AS, Alfelali M, Arbon P, Booy R, Rashid H. Burden of vaccine preventable diseases at large events. Vaccine 2015; 33:6552-63. [PMID: 26437018 DOI: 10.1016/j.vaccine.2015.09.076] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/14/2015] [Accepted: 09/22/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Large events or mass gatherings (MGs) are known to amplify the risk of infectious diseases, many of which can be prevented by vaccination. In this review we have evaluated the burden of vaccine preventable diseases (VPDs) in MGs. METHODS Major databases like PubMed and Embase, Google Scholar and pertinent websites were searched by using MeSH terms and text words; this was supplemented by hand searching. Following data abstraction, the pooled estimate of the burden of VPDs was calculated when possible; otherwise a narrative synthesis was conducted. RESULTS In the past, at religious MGs like Hajj and Kumbh Mela, cholera caused explosive outbreaks; but currently respiratory infections, notably influenza, are the commonest diseases not only at Hajj but also at World Youth Day and Winter Olympiad. The recent cumulative attack rate of influenza at Hajj is 8.7% (range 0.7-15.8%), and the cumulative prevalence is 3.6% (range: 0.3-38%). Small outbreaks of measles (13-42 cases per event) have been reported at sport, entertainment and religious events. A sizeable outbreak (>200 cases) was reported following a special Easter Festival in Austria. An outbreak of hepatitis A occurred following the 'Jam bands' music festival. Other VPDs including pneumococcal disease, pertussis and tuberculosis have been reported in relation to MG attendance. CONCLUSION VPDs not only affect the participants of MGs but also their contacts; vaccine uptake is variable and vaccine implementation is likely to have beneficial effects. Research to address the knowledge gaps surrounding VPDs at MGs is needed.
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Affiliation(s)
- Amani S Alqahtani
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia; School of Public Health, The University of Sydney, Sydney, NSW, Australia.
| | - Mohammad Alfelali
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Saudi Arabia
| | - Paul Arbon
- Flinders University World Health Organisation Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Adelaide, SA, Australia
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Australia
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Gardy JL, Naus M, Amlani A, Chung W, Kim H, Tan M, Severini A, Krajden M, Puddicombe D, Sahni V, Hayden AS, Gustafson R, Henry B, Tang P. Whole-Genome Sequencing of Measles Virus Genotypes H1 and D8 During Outbreaks of Infection Following the 2010 Olympic Winter Games Reveals Viral Transmission Routes. J Infect Dis 2015; 212:1574-8. [DOI: 10.1093/infdis/jiv271] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 03/18/2015] [Indexed: 11/13/2022] Open
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Maltezou HC, Lionis C. The financial crisis and the expected effects on vaccinations in Europe: a literature review. Infect Dis (Lond) 2015; 47:437-46. [PMID: 25739315 DOI: 10.3109/23744235.2015.1018315] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Starting in 2008 several European countries experienced a financial crisis. Historically, diseases whose prevention and treatment depend highly on the continuity of healthcare re-emerge during political and financial crises. Evidence suggests that the current financial crisis has had an impact on the health and welfare of Europeans and that population health status and morbidity as well as mortality patterns may change in the coming years. At the same time decisions about expenditure for health services may impact the ability of public health providers to respond. It is expected that the current crisis will further exacerbate socioeconomic and health inequalities and novel vulnerable groups will emerge in addition to existing ones. We review the available evidence and discuss how the current crisis may have an impact on vaccine-preventable diseases and influence vaccination coverage rates in Europe.
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Affiliation(s)
- Helena C Maltezou
- From the 1 Department for Interventions in Health Care Facilities, Hellenic Center for Disease Control and Prevention , Athens
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11
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Jost M, Luzi D, Metzler S, Miran B, Mutsch M. Measles associated with international travel in the region of the Americas, Australia and Europe, 2001-2013: a systematic review. Travel Med Infect Dis 2014; 13:10-8. [PMID: 25468523 DOI: 10.1016/j.tmaid.2014.10.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/11/2014] [Accepted: 10/27/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Travel volumes are still increasing resulting in a more interconnected world and fostering the spread of infectious diseases. We aimed to evaluate the relevance of travel-related measles, a highly transmissible and vaccine-preventable disease. METHOD Between 2001 and 2013, surveillance and travel-related measles data were systematically reviewed according to the PRISMA guidelines with extraction of relevant articles from Medline, Embase, GoogleScholar and from public health authorities in the Region of the Americas, Europe and Australia. RESULTS From a total of 960 records 44 articles were included and they comprised 2128 imported measles cases between 2001 and 2011. The proportion of imported cases in Europe was low at 1-2%, which reflects the situation in a measles-endemic region. In contrast, imported and import-related measles accounted for up to 100% of all cases in regions with interrupted endemic measles transmission. Eleven air-travel related reports described 132 measles index cases leading to 47 secondary cases. Secondary transmission was significantly more likely to occur if the index case was younger or when there were multiple infectious cases on board. Further spread to health care settings was found. Measles cases associated with cruise ship travel or mass gatherings were sporadically observed. CONCLUSIONS Within both, endemic and non-endemic home countries, pretravel health advice should assess MMR immunity routinely to avoid measles spread by nonimmune travelers. To identify measles spread as well as to increase and sustain high vaccination coverages joint efforts of public health specialists, health care practitioners and travel medicine providers are needed.
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Affiliation(s)
- M Jost
- Epidemiology, Biostatistics and Prevention Institute, Department of Public Health, Division of Infectious Diseases, University of Zurich, Zurich, Switzerland.
| | - D Luzi
- Epidemiology, Biostatistics and Prevention Institute, Department of Public Health, Division of Infectious Diseases, University of Zurich, Zurich, Switzerland.
| | - S Metzler
- Epidemiology, Biostatistics and Prevention Institute, Department of Public Health, Division of Infectious Diseases, University of Zurich, Zurich, Switzerland.
| | - B Miran
- Epidemiology, Biostatistics and Prevention Institute, Department of Public Health, Division of Infectious Diseases, University of Zurich, Zurich, Switzerland.
| | - M Mutsch
- Epidemiology, Biostatistics and Prevention Institute, Department of Public Health, Division of Infectious Diseases, University of Zurich, Zurich, Switzerland.
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Severi E, Kitching A, Crook P. Evaluation of the Health Protection Event-Based Surveillance for the London 2012 Olympic and Paralympic Games. ACTA ACUST UNITED AC 2014; 19. [PMID: 24970374 DOI: 10.2807/1560-7917.es2014.19.24.20832] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Health Protection Agency (HPA) (currently Public Health England) implemented the Health Protection Event-Based Surveillance (EBS) to provide additional national epidemic intelligence for the 2012 London Olympic and Paralympic Games (the Games). We describe EBS and evaluate the system attributes. EBS aimed at identifying, assessing and reporting to the HPA Olympic Coordination Centre (OCC) possible national infectious disease threats that may significantly impact the Games. EBS reported events in England from 2 July to 12 September 2012. EBS sourced events from reports from local health protection units and from screening an electronic application 'HPZone Dashboard' (DB). During this period, 147 new events were reported to EBS, mostly food-borne and vaccine-preventable diseases: 79 from regional units, 144 from DB (76 from both). EBS reported 61 events to the OCC: 21 of these were reported onwards. EBS sensitivity was 95.2%; positive predictive value was 32.8%; reports were timely (median one day; 10th percentile: 0 days - same day; 90th percentile: 3.6 days); completeness was 99.7%; stability was 100%; EBS simplicity was assessed as good; the daily time per regional or national unit dedicated to EBS was approximately 4 hours (weekdays) and 3 hours (weekends). OCC directors judged EBS as efficient, fast and responsive. EBS provided reliable, reassuring, timely, simple and stable national epidemic intelligence for the Games.
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Affiliation(s)
- E Severi
- Health Protection Agency, London regional Epidemiology Unit, London, United Kingdom
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Williams K, Sinclair C, McEwan R, Fleet K, Balasegaram S, Manuel R. Impact of the London 2012 Olympic and Paralympic Games on demand for microbiology gastrointestinal diagnostic services at the Public Health Laboratory London. J Med Microbiol 2014; 63:968-974. [PMID: 24809387 DOI: 10.1099/jmm.0.070821-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Planning for the London 2012 Olympic and Paralympic Games at the Public Health Laboratory London was based on the requirement to meet potential increased demand with scalable capacity. The aim of this study was to determine the impact on demand for microbiology gastrointestinal diagnostic services during the Games period. Retrospective cross-sectional time-series data analysis was used to assess the number of gastrointestinal specimens received in the laboratory and the number of positive results. There was no increase in the number of gastrointestinal specimens received during the Games period, thus the Games had no impact on demand for microbiology gastrointestinal diagnostic services at the laboratory. There was a decrease in the number of public health specimens received for culture [incidence rate ratio = 0.34, 95% confidence interval (CI) = 0.13-0.86, P = 0.02] and a decrease in the number of culture positive community specimens (odds ratio = 0.59, 95 % CI = 0.40-0.85, P = 0.005), suggesting a decrease in gastrointestinal illness during the Games period. As previous planning assumptions were not based on actual specimen activity, the results of this study may modify the extent of additional planning for microbiological services required for mass gatherings.
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Affiliation(s)
- K Williams
- Public Health Laboratory London, Public Health England, London, UK
| | - C Sinclair
- Field Epidemiology Services Victoria, Public Health England, London, UK
| | - R McEwan
- Public Health Laboratory London, Public Health England, London, UK
| | - K Fleet
- North East and North Central London Health Protection Team, Public Health England, London, UK
| | - S Balasegaram
- Field Epidemiology Services Victoria, Public Health England, London, UK
| | - R Manuel
- Public Health Laboratory London, Public Health England, London, UK
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14
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Respiratory tract infections during the annual Hajj: potential risks and mitigation strategies. Curr Opin Pulm Med 2013; 19:192-7. [PMID: 23429098 DOI: 10.1097/mcp.0b013e32835f1ae8] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Mass gatherings such as religious pilgrimages, sporting events and music concerts are becoming larger and more frequent. The scale and frequency of large-scale international events pose substantial risks to the spread of infectious diseases. The available literature on respiratory tract infections at the Hajj pilgrimage - annually attended by 3 million pilgrims from all over the globe - are reviewed. RECENT FINDINGS The most common respiratory tract infection viruses are influenza and rhinovirus. Despite the occurrence of the Hajj during the 2009 H1N1 pandemic the available literature did not show an increased rate of infection. In hospitalized patients, pneumonia is a significant cause of admission accounting for 20-50% of such admissions. SUMMARY The use of masks may reduce exposure to droplet nuclei, the main mode of transmission of most respiratory tract infections. The practice of social distancing, hand hygiene, and contact avoidance was associated with reduced risk of respiratory illness. In addition, utilizing the recommended vaccines would decrease the risk of acquiring respiratory tract pathogens.
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Stahl JP, Salmon D, Bruneel F, Caumes E, Freymuth F, Bru JP, Morand P, Roblot F, Schmit JL, Strady C, Timsit JF, Rabaud C. Adult patients hospitalized for measles in France, in the 21st century. Med Mal Infect 2013; 43:410-6. [PMID: 24050842 DOI: 10.1016/j.medmal.2013.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND An epidemic of measles broke out in France in 2008. We designed a retrospective study focusing on adults hospitalized for measles in 2010/2011. METHODS A case was any patient aged more than 15 years, hospitalized (September 2010 to September 2011) with a typical rash or a biological diagnosis. Data was collected with standardized questionnaires in participating hospitals. RESULTS Four hundred and sixty cases were reported: sex-ratio (M/F) = 0.93, median age 26 years (σ = 8.8). Twenty-nine cases were severe (6.5%), 27 of which hospitalized in an ICU. Three hundred and twelve (68%) cases had elevated serum transaminases (EST), 155 (34%) cases had pneumonia, 34 (7%) cases had elevated serum creatinine (ESC), four (0.9%) cases had elevated serum amylase and lipase (ESAL), and three (0.7%) cases had neurological symptoms. One hundred and four (23%) patients presented simultaneously with EST and pneumonia. One patient presenting with severe pneumonia died (0.2%). One hundred and ten (24%) patients received antibiotics during a median seven days. CONCLUSION Measles can present as various syndromes in adults and be responsible for a high burden during outbreaks. The immediate outcome is favorable in most patients. Long-term outcome needs further investigations to identify possible late complications.
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Affiliation(s)
- J P Stahl
- Infectious Diseases, Joseph-Fourier University 1, CHU, 38043 Grenoble, France.
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16
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Kondova IT, Milenkovic Z, Marinkovic SP, Bosevska G, Kuzmanovska G, Kondov G, Alabakovska S, Muller CP, Hübschen JM. Measles outbreak in Macedonia: epidemiological, clinical and laboratory findings and identification of susceptible cohorts. PLoS One 2013; 8:e74754. [PMID: 24040337 PMCID: PMC3769294 DOI: 10.1371/journal.pone.0074754] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 08/06/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Despite a 92-99% national vaccination coverage since 2000, the former Yugoslav Republic of Macedonia experienced a large measles outbreak between 2010 and 2011. Here we investigate the characteristics of patients hospitalized during this outbreak at the Clinic of Infectious Diseases in Skopje. METHODS Epidemiological, clinical and laboratory data of 284 measles patients, including 251 from Skopje (43.80% of the 573 reported cases) and 33 from elsewhere in Macedonia were collected. RESULTS The most affected age groups were children up to 4 years of age and adolescents/adults of 15 years and older. Most patients were unvaccinated (n=263, 92.61%) and many had non-Macedonian nationalities (n=156, 54.93%) or belonged to the Roma ethnicity (n=73, 25.70%). Bronchopneumonia and diarrhea were the most common complications. Eighty-two out of 86 tested patients (95.35%) had measles-specific IgM antibodies. The outbreak was caused by the measles variant D4-Hamburg. CONCLUSIONS The epidemic identified pockets of susceptibles in Skopje and indicated that additional vaccination opportunities in particular for people with non-Macedonian nationality and traveler communities are warranted to ensure efficient measles control in Macedonia. The high attack rate among children of less than 1 year suggests that vaccination before 12 months of age should be considered in high risk settings.
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Affiliation(s)
- Irena T. Kondova
- University Clinic of Infectious Diseases and Febrile Conditions, Clinical Centre, Medical Faculty, Skopje, R. Macedonia
- * E-mail:
| | - Zvonko Milenkovic
- University Clinic of Infectious Diseases and Febrile Conditions, Clinical Centre, Medical Faculty, Skopje, R. Macedonia
| | - Sanja P. Marinkovic
- University Clinic of Infectious Diseases and Febrile Conditions, Clinical Centre, Medical Faculty, Skopje, R. Macedonia
| | | | | | - Goran Kondov
- University Clinic for Thoracovascular Surgery, Clinical Centre, Medical Faculty, Skopje, R. Macedonia
| | | | - Claude P. Muller
- Institute of Immunology, Centre de Recherche Public de la Santé / Laboratoire National de Santé, Luxembourg, Luxembourg
| | - Judith M. Hübschen
- Institute of Immunology, Centre de Recherche Public de la Santé / Laboratoire National de Santé, Luxembourg, Luxembourg
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Molekulare Surveillance belegt Fortschritt im Eliminationsprozess der Masern. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:1238-42. [DOI: 10.1007/s00103-013-1795-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Jones J, Lawrence J, Payne Hallström L, Mantero J, Kirkbride H, Walsh A, Jermacane D, Simons H, Hansford KM, Bennett E, Catchpole M. International infectious disease surveillance during the London Olympic and Paralympic Games 2012: process and outcomes. ACTA ACUST UNITED AC 2013; 18:20554. [PMID: 23968829 DOI: 10.2807/1560-7917.es2013.18.32.20554] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Surveillance for possible international infectious disease threats to the Olympic and Paralympic Games in London, United Kingdom, was conducted from 2 July to 12 September 2012 by a collaborative team comprising representatives from the Health Protection Agency (Public Health England since April 2013), the European Centre for Disease Prevention and Control and the National Travel Health Network and Centre. Team members enhanced their usual international surveillance activities and undertook joint risk assessments of incidents identified as relevant through an agreed set of criteria designed for the Games and using tools developed for this purpose. Although team members responded to a range of international disease incidents as part of their routine roles during this period, no incident was identified that represented a threat to the Games. Six incidents were highlighted by the team that were likely to attract media attention and hence could generate political and public concern. Responding to such concern is an important aspect of the overall public health management of mass gathering events. The lessons learned about the process and outcomes of the enhanced international surveillance will help inform planning by future hosts of similar events.
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Affiliation(s)
- J Jones
- Travel and Migrant Health Section, Health Protection Services, Colindale, Health Protection Agency now Public Health England, London, United Kingdom.
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Gautret P, Botelho-Nevers E, Brouqui P, Parola P. The spread of vaccine-preventable diseases by international travellers: a public-health concern. Clin Microbiol Infect 2012; 18 Suppl 5:77-84. [PMID: 22862565 DOI: 10.1111/j.1469-0691.2012.03940.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vaccine-preventable diseases (VPDs) are costly at both the individual and societal levels. The most common VPDs recorded in travellers are enteric (typhoid or paratyphoid B) fever, acute viral hepatitis, influenza, varicella, measles, pertussis and bacterial meningitis. Travellers suffering from VPDs are frequently hospitalized, illustrating the point that VPDs are serious and expensive. Many travellers are not properly immunized before travel. In addition to individual consequences, VPDs can have public-health consequences if they are introduced or re-introduced by infected travellers returning to areas with susceptible populations. The international spread of poliomyelitis, Neisseria meningitidis serogroup W135 meningococcal infections, measles and influenza provides strong evidence of the role of international travel in the globalization of VPDs. The surveillance of the emergence, re-emergence or spread of VPDs is essential to adapt pre-travel advice and the responses to the VPD.
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Affiliation(s)
- P Gautret
- Institut Hospitalo Universitaire des Maladies Infectieuses et Tropicales, Hôpital Nord, AP-HM, Chemin des Bourrelys, Marseille Cedex, France.
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Al-Tawfiq JA, Memish ZA. Mass gatherings and infectious diseases: prevention, detection, and control. Infect Dis Clin North Am 2012; 26:725-37. [PMID: 22963780 DOI: 10.1016/j.idc.2012.05.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Mass gatherings have attracted the attention of the medical community because of the increased demand made on existing services and the potential for public health problems resulting from changes in population dynamics and behaviors. Crowding, lack of hygiene, and rapid population movement at mass gatherings can lead to the emergence of infectious diseases, with the potential for spread across the globe. Numerous infections pose considerable challenges to organizers of mass gatherings and the hosts of these events. This review highlights the risks of infectious diseases, and key interventions for their prevention, at mass gatherings.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- Saudi Aramco Medical Services Organization, Dhahran Health Center, Saudi Aramco, Dhahran 31311, Kingdom of Saudi Arabia
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Abubakar I, Gautret P, Brunette GW, Blumberg L, Johnson D, Poumerol G, Memish ZA, Barbeschi M, Khan AS. Global perspectives for prevention of infectious diseases associated with mass gatherings. THE LANCET. INFECTIOUS DISEASES 2012; 12:66-74. [PMID: 22192131 DOI: 10.1016/s1473-3099(11)70246-8] [Citation(s) in RCA: 185] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We assess risks of communicable diseases that are associated with mass gatherings (MGs), outline approaches to risk assessment and mitigation, and draw attention to some key challenges encountered by organisers and participants. Crowding and lack of sanitation at MGs can lead to the emergence of infectious diseases, and rapid population movement can spread them across the world. Many infections pose huge challenges to planners of MGs; however, these events also provide an opportunity to engage in public health action that will benefit host communities and the countries from which participants originate.
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Infectious disease surveillance and modelling across geographic frontiers and scientific specialties. THE LANCET. INFECTIOUS DISEASES 2012; 12:222-30. [PMID: 22252149 DOI: 10.1016/s1473-3099(11)70313-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infectious disease surveillance for mass gatherings (MGs) can be directed locally and globally; however, epidemic intelligence from these two levels is not well integrated. Modelling activities related to MGs have historically focused on crowd behaviours around MG focal points and their relation to the safety of attendees. The integration of developments in internet-based global infectious disease surveillance, transportation modelling of populations travelling to and from MGs, mobile phone technology for surveillance during MGs, metapopulation epidemic modelling, and crowd behaviour modelling is important for progress in MG health. Integration of surveillance across geographic frontiers and modelling across scientific specialties could produce the first real-time risk monitoring and assessment platform that could strengthen awareness of global infectious disease threats before, during, and immediately after MGs. An integrated platform of this kind could help identify infectious disease threats of international concern at the earliest stages possible; provide insights into which diseases are most likely to spread into the MG; help with anticipatory surveillance at the MG; enable mathematical modelling to predict the spread of infectious diseases to and from MGs; simulate the effect of public health interventions aimed at different local and global levels; serve as a foundation for scientific research and innovation in MG health; and strengthen engagement between the scientific community and stakeholders at local, national, and global levels.
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