Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events[1]
Summary
This review focuses on the main public health issues arising from planned mass gathering events held between 2013 and 2018, following an earlier Lancet Series on mass gatherings medicine that covered planning and surveillance systems, public health threats and health-care provider experiences from events in 2012 and 2013. It highlights public health and research data on transmission of infectious diseases and antibiotic-resistant bacteria, mass casualty incidents, and non-communicable diseases including thermal disorders. The authors state that in the events discussed, the combination of a large influx of people, many from countries with outbreak-prone infectious diseases, with a high degree of crowd interaction imposed substantial burdens on host countries' health systems. They report that the detection and transmission of antibiotic-resistant bacteria in pilgrims attending the Kumbh Mela and the Hajj raises concern about possible globalisation from mass-gathering religious events. Priorities for further investment and research opportunities are discussed.
So what
For anyone planning a large international gathering this supports treating imported infection and antimicrobial resistance as a host health-system planning issue rather than only an on-site clinical one, and building surveillance into the event plan from the start. The review names concerns and research priorities rather than quantifying risk, so it is a framing document for early conversations with public health authorities, not a basis for specific screening thresholds.
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