Estimating the frequency and characteristics of respiratory disease outbreaks at mass gatherings in the United States: Findings from a state and local health department assessment
Open Access
- 27 October 2017
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 12 (10), e0186730
- https://doi.org/10.1371/journal.pone.0186730
Abstract
Mass gatherings create environments conducive to the transmission of infectious diseases. Thousands of mass gatherings are held annually in the United States; however, information on the frequency and characteristics of respiratory disease outbreaks and on the use of nonpharmaceutical interventions at these gatherings is scarce. We administered an online assessment to the 50 state health departments and 31 large local health departments in the United States to gather information about mass gathering-related respiratory disease outbreaks occurring between 2009 and 2014. The assessment also captured information on the use of nonpharmaceutical interventions to slow disease transmission in these settings. We downloaded respondent data into a SAS dataset for descriptive analyses. We received responses from 43 (53%) of the 81 health jurisdictions. Among these, 8 reported 18 mass gathering outbreaks. More than half (n = 11) of the outbreaks involved zoonotic transmission of influenza A (H3N2v) at county and state fairs. Other outbreaks occurred at camps (influenza A (H1N1)pdm09 [n = 2] and A (H3) [n = 1]), religious gatherings (influenza A (H1N1)pdm09 [n = 1] and unspecified respiratory virus [n = 1]), at a conference (influenza A (H1N1)pdm09), and a sporting event (influenza A). Outbreaks ranged from 5 to 150 reported cases. Of the 43 respondents, 9 jurisdictions used nonpharmaceutical interventions to slow or prevent disease transmission. Although respiratory disease outbreaks with a large number of cases occur at many types of mass gatherings, our assessment suggests that such outbreaks may be uncommon, even during the 2009 influenza A (H1N1) pandemic, which partially explains the reported, but limited, use of nonpharmaceutical interventions. More research on the characteristics of mass gatherings with respiratory disease outbreaks and effectiveness of nonpharmaceutical interventions would likely be beneficial for decision makers at state and local health departments when responding to future outbreaks and pandemics.This publication has 27 references indexed in Scilit:
- Mass Gatherings and Respiratory Disease Outbreaks in the United States – Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting SystemPLOS ONE, 2016
- Outbreak of Variant Influenza A(H3N2) Virus in the United StatesClinical Infectious Diseases, 2013
- Effect of Weather on Medical Patient Volume at Kansas Speedway Mass GatheringsJournal of Emergency Nursing, 2013
- Modeling rapidly disseminating infectious disease during mass gatheringsBMC Medicine, 2012
- Attack Rates Assessment of the 2009 Pandemic H1N1 Influenza A in Children and Their Contacts: A Systematic Review and Meta-AnalysisPLOS ONE, 2012
- Crowd and environmental management during mass gatheringsThe Lancet Infectious Diseases, 2012
- Community transmission of influenza A (H1N1)v virus at a rock festival in Belgium, 2-5 July 2009Eurosurveillance, 2009
- Inactivation of influenza A viruses in the environment and modes of transmission: A critical reviewJournal of Infection, 2008
- Effect of Hand Hygiene on Infectious Disease Risk in the Community Setting: A Meta-AnalysisAmerican Journal of Public Health, 2008
- OUTBREAK OF A2/HONG KONG/68 INFLUENZA AT AN INTERNATIONAL MEDICAL CONFERENCEThe Lancet, 1969