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WHO Releases Interim Guidance For Mass Gathering Events

 

 

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With the Hajj later this month, the XXI Olympic Winter Games in Vancouver early next year, the Superbowl XLIV in January, Carnival in Rio, Mardi Gras in New Orleans and many other mass gathering events planned around the world – an influenza pandemic is a serious complicating factor.


The World Health Organization has released an 8-page guidance document entitled:

 

Interim planning considerations for mass gatherings in the context of pandemic (H1N1) 2009 influenza

Publication date: November 2009
Download the document [pdf 163kb]


In the Introduction, the authors lay out the intent of the document.

 

Introduction 


Mass gatherings are highly visible events with the potential for serious public health and political consequences  if  they are not planned and managed carefully. There  is ample documentation  that  mass  gatherings  can  amplify  and  spread  infectious  diseases.

 
Respiratory  infections,  including  influenza, have been  frequently associated with mass gatherings.  Such infections can be transmitted during the mass gathering, during transit to and from the event, and in participants’ home communities upon their return. 


Planners  of  mass  gatherings  face  special  challenges  during  a  global  influenza pandemic. The purpose of  this document  is  to outline key planning considerations for organizers of mass gatherings  in  the context of pandemic  (H1N1) 2009  influenza.  It should be used  in conjunction with WHO’s Communicable disease alert and  response for mass gatherings.


This document was prepared during September – October 2009 by WHO staff.  It was reviewed  by WHO's Virtual  Interdisciplinary Advisory Group  on Mass Gatherings.  It  is based on currently available information about pandemic (H1N1) 2009 influenza. As the pandemic  situation  evolves  and  additional  information  becomes  available,  it  may  be necessary to revise the document. Review of the document is planned in the first quarter of 2010.

 

Without speaking directly to whether any specific type of event should be cancelled or modified, they authors do recommend that a risk assessment be undertaken before an event is to proceed.

 

Risk assessment

The decision to proceed with a mass gathering or to restrict, modify, postpone, or cancel the  event  should  be  based  on  a  thorough  risk  assessment.  Event  planners  should undertake  such  an  assessment  in  partnership  with  local  and  national  public  health authorities.  The  risk  assessment  should  take  into  account  available  information  about pandemic (H1N1) 2009 influenza at global, national, and local levels. 


As part of the risk assessment, some factors may be of particular relevance such as:

  • Influenza  activity:    The  level  of  pandemic  influenza  activity  circulating  in  the community  where  the  mass  gathering  is  to  be  held  should  be  considered. However, it is difficult to predict the level of activity and which strains of influenza will  be  circulating  very  far  in  advance.  WHO  provides  weekly  updates  of pandemic activity.
  • Period of  time over which  the mass gathering will  take place:  If  the duration of the  mass  gathering  is  more  than  the  typical  incubation  period  for  pandemic (H1N1) 2009  influenza  (2-3 days),  then  the majority of event-associated cases would be expected to occur while the mass gathering is underway. In contrast, if the duration of the event is shorter, most cases would likely occur after the event as people travel and return to their home communities.
  • Age  of  participants:  Since  younger  age  groups  appear  to  be  more  affected, mass  gathering  comprised  principally  of  children  and  young  adults  may  be associated with increased transmission compared with those comprised of older age groups.   
  • Occurrence  of  severe  disease  and  health  care  capacity:  Although  severe disease  is uncommon,  treatment of  these patients  is challenging and  resource intensive with emergency departments and  intensive care units experiencing a disproportionate burden.    

 

The document then goes on to discuss what steps event organizers can take to reduce the transmission of the pandemic virus, or cope with influenza cases.

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