Emergence of medicine for mass gatherings: lessons from the Hajj

Abstract

Although definitions of mass gatherings (MG) vary greatly, they consist of large numbers of people attending an event at a specific site for a finite time. Examples of MGs include World Youth Day, the summer and winter Olympics, rock concerts, and political rallies. Some of the largest MGs are spiritual in nature. Among all MGs, the public health issues, associated with the Hajj (an annual pilgrimage to Mecca, Saudi Arabia) is clearly the best reported-probably because of its international or even intercontinental implications in terms of the spread of infectious disease. Hajj routinely attracts 2·5 million Muslims for worship. WHO's global health initiatives have converged with Saudi Arabia's efforts to ensure the wellbeing of pilgrims, contain infectious diseases, and reinforce global health security through the management of the Hajj. Both initiatives emphasise the importance of MG health policies guided by sound evidence and based on experience and the timeliness of calls for a new academic science-based specialty of MG medicine.

Developing Legacy: Health Planning in the Host City of Porto Alegre for the 2014 Football World Cup

“…Such benefits have been identified when planning for the Hajj, which has resulted in an advanced health care system and a pluralistic approach to public health. 10 The World Cup in Brazil posed challenges for infectious diseases control due to the increase in population and population movement 20 from the event having 12 host cities. In Porto Alegre, the World Cup represented an enormous challenge where no previous event of this size was hosted.…”

“…In particular, to implement information and communication resources to monitor and respond to public health emergency situations during these events and to increase the qualification of emergency services. 10 In Brazil, the Ministry of Sports (Brasília-DF) promoted the development of projects in the host cities to identify actions, projects, and constructions developed to prepare for the World Cup in the areas of airports, arenas, energy, urban mobility, security, telecommunications, tourism, and health.…”

Exploring the evidence base for national and regional policy interventions to combat resistance

“…Also, unique to the region is the annual Hajj gathering in Saudi Arabia, of up to 3 million pilgrims from every country of the world, over a 3-4 week period. 169 The size and variety of the microbial biomass that gets transported, mixed and redistributed on such a massive scale is beyond the capacity of any available system to assay and track the AMR organisms. Mass movement of microbes in the GCC is also linked to the industrialization of food production.…”

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

“…[3][4][5]23 Emerging diseases such as Ebola, MERS, Alkhumra viral hemorrhagic fever, Rift Valley fever, and unidentified imported diseases having intercontinental implications challenge global public health security during Hajj. 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.…”