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The Impact of Mass Gatherings on Emergency Department Patient Presentations with Communicable Diseases Related to Syndromic Indicators: An Integrative Review

Published online by Cambridge University Press:  19 February 2020

Yunjing (Shirley) Qiu Open the ORCID record for Yunjing (Shirley) Qiu [Opens in a new window] ,
Julia Crilly ,
Peta-Anne Zimmerman  and
Jamie Ranse
Yunjing (Shirley) Qiu*
Affiliation:
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
Julia Crilly
Affiliation:
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
Peta-Anne Zimmerman
Affiliation:
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia Department of Infection Control, Gold Coast Health, Gold Coast, Queensland, Australia
Jamie Ranse
Affiliation:
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
*
Correspondence: Yunjing Qiu, RN, School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia, E-mail: shirley.shirley28@gmail.com
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Abstract

Background:

Mass-gathering events (MGEs) are commonly associated with a higher than average rate of morbidity. Spectators, workers, and the substantial number of MGE attendees can increase the spread of communicable diseases. During an MGE, emergency departments (EDs) play an important role in offering health care services to both residents of the local community and event attendees. Syndromic indicators (SIs) are widely used in an ED surveillance system for early detection of communicable diseases.

Aim:

This literature review aimed to develop an understanding of the effect of MGEs on ED patient presentations with communicable diseases and their corresponding SIs.

Method:

An integrative literature review methodology was used. Online databases were searched to retrieve relevant academic articles that focused on MGEs, EDs, and SIs. Inclusion/exclusion criteria were applied to screen articles. The Standard Quality Assessment Criteria for Evaluating Primary Research (QualSyst) assessment tool was used to assess the quality of included papers.

Results:

Eleven papers were included in this review; all discussed the impact of an MGE on patient presentations with communicable diseases at EDs/hospitals. Most included studies used the raw number of patients who presented or were admitted to EDs/hospitals to determine impact. Further, the majority of studies focused on either respiratory infections (n = 4) or gastrointestinal infections (n = 2); two articles reported on both. Eight articles mentioned SIs; however, such information was limited. The quality of evidence (using QualSyst) ranged from 50% to 90%.

Conclusions:

Limited research exists on the impact of MGEs on ED presentations with communicable diseases and related SIs. Recommendations for future MGE studies include assessing differences in ED presentations with communicable diseases regarding demographics, clinical characteristics, and outcomes before, during, and after the event. This would benefit health care workers and researchers by offering more comprehensive knowledge for application into practice.

Keywords

communicable diseaseemergency departmentmass gathering
Type
Systematic Review
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 2 , April 2020 , pp. 206 - 211
Copyright
© World Association for Disaster and Emergency Medicine 2020

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References

Arbon, P. Mass-gathering medicine: a review of the evidence and future directions for research. Prehosp Disaster Med. 2007;22(2):131–135.10.1017/S1049023X00004507CrossRefGoogle ScholarPubMed
Locoh-Donou, S, Yan, G, Berry, T, et al. Mass gathering medicine: event factors predicting patient presentation rates. Intern Emerg Med. 2016;11(5):745–752.10.1007/s11739-015-1387-1CrossRefGoogle ScholarPubMed
Gautret, P, Steffen, R. Communicable diseases as health risks at mass gatherings other than Hajj: what is the evidence? Int J Infect Dis. 2016;47:46–52.10.1016/j.ijid.2016.03.007CrossRefGoogle ScholarPubMed
Ranse, J, Hutton, A, Keene, T, et al. Health service impact from mass gatherings: a systematic literature review. Prehosp Disaster Med. 2017;32(1):71–77.10.1017/S1049023X16001199CrossRefGoogle ScholarPubMed
Turris, SA, Lund, A. Triage during mass gatherings. Prehosp Disaster Med. 2012;27(5):531–535.10.1017/S1049023X12001446CrossRefGoogle ScholarPubMed
Lowthian, JA, Curtis, AJ, Jolley, DJ, Stoelwinder, JU, McNeil, JJ, Cameron, PA. Demand at the emergency department front door: 10-year trends in presentations. Med J Aust. 2012;196:128–132.10.5694/mja11.10955CrossRefGoogle ScholarPubMed
Welzel, TB, Koenig, KL, Bey, T, Visser, E. Effect of hospital staff surge capacity on preparedness for a conventional mass casualty event. West J Emerg Med. 2010;11(2):189–196.Google ScholarPubMed
Colón-González, FJ, Lake, IR, Morbey, RA, Elliot, AJ, Pebody, R, Smith, GE. A methodological framework for the evaluation of syndromic surveillance systems: a case study of England. BMC l Public Health. 2018;18(1):544–557.10.1186/s12889-018-5422-9CrossRefGoogle ScholarPubMed
Morbey, RA, Elliot, AJ, Charlett, A, Verlander, NQ, Andrews, N, Smith, GE. The application of a novel ‘rising activity, multi-level mixed effects, indicator emphasis’ (RAMMIE) method for syndromic surveillance in England. J Bioinform. 2015;31(22):3660–3665.Google ScholarPubMed
Elliot, AJ, Hughes, HE, Hughes, TC, et al. Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic Games. Emerg Med J. 2012;29(12):954–960.10.1136/emermed-2011-200684CrossRefGoogle ScholarPubMed
World Health Organization. Communicable disease alert and response for mass gatherings: key considerations. http://www.who.int/csr/Mass_gatherings2.pdf. Published 2008. Accessed August 10, 2018.Google Scholar
Abubakar, I, Gautret, P, Brunette, GW, et al. Global perspectives for prevention of infectious diseases associated with mass gatherings. Lancet Infect Dis. 2012;12(1):66–74.10.1016/S1473-3099(11)70246-8CrossRefGoogle ScholarPubMed
Memish, ZA, Zumla, A, Alhakeem, RF, et al. Hajj: infectious disease surveillance and control. The Lancet. 2014;383(9934):2073–2082.10.1016/S0140-6736(14)60381-0CrossRefGoogle ScholarPubMed
DeMott, JM, Hebert, CL, Novak, M, Mahmood, S, Peksa, GD. Characteristics and resource utilization of patients presenting to the ED from mass gathering events. Am J Emerg Med. 2018;36(6):983–987.10.1016/j.ajem.2017.11.006CrossRefGoogle ScholarPubMed
Liberati, A, Altman, DG, Tetzlaff, J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):1–34.10.1016/j.jclinepi.2009.06.006CrossRefGoogle ScholarPubMed
Whittemore, R, Knafl, K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546–553.10.1111/j.1365-2648.2005.03621.xCrossRefGoogle ScholarPubMed
Kmet, LM, Lee, RC, Cook, LS. Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Edmonton, Alberta, Canada: Alberta Heritage Foundation for Medical Research (AHFMR). AHFMR - HTA Initiative #13.Google Scholar
Lee, L, Packer, TL, Tang, SH, Girdler, S. Self-management education programs for age-related macular degeneration: a systematic review. Australas J Ageing. 2008;27(4):170–176.Google ScholarPubMed
Al-Lami, F, Al-Fatlawi, A, Bloland, P, et al. Pattern of morbidity and mortality in Karbala hospitals during Ashura mass gathering at Karbala, Iraq 2010. East Mediterr Health J. 2013;19(2):S13–S18.10.26719/2013.19.Supp2.S13CrossRefGoogle ScholarPubMed
Brockmann, S, Piechotowski, I, Bock-Hensley, O, et al. Outbreak of leptospirosis among triathlon participants in Germany, 2006. BMC Infect Dis. 2010;10(1):1–5.10.1186/1471-2334-10-91CrossRefGoogle ScholarPubMed
Smith, MWH, Fulde, GWO, Hendry, PM. World Youth Day 2008: did it stress Sydney hospitals? Med J Aust. 2008;189(11-12):630–632.CrossRefGoogle ScholarPubMed
Botelho-Nevers, E, Gautret, P, Benarous, L, Charrel, R, Felkai, P, Parola, P. Travel-related influenza A/H1N1 infection at a rock festival in Hungary: one virus may hide another one. J Travel Med. 2010;17(3):197–198.10.1111/j.1708-8305.2010.00410.xCrossRefGoogle Scholar
Zepeda-Lopez, HM, Perea-Araujo, L, Miliar-García, A, et al. Inside the outbreak of the 2009 influenza A (H1N1) virus in Mexico. PLoS One. 2010:5(10):e13256.10.1371/journal.pone.0013256CrossRefGoogle ScholarPubMed
Chen, TH, Kutty, P, Lowe, LE, et al. Measles outbreak associated with an international youth sporting event in the United States, 2007. Pediatr Infect Dis J. 2010;29(9):794–800.CrossRefGoogle ScholarPubMed
Lim, HC, Cutter, J, Lim, WK, Ee, A, Wong, YC, Tay, BK. The influenza A (H1N1-2009) experience at the inaugural Asian Youth Games Singapore 2009: mass gathering during a developing pandemic. Br J Sports Med. 2010;44(7):528–532.CrossRefGoogle ScholarPubMed
Chowell, G, Nishiura, H, Viboud, C. Modeling rapidly disseminating infectious disease during mass gatherings. BMC Med. 2012;10:159.10.1186/1741-7015-10-159CrossRefGoogle ScholarPubMed
Cummiskey, J, Borrione, P, Bachl, N, Ergen, E, Pigozzi, F. Report of a serious reportable communicable disease at a major sporting event. J Sports Med Phys Fitness. 2008:48(2):125–128.Google Scholar
Grgicˇ-Vitek, M, Frelih, T, Ucakar, V, et al. An outbreak of measles associated with an international dog show in Slovenia, November 2014. Euro Surveill. 2015;20(3):1–4.Google Scholar
Pfaff, G, Lohr, D, Santibanez, S, et al. Spotlight on measles 2010: measles outbreak among travelers returning from a mass gathering Germany, September to October 2010. Euro Surveill. 2010;15(50):1–4.Google Scholar
Verhoef, L, Duizer, E, Vennema, H, et al. Import of norovirus infections in the Netherlands and Ireland following pilgrimages to Lourdes, 2008: preliminary report. Euro Surveill. 2008;13(44):1–2.Google ScholarPubMed
David, S, Roy, N. Public health perspectives from the biggest human mass gathering on earth: Kumbh Mela, India. Int J Infect Dis. 2016;47:42–45.10.1016/j.ijid.2016.01.010CrossRefGoogle ScholarPubMed
Yanagisawa, N, Wada, K, Spengler, JD, Sanchez-Pina, R. Health preparedness plan for dengue detection during the 2020 summer Olympic and Paralympic games in Tokyo. PLoS Negl Trop Dis. 2018;12(9):e0006755.CrossRefGoogle ScholarPubMed
Malik, MT, Gumel, A, Thompson, LH, Strome, T, Mahmud, SM. “Google flu trends” and emergency department triage data predicted the 2009 pandemic H1N1 waves in Manitoba. Canadian Journal of Public Health. 2011;102(4):294–297.10.1007/BF03404053CrossRefGoogle Scholar
Ranse, J, Hutton, A. Minimum data set for mass gathering health research and evaluation: a discussion paper. Prehosp Disaster Med. 2012;27(6):543–550.CrossRefGoogle ScholarPubMed