Abstract
In the minds of many, large scale open air festivals have become associated with spring and summer, attracting many people, and in the case of music festivals, thousands of music fans. These festivals share the usual health risks associated with large mass gatherings, including transmission of communicable diseases and risk of outbreaks. Large scale open air festivals have however specific characteristics, including outdoor settings, on-site housing and food supply and the generally young age of the participants. Outbreaks at large scale open air festivals have been caused by Cryptosporium parvum, Campylobacter spp., Escherichia coli, Salmonella enterica, Shigella sonnei, Staphylococcus aureus, hepatitis A virus, influenza virus, measles virus, mumps virus and norovirus. Faecal-oral and respiratory transmissions of pathogens result from non-compliance with hygiene rules, inadequate sanitation and insufficient vaccination coverage. Sexual transmission of infectious diseases may also occur and is likely to be underestimated and underreported. Enhanced surveillance during and after festivals is essential. Preventive measures such as immunisations of participants and advice on-site and via social networks should be considered to reduce outbreaks at these large scale open air festivals.
Highlights
Mass gathering (MG) medicine is an emerging specialty [1] that includes effective strategies and planning to address health security and risks associated with MGs
107 articles were retrieved through MEDLINE and scanning of reference lists, and 23 of these were relevant to our subject from a review of titles, abstracts, and full text of the articles obtained
Outbreaks and infectious diseases occurring during large scale open air festivals were classified into three categories: (i) faecal-oral transmission and gastrointestinal diseases, (ii) respiratory transmission and respiratory infections and (iii) blood-borne and sexually transmitted diseases
Summary
Definitions vary greatly, with some sources specifying any gathering to be a MG when more than 1,000 individuals attend, whereas others require the attendance of as many as 25,000 people to qualify [2]. Occur irrespective of the size of a gathering and are described in settings such as private parties, weddings, and other events involving fewer than 1,000 attendees, and in large MGs, such as religious MGs, attended by millions of people [3]. In addition to the number of people, MGs are events at a specific site for a definite time which may greatly vary between different MGs. In addition to the number of people, MGs are events at a specific site for a definite time which may greatly vary between different MGs These gatherings might be planned or unplanned and recurrent or sporadic
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