Preparedness and response during Mass-gatherings: The ongoing experience of the Regional Plan for surveillance and response to infectious diseases emergencies during the extraordinary Jubilee 2015-16

Abstract

Purpose: International mass events - such as the London Olympics, the World Cup in Brazil, the Expo in Milan, the Hajii - increase the risk of transmission of certain infectious diseases, either endemic or imported, leading to the emergence of outbreaks and stressing the prevention and control contermeasures. The extraordinary Jubilee 2015-16 constitutes a year-long mass event, that for intensity and duration, represents a challenge for the regional health system. Methods & Materials: During the Jubilee, the Lazio Region, where Rome is located, is implementing a regional plan for surveillance and management of Infectious Emergencies. Starting from December 8, 2015 data from different integrated surveillance systems are continuously analyzed: notifications of infectious diseases (including special surveillance), syndromic surveillance, event based surveillance Surveillance and response activities include: a) collecting and analyzing data diseases notification system; b) evaluation of syndromic surveillance data; c) International Alert monitoring; d) evaluation of alerts and activation of response and control measures. Results: On June 5th, 2016, 4251 notifications have been reported with increasing frequency since the beginning of the Jubilee. For each disease, the absolute and relative frequency has been compared weekly with previous years 2013-2014 and with the trends of the previous weeks. This led to the analysis and evaluation of 70 alerts. The daily evaluation of individual notifications and its link with a Jubilee event led to the investigation of 12 events (i.e. pulmonary tuberculosis, chicken pox, measles, flu, hepatitis and rotavirus infection, listeriosis and others). Syndromic surveillance is evaluated bi-weekly and 50 evaluations have been conducted and 67 alerts have been analyzed so far, generated more frequently from “Respiratory syndrome with fever”, “Acute haemorrhagic fever with rash” “and” fever with lymphadenitis”. The event based surveillance reported about 10 events per week for a total of about 280 alerts. Conclusion: The implementation of the plan has made possible the close monitoring of potential infectious emergencies in the Lazio region during the reported period. Given the increase of travels and possibilità to easily partecipate to mass events, sharing the experience during mass gatherings is crucial to find common solutions to public health issues.