2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Public Health and Mass Gathering Events: Assessing 
Need for Surveillance in Wales, UK

Priyanka Parmar1 and Daniel RH Thomas*2

1Immunisation Technical Support Unit, Public Health Foundation of India, Gurgaon, India; 2Public Health Wales, UK

Objective
To identify the need of surveillance during mass gathering events in 

Wales by identifying a causal relationship between public health and 
characteristics of a mass gathering event grounded on risk assessment.

Introduction
Mass gathering is defined by WHO as – “More than specified 

number of persons (which can be as few as 1000 persons to more than 
25000) at a specific location for a specific purpose (social function, 
large public event or sports competition) for a defined period of 
time”1. Mass gatherings are considered to have the potential for public 
health incidents, outbreaks and casualties attributed to the inevitable 
overcrowding in a place. Because populations are increasingly mobile, 
and more able to attend large gatherings, the risk for outbreaks of 
infectious diseases among a susceptible population has increased, and a 
substantial responsibility is placed on health services if outbreaks occur.

Currently, there are no existing programmes of surveillance for 
mass gathering events in Wales. Although a variety of surveillance 
system exist, no systematic process is established to gather the 
information from important large events and collect into a common 
database for future reference and to study the impact. The number of 
people attending these gatherings in Wales range from few thousands 
to 250,000.

Methods
An intensive literature review was carried out to identify risk 

variables in mass gathering events. Based on identified risks a ‘risk 
assessment tool’ was developed for the mass gathering events. The 
risk variables are given a score according to its known risk level. The 
maximum total risk level score of an event according to tool can be 27 
and lowest 2. All the identified mass gathering events in Wales were 
assessed according to this tool. A web based semi structured survey 
to identify public health issues during mass gatherings in Wales was 
designed on the NHS website for local public health officials involved 
in preparedness of mass gatherings.

Results
The assessment tool was observed consistent with the other 

international events in the world when their risk levels were compared. 
Mass gathering events in Wales were identified as low and medium 
risks. High risk events that were identified by tool were also identified 
in the survey. Alcohol and drug abuse, food safety, accidents, young 
adults and poor weather (rain) were the factors mainly highlighted as 
high risk variables in the survey. 75% of the respondents mentioned 
prior preventive measures undertaken during mass gatherings. 
Follow up of the mass gathering events and surveillance were noticed 
to be absent. Surveillance is a part of ongoing epidemiological 
surveillance in different health sectors but mass gathering events are 
only monitored if any serious outbreak occurs otherwise the routine 
measures are followed.

Conclusions
The risk level depends on the dose of each risk variable in the event 

on the attending individuals. The need for a continuous surveillance is 

associated to the risk level of the event: High - Requires surveillance 
and action to be taken to reduce consequences; Moderate - Requires 
regular monitoring and preparedness ; Low - Requires routine 
measures. Thoroughly planned and prepared events usually show 
fewer chances of any public health issues. Various factors have been 
identified as high risks (weather, age group of attendees and alcohol 
and drug abuse) which necessitate the need of monitoring the events. 
Most of the studies were found to support enhanced surveillance 
system during large national and international mass gathering events, 
which helps them to see the outcome of the surveillance and impact 
of the mass gathering. Enhancing the current surveillance system to 
establish a collaborated department would require less resources to 
monitor events and for training in emergency conditions. A detailed 
planning of deliveries during future events, adequate staffing, defined 
funding and resources and cost effectiveness should be implemented.

Keywords
Mass gatherings; Mass gathering events; Surveillance; risk assessment

References

1. Communicable disease alert and response for mass gathering. Key
Considerations. World Health Organisation. June 2008. 7 p.

*Daniel RH Thomas

E-mail: daniel,thomas@wales.nhs.uk    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 7(1):e153, 2015