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Review
. 2019 Dec;8(4):569-579.
doi: 10.1007/s40121-019-00262-9. Epub 2019 Aug 30.

Incidence and Prevention of Invasive Meningococcal Disease in Global Mass Gathering Events

Abdul Razak Muttalif  1 , Jessica V Presa  2 , Hammam Haridy  3 , Amgad Gamil  3 , Lidia C Serra  4 , Alejandro Cané  5
Affiliations
Review

Incidence and Prevention of Invasive Meningococcal Disease in Global Mass Gathering Events

Abdul Razak Muttalif et al. Infect Dis Ther. 2019 Dec.

Abstract

Introduction: Mass gathering events involve close contact among large numbers of people in a specific location at the same time, an environment conducive to transmission of respiratory tract illnesses including invasive meningococcal disease (IMD). This report describes IMD incidence at mass gatherings over the past 10 years and discusses strategies to prevent IMD at such events.

Methods: A PubMed search was conducted in December 2018 using a search string intended to identify articles describing IMD at mass gatherings, including religious pilgrimages, sports events, jamborees, and refugee camps. The search was limited to articles in English published from 2008 to 2018. Articles were included if they described IMD incidence at a mass gathering event.

Results: A total of 127 articles were retrieved, of which 7 reported on IMD incidence at mass gatherings in the past 10 years. Specifically, in Saudi Arabia between 2002 and 2011, IMD occurred in 16 Hajj pilgrims and 1 Umrah pilgrim; serotypes involved were not reported. At a youth sports festival in Spain in 2008, 1 case of serogroup B IMD was reported among 1500 attendees. At the 2015 World Scout Jamboree in Japan, an outbreak of serogroup W IMD was identified in five scouts and one parent. At a refugee camp in Turkey, one case of serogroup B IMD was reported in a Syrian girl; four cases of serogroup X IMD occurred in an Italian refugee camp among refugees from Africa and Bangladesh. In 2017, a funeral in Liberia resulted in 13 identified cases of serogroup C IMD. Requiring meningococcal vaccination for mass gathering attendees and vaccinating refugees might have prevented these IMD cases.

Conclusions: Mass gathering events increase IMD risk among attendees and their close contacts. Vaccines preventing IMD caused by serogroups ACWY and B are available and should be recommended for mass gathering attendees.

Funding: Pfizer.

Keywords: Invasive meningococcal disease; Mass gathering; Neisseria meningitidis; Vaccination.

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Conflict of interest statement

Dr Abdul Razak Muttalif has nothing to declare. Dr Jessica V. Presa is an employee of Pfizer. Dr Hammam Haridy is an employee of Pfizer. Dr Amgad Gamil is an employee of Pfizer. Dr Lidia C. Serra is an employee of Pfizer. Dr Alejandro Cané is an employee of Pfizer.

References

    1. World Health Organization. Public health for mass gatherings: key considerations. Available at: http://apps.who.int/iris/bitstream/handle/10665/162109/WHO_HSE_GCR_2015..... Accessed December 4, 2018.
    1. Centers for Disease Control and Prevention. Travel to mass gatherings. Available at: https://wwwnc.cdc.gov/travel/yellowbook/2018/advising-travelers-with-spe.... Accessed December 10, 2018.
    1. Parker S. The Hajj: a constant travel destination amidst changing times. South Afr J Epidemiol Infect. 2010;25:14–18.
    1. Badahdah AM, Rashid H, Khatami A, Booy R. Meningococcal disease burden and transmission in crowded settings and mass gatherings other than Hajj/Umrah: a systematic review. Vaccine. 2018;36:4593–4602. doi: 10.1016/j.vaccine.2018.06.027. - DOI - PubMed
    1. Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13. Washington: Public Health Foundation; 2015.

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