Could influenza transmission be reduced by restricting mass gatherings? Towards an evidence-based policy framework

David A. Ishola; Nick Phin

doi:10.1016/j.jegh.2011.06.004

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Volume 1, Issue 1, December 2011, Pages 33 - 60

Could influenza transmission be reduced by restricting mass gatherings? Towards an evidence-based policy framework

Authors

David A. Ishola^a^{, b}^,david.ishola@hpa.org.uk, Nick Phin^a^{, c}^{, *}^,nick.phin@hpa.org.uk

^aPandemic Influenza and Legionnaires’ Disease Section, Health Protection Services, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, United Kingdom

^bCentre for Infectious Disease Epidemiology, Department of Infection and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, United Kingdom

^cFaculty of Health and Social Care, University of Chester, Riverside Campus, Castle Drive, Chester CH1 1SL, United Kingdom

^*Corresponding author at: Pandemic Influenza and Legionnaires’ Disease Section, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, United Kingdom. Tel.: +44 2083276661; fax: +44 2082007868.

Corresponding Author

Nick Phinnick.phin@hpa.org.uk

Received 28 March 2011, Revised 20 June 2011, Accepted 20 June 2011, Available Online 17 August 2011.

DOI: 10.1016/j.jegh.2011.06.004 How to use a DOI?
Keywords: Influenza; Mass gathering; Transmission; Evidence; Policy
Abstract: Introduction: Mass gatherings (MG) may provide ideal conditions for influenza transmission. The evidence for an association between MG and influenza transmission is reviewed to assess whether restricting MG may reduce transmission.

Methods: Major databases were searched (Pubmed, EMBASE, Scopus, CINAHL), producing 1706 articles that were sifted by title, abstract, and full-text. A narrative approach was adopted for data synthesis.

Results: Twenty-four papers met the inclusion criteria, covering MG of varying sizes and settings, and including 9 observational studies, 10 outbreak reports, 4 event reports, and a quasi-experimental study. There is some evidence that certain types of MG may be associated with increased risk of influenza transmission. MG may also “seed” new strains into an area, and may instigate community transmission in a pandemic. Restricting MGs, in combination with other social distancing interventions, may help reduce transmission, but it was not possible to identify conclusive evidence on the individual effect of MG restriction alone. Evidence suggests that event duration and crowdedness may be the key factors that determine the risk of influenza transmission, and possibly the type of venue (indoor/outdoor).

Conclusion: These factors potentially represent a basis for a policy-making framework for MG restrictions in the event of a severe pandemic.
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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Journal: Journal of Epidemiology and Global Health
Volume-Issue: 1 - 1
Pages: 33 - 60
Publication Date: 2011/08/17
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.1016/j.jegh.2011.06.004 How to use a DOI?
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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TY  - JOUR
AU  - David A. Ishola
AU  - Nick Phin
PY  - 2011
DA  - 2011/08/17
TI  - Could influenza transmission be reduced by restricting mass gatherings? Towards an evidence-based policy framework
JO  - Journal of Epidemiology and Global Health
SP  - 33
EP  - 60
VL  - 1
IS  - 1
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2011.06.004
DO  - 10.1016/j.jegh.2011.06.004
ID  - Ishola2011
ER  -

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