Steffen Robert
Abteilung für Epidemiologie und Prävention übertragbarer Krankheiten/Zentrum für Reisemedizin, Institut für Sozial- und Präventivmedizin, Universität Zürich.
Ther Umsch. 2013 Jun;70(6):350-2. doi: 10.1024/0040-5930/a000415.
Experience from mass gatherings - usually attended by at least 25'000 persons - shows that approximately one in a thousand participants will consult with an on-site medical emergency service. Communicable diseases usually play a minor role. Historically outbreaks of meningococcal disease were recorded after the hajj, but this has been well controlled in the past few years subsequent to vaccinations and other measures required by the Kingdom of Saudi Arabia health authorities. Major stress of the regional public health system is associated with accidents and non-communicable diseases, the majority being trivial. Host and environmental risk factors can result in a dramatic increase in the rate of consultations: Age and pre-existing illness play a decisive role particularly in pilgrims, be that in Mecca or Lourdes. Emotional factors may influence behavior; aggressions can develop. Alcohol and drugs, also the duration of an event may play a decisive role. Extreme climatic conditions, both heat and cold, also exhaustion result in a dramatic increase of emergency consultations. Infrastructure must be adapted for the crowd size, particularly stampede associated disasters can be avoided. The World Health Organization and other interested expert groups have in the past few years formulated interdisciplinary programs for prevention.
大型集会（通常至少有2.5万人参加）的经验表明，大约每千名参与者中会有一人向现场医疗急救服务机构咨询。传染病通常起的作用较小。历史上，朝觐后曾记录到脑膜炎球菌病的疫情，但在沙特阿拉伯王国卫生当局要求进行疫苗接种和采取其他措施之后，在过去几年里这一情况已得到很好的控制。区域公共卫生系统面临的主要压力与事故和非传染性疾病有关，其中大多数情况并不严重。宿主和环境风险因素可能导致咨询率大幅上升：年龄和既有疾病在朝圣者中起着决定性作用，无论是在麦加还是卢尔德都是如此。情绪因素可能影响行为；可能会出现攻击行为。酒精和药物，以及活动的持续时间也可能起决定性作用。极端气候条件，包括炎热和寒冷，以及疲惫都会导致紧急咨询大幅增加。基础设施必须根据人群规模进行调整，特别是可以避免与踩踏相关的灾难。世界卫生组织和其他相关专家小组在过去几年里制定了跨学科的预防计划。
