Rainey Jeanette J, Phelps Tiffani, Shi Jianrong
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
PLoS One. 2016 Aug 18;11(8):e0160378. doi: 10.1371/journal.pone.0160378. eCollection 2016.
Because mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings during a moderate or severe pandemic. Despite these recommendations, limited empirical information exists on the frequency and characteristics of mass gathering-related respiratory disease outbreaks occurring in the United States.
We conducted a systematic literature review to identify articles about mass gathering-related respiratory disease outbreaks occurring in the United States from 2005 to 2014. A standard form was used to abstract information from relevant articles identified from six medical, behavioral and social science literature databases. We also analyzed data from the National Outbreaks Reporting System (NORS), maintained by the Centers for Disease Control and Prevention since 2009, to estimate the frequency of mass gathering-related respiratory disease outbreaks reported to the system.
We identified 21 published articles describing 72 mass gathering-related respiratory disease outbreaks. Of these 72, 40 (56%) were associated with agriculture fairs and Influenza A H3N2v following probable swine exposure, and 25 (35%) with youth summer camps and pandemic Influenza A H1N1. Outbreaks of measles (n = 1) and mumps (n = 2) were linked to the international importation of disease. Between 2009 and 2013, 1,114 outbreaks were reported to NORS, including 96 respiratory disease outbreaks due to Legionella. None of these legionellosis outbreaks was linked to a mass gathering according to available data.
Mass gathering-related respiratory disease outbreaks may be uncommon in the United States, but have been reported from fairs (zoonotic transmission) as well as at camps where participants have close social contact in communal housing. International importation can also be a contributing factor. NORS collects information on certain respiratory diseases and could serve as a platform to monitor mass gathering-related respiratory outbreaks in the future.
由于群体聚集会创造有利于传染病传播的环境，公共卫生官员可能会建议在中度或重度疫情期间推迟或取消大型集会。尽管有这些建议，但关于美国发生的与群体聚集相关的呼吸道疾病暴发的频率和特征的实证信息有限。
我们进行了一项系统的文献综述，以确定2005年至2014年在美国发生的与群体聚集相关的呼吸道疾病暴发的文章。使用标准表格从六个医学、行为和社会科学文献数据库中识别出的相关文章中提取信息。我们还分析了自2009年以来由疾病控制和预防中心维护的国家疫情报告系统（NORS）的数据，以估计报告给该系统的与群体聚集相关的呼吸道疾病暴发的频率。
我们识别出21篇已发表的文章，描述了72起与群体聚集相关的呼吸道疾病暴发。在这72起暴发中，40起（56%）与农业展会以及可能接触猪后感染甲型H3N2v流感有关，25起（35%）与青少年夏令营和甲型H1N1大流行性流感有关。麻疹（n = 1）和腮腺炎（n = 2）的暴发与疾病的国际输入有关。2009年至2013年期间，有1114起疫情报告给了NORS，其中包括96起因军团菌引起的呼吸道疾病暴发。根据现有数据，这些军团病暴发均与群体聚集无关。
在美国，与群体聚集相关的呼吸道疾病暴发可能并不常见，但在展会（人畜共患病传播）以及参与者在集体宿舍中有密切社交接触的营地中均有报告。国际输入也可能是一个促成因素。NORS收集有关某些呼吸道疾病的信息，未来可作为监测与群体聚集相关的呼吸道暴发的平台。
