National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, The University of Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, The University of Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, NSW, Australia.
Vaccine. 2018 Jul 25;36(31):4593-4602. doi: 10.1016/j.vaccine.2018.06.027. Epub 2018 Jun 28.
Mass gatherings (MGs) such as the Hajj and Umrah pilgrimages are known to amplify the risk of invasive meningococcal disease (IMD) due to enhanced transmission of the organism between attendees. The burden of IMD at MGs other than Hajj and Umrah has not previously been quantified through a systematic review.
A systematic search for relevant articles in PubMed and Embase was conducted using MeSH terms; this was buttressed by hand searching. Following data abstraction, a narrative synthesis was conducted to quantify the burden of IMD at MGs and identify potential risk factors and mitigation measures.
Thirteen studies reporting occurrence of IMD at MGs or similar crowded settings were identified. Eight studies reported cases or outbreaks in MGs of ≥1000 people; five others reported IMD in other crowded settings; all occurred between 1991 and 2015. All age groups were involved in the identified studies; however the majority of cases (∼80%) were young people aged 15-24 years. The number of affected people ranged from one to 321 cases and the overall crude estimate of incidence was calculated as 66 per 100,000 individuals. Serogroups A, C, B and W were identified, with serogroups A and C being most common. Of 450 cases of IMD reported in non-Hajj/Umrah MGs, 67 (14.9%) had fatal outcomes.
IMD outbreaks at non-Hajj/Umrah MGs are generally much smaller than Hajj-related outbreaks and affect mainly young people. Health education and vaccination should be considered for attendees of high risk non-Hajj/Umrah MGs, especially those involving adolescents and young adults.
麦加朝觐和副朝朝圣等大规模集会由于参会者之间病原体的传播增强，已知会放大侵袭性脑膜炎球菌病（ IMD ）的风险。以前，尚未通过系统评价来量化除朝觐和副朝外的大规模集会中 IMD 的负担。
使用 MeSH 术语在 PubMed 和 Embase 中进行了相关文章的系统搜索；通过手动搜索进行了补充。在提取数据后，进行了叙述性综合分析，以量化大规模集会中 IMD 的负担，并确定潜在的危险因素和缓解措施。
确定了 13 项报告大规模集会或类似拥挤环境中发生 IMD 的研究。有 8 项研究报告了 1000 人以上的大规模集会中的病例或暴发；另外 5 项报告了其他拥挤环境中的 IMD ；所有这些研究都发生在 1991 年至 2015 年之间。所有年龄组都参与了确定的研究；但是，大多数病例（约 80％）是年龄在 15-24 岁的年轻人。受影响的人数从 1 例到 321 例不等，总发病率的粗略估计为每 100000 人 66 例。确定了 A 、 C 、 B 和 W 血清群，其中 A 血清群和 C 血清群最为常见。在 450 例非朝觐/副朝大规模集会中的 IMD 报告病例中，有 67 例（14.9％）死亡。
非朝觐/副朝大规模集会中的 IMD 暴发通常比朝觐相关暴发小得多，主要影响年轻人。应考虑为高危非朝觐/副朝大规模集会的与会者，尤其是涉及青少年和年轻成年人的集会者，开展健康教育和接种疫苗。
