International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

Philippe Gautret, Kristina M. Angelo, Hilmir Asgeirsson, Alexandre Duvignaud, Perry J.J. van Genderen, Emmanuel Bottieau, Lin H. Chen, Salim Parker, Bradley A. Connor, Elizabeth D. Barnett, Michael Libman, Davidson H. Hamer, Emilie Javelle, Marc Mendelson, Hedvig Glans, Eric Caumes, Poh Lian Lim, Jonathan Alpern, William Stauffer, Andrea BoggildKevin Kain, Karin Leder, Joseph Torresi, Katherine Plewes, Wayne Ghesquiere, Denis Malvy, Francois Chappuis, Giles Eperon, Sarah Borwein, Johnnie Yates, Brian Ward, Jesse Waggoner, Henry Wu, Israel Molina, Dan Bourque, Kunjana Mavunda, Mugen Ujiie, Satoshi Katsuna, Carsten Larsen, Christian Wejse, Noreen Hynes, Paul Kelly, Susan Kuhn, Cecilia Perret Perez, Thomas Weitzel, Sabine Jordan, Mauro Saio, Michael Beadsworth, Nicholas Beeching, Mogens Jensenius, Susan Anderson, Patricia Schlagenhauf, Rainer Weber

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background: Travelers to international mass gatherings may be exposed to conditions which increase their risk of acquiring infectious diseases. Most existing data come from single clinical sites seeing returning travelers, or relate to single events. Methods: Investigators evaluated ill travelers returning from a mass gathering, and presenting to a GeoSentinel site between August 2015 and April 2019, and collected data on the nature of the event and the relation between final diagnoses and the mass gathering. Results: Of 296 ill travelers, 51% were female and the median age was 54 years (range: 1–88). Over 82% returned from a religious mass gathering, most frequently Umrah or Hajj. Only 3% returned from the Olympics in Brazil or South Korea. Other mass gatherings included other sporting events, cultural or entertainment events, and conferences. Respiratory diseases accounted for almost 80% of all diagnoses, with vaccine preventable illnesses such as influenza and pneumonia accounting for 26% and 20% of all diagnoses respectively. This was followed by gastrointestinal illnesses, accounting for 4.5%. Sixty-three percent of travelers reported having a pre-travel encounter with a healthcare provider. Conclusions: Despite this surveillance being limited to patients presenting to GeoSentinel sites, our findings highlight the importance of respiratory diseases at mass gatherings, the need for pre-travel consultations before mass gatherings, and consideration of vaccination against influenza and pneumococcal disease.

Original languageEnglish (US)
Article number101504
JournalTravel Medicine and Infectious Disease
StatePublished - Nov 1 2019

Bibliographical note

Funding Information:
GeoSentinel, the Global Surveillance Network of the International Society of Travel Medicine (ISTM) , is supported by a Cooperative Agreement ( U50CK00189 ) from the Centers for Disease Control and Prevention (CDC) , as well as funding from the ISTM and the Public Health Agency of Canada . The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of CDC.

Publisher Copyright:
© 2019 Elsevier Ltd


  • Mass gatherings
  • Oylmpics
  • Respiratory
  • Surveillance


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