Agency issues health guidance ahead of mass-gathering sports events

With the Euros and Olympic Games expected together to draw millions of domestic and foreign tourists this summer, a European health agency has issued guidance designed to avert health risks posed by mass attended gatherings. 

The Euro 2024 football championships started on Friday (14 June) in Germany and will last until 14 July, when the two last-standing teams will play the final game in Berlin. During this month, thousands of football fans will travel across the country to attend the games in ten selected host cities.    

Over two million tickets have been sold to fans from 190 countries, according to the UEFA. 

France, the other big host of the summer, expects more than 15 million visitors during the Olympic and Paralympic Games that will run from 26 July to 8 September.    

Preparing for these mass gathering events, the European Centre for Disease Prevention and Control (ECDC) has issued recommendations for public health authorities to prepare for possible risks.    

The ECDC defines events where “the number of people attending is sufficient to strain the planning and response resources of the community, city, or nation hosting the event” as mass gatherings, warning they present several public health challenges to the national authorities of the organising countries as participants attend from many countries and, often there are big crowds.    

The recommendations flag multiple factors that can increase the risks of public health threats such as the transmission of imported infectious diseases, the increase of vulnerable individuals, the sale of food and beverage through street vendors, intensified risk behaviours like the consumption of alcohol and drugs and the pressure on the health systems.    

To avoid an excessive workload for national health authorities, preparedness for mass gatherings usually starts two or more years before the event.    

ECDC recommended that the main strategy for the public health sector should be to reinforce existing surveillance systems and avoid developing completely new systems for the events.    

According to the agency, the enhancement of surveillance capacities should include the digitalisation of periodic epidemiological and threat reports, the reinforcement of food and waterborne disease testing frameworks, and the improvement of vector surveillance and ventilation in crowded spaces.    

Recommendations include informing the general public attending events about relevant any vaccines needed, general hygiene rules including hand-washing and appropriate food handling, and protections against extreme weather conditions and insects.    

Other instructions relate to consumption of alcohol and drugs and advice on safe sex practices.    

Previous cases of outbreaks linked to mass gathering events include cases of Legionnaire’s – severe pneumonia – in Edinburgh before the London 2012 Olympic Games and a recent botulism outbreak in France during the Rugby World Cup in 2023.   

However, the ECDC noted that in most cases, it can be difficult to determine if an outbreak happening in temporal association with a mass event would have occurred if the gathering had not taken place.