Mass Gathering Surveillance: New ESSENCE Report  and Collaboration Win Gold in OR

ObjectiveTo streamline production of a daily epidemiology report includingsyndromic surveillance, notifiable disease, and outbreak data duringa mass gatheringIntroductionThe 2016 U.S. Olympic Track and Field Team Trials were heldJuly 1-10 in Eugene, OR. This mass gathering included over 1,000athletes, 1,500 volunteers, and 175,000 spectators. The Oregon PublicHealth Division (PHD) and Lane County Public Health (LCPH)participated in pre-event planning and collaborated to produce adaily epidemiology report for the Incident Management Team (IMT)during the event. The state and county public health agencies hadcollaborated on surveillance for prior mass gatherings, including the2012 Trials. However, 2016 was the first opportunity to use completestate and county syndromic surveillance data.MethodsPHD staff developed an ESSENCE report, highlighting sevenpriority health outcomes: total emergency department visits; injury,gastrointestinal, respiratory, and fever syndromes; and asthma-like and heat-related illness queries. The report included side-by-side comparisons of county and state time series graphs, a tablesummarizing reportable diseases, and space to narratively describeoutbreaks. PHD staff did a virtual demonstration and in-persontutorial for LCPH staff on how to run the report. ESSENCE accesspermissions had to be modified so that county users could see andproduce state time-series graphs but not data details for non-LaneCounty visits. Emphasis was placed on interpretation of likelyscenarios, i.e., one or two days with a warning that was not indicativeof an incident of public health importance.ResultsDuring the event, LCPH staff were able to run the reportsuccessfully, i.e., there were no technical glitches. For the first fewdays, LCPH staff consulted with PHD staff about epidemiologicalinterpretation. State data were of specific interest since data detailswere suppressed. Additionally, increases were seen in the injurysyndrome in the days preceding the July 4 holiday. Stratification bykey demographic factors and looking at subsyndrome breakdownson warning and alert days provided the needed information withoutrequiring the use of the detail details.ConclusionsAfter the event, there were three main recommendations forimproving the process.LCPH suggested that the side-by-side visualization of countyand state time series graphs was useful to see trends but the relativescale of the number of visits was unclear due to size and placement(see figure 1). Solutions for future reports include additionalexplanatory text, limiting the report to only county data, and alternativevisualizations that highlight the differences in visit magnitude.As part of the IMT process, the LCPH lead felt that her efforts tophysically go to the Emergency Operations Center to run the reporthelped facilitate communication with partners. However, it is notclear if this effort directly translated into IMT use of the report, whichwas posted to the online event management system and not includedin the daily situation status reports. While LCPH leadership and staffreported anecdotally that they found the report to be very useful,no formal evaluation of use was done with either public health orIMT staff. In advance of the next event, state and county staff shouldprepare evaluation metrics.The report feature in ESSENCE is a bit cumbersome to set up, butit allows for easy production of appealing and customizable reports.This template can be modified for future mass gatherings, includingathletic competitions and county fairs. PHD staff will continueto collaborate with LCPH to repurpose and improve the report foruse in Lane and other counties. Fostering local user comfort withinterpreting ESSENCE data and generating summaries for local useis a priority of the OR ESSENCE team.

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Assessment of Temporary Medical Clinics During the Arbaeenia Mass Gathering at Al-Karkh, Baghdad, Iraq, in 2014: Cross-Sectional Study

JMIR Public Health and Surveillance ◽

10.2196/10903 ◽

2019 ◽

Vol 5 (3) ◽

pp. e10903 ◽

Cited By ~ 1

Author(s):

Faris Lami ◽

Ali Abdalkader Ali ◽

Kareem Fathullah ◽

Hana Abdullatif

Keyword(s):

Public Health ◽

Health Care ◽

Health Workforce ◽

Mass Gathering ◽

Mass Gatherings ◽

Medical Supplies ◽

Set Up ◽

Almost All ◽

Basic Medical ◽

Equipment And Instruments

Background During mass gatherings, public health services and other medical services should be planned to protect attendees and people living around the venue to minimize the risk of disease transmission. These services are essential components of adequate planning for mass gatherings. The Arbaeenia mass gathering signifies the remembrance of the death of Imam Hussain, celebrated by Shiite Muslims, and takes place in Karbala, which is a city in southern Iraq. This annual mass gathering is attended by millions of people from within and outside Iraq. Objective This study aimed to map the availability of medical supplies, equipment, and instruments and the health workforce at the temporary clinics located in Al-Karkh, Baghdad, Iraq, in 2014. Methods This assessment was conducted on the temporary clinics that served the masses walking from Baghdad to Karbala. These clinics were set up by governmental and nongovernmental organizations (NGOs) and some faith-based civil society organizations, locally known as mawakib. We developed a checklist to collect information on clinic location, affiliation, availability of safe water and electricity, health personnel, availability of basic medical equipment and instruments, drugs and other supplies, and average daily number of patients seen by the clinic. Results A total of 30 temporary clinics were assessed: 18 clinics were set up by the Ministry of Health of Iraq and 12 by other governmental organizations and NGOs. The clinics were staffed by a total of 44 health care workers. The health workers served 16,205 persons per day, an average of 540 persons per clinic, and 368 persons per health care worker per day. The majority of clinics (63% [19/30]-100% [30/30]) had basic medical diagnostic equipment. Almost all clinics had symptom relief medications (87% [26/30]-100% [30/30]). Drugs for diabetes and hypertension were available in almost half of the clinics. The majority of clinics had personal hygiene supplies and environmental sanitation detergents (78%-90%), and approximately half of the clinics had medical waste disposal supplies. Instruments for cleansing and dressing wounds and injuries were available in almost all clinics (97%), but only 4 clinics had surgical sterilization instruments. Conclusions Although temporary clinics were relatively equipped with basic medical supplies, equipment, and instruments for personal medical services, the health workforce was insufficient, given the number of individuals seeking care, and only limited public health service, personal infection control, and supplies were available at the clinics.

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Assessment of Temporary Medical Clinics During the Arbaeenia Mass Gathering at Al-Karkh, Baghdad, Iraq, in 2014: Cross-Sectional Study (Preprint)

10.2196/preprints.10903 ◽

2018 ◽

Author(s):

Faris Lami ◽

Ali Abdalkader Ali ◽

Kareem Fathullah ◽

Hana Abdullatif

Keyword(s):

Public Health ◽

Health Care ◽

Health Workforce ◽

Mass Gathering ◽

Mass Gatherings ◽

Medical Supplies ◽

Set Up ◽

Almost All ◽

Basic Medical ◽

Equipment And Instruments

BACKGROUND During mass gatherings, public health services and other medical services should be planned to protect attendees and people living around the venue to minimize the risk of disease transmission. These services are essential components of adequate planning for mass gatherings. The Arbaeenia mass gathering signifies the remembrance of the death of Imam Hussain, celebrated by Shiite Muslims, and takes place in Karbala, which is a city in southern Iraq. This annual mass gathering is attended by millions of people from within and outside Iraq. OBJECTIVE This study aimed to map the availability of medical supplies, equipment, and instruments and the health workforce at the temporary clinics located in Al-Karkh, Baghdad, Iraq, in 2014. METHODS This assessment was conducted on the temporary clinics that served the masses walking from Baghdad to Karbala. These clinics were set up by governmental and nongovernmental organizations (NGOs) and some faith-based civil society organizations, locally known as mawakib. We developed a checklist to collect information on clinic location, affiliation, availability of safe water and electricity, health personnel, availability of basic medical equipment and instruments, drugs and other supplies, and average daily number of patients seen by the clinic. RESULTS A total of 30 temporary clinics were assessed: 18 clinics were set up by the Ministry of Health of Iraq and 12 by other governmental organizations and NGOs. The clinics were staffed by a total of 44 health care workers. The health workers served 16,205 persons per day, an average of 540 persons per clinic, and 368 persons per health care worker per day. The majority of clinics (63% [19/30]-100% [30/30]) had basic medical diagnostic equipment. Almost all clinics had symptom relief medications (87% [26/30]-100% [30/30]). Drugs for diabetes and hypertension were available in almost half of the clinics. The majority of clinics had personal hygiene supplies and environmental sanitation detergents (78%-90%), and approximately half of the clinics had medical waste disposal supplies. Instruments for cleansing and dressing wounds and injuries were available in almost all clinics (97%), but only 4 clinics had surgical sterilization instruments. CONCLUSIONS Although temporary clinics were relatively equipped with basic medical supplies, equipment, and instruments for personal medical services, the health workforce was insufficient, given the number of individuals seeking care, and only limited public health service, personal infection control, and supplies were available at the clinics.

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What did Syndromic Surveillance Show During London 2012? Lessons for Mass Gatherings

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v7i1.5835 ◽

2015 ◽

Vol 7 (1) ◽

Author(s):

Dan Todkill ◽

Helen Hughes ◽

Alex Elliot ◽

Roger Morbey ◽

Obaghe Edeghere ◽

...

Keyword(s):

Public Health ◽

General Practitioner ◽

Syndromic Surveillance ◽

Lessons Learned ◽

Surveillance Systems ◽

Mass Gathering ◽

Daily Number ◽

Mass Gatherings ◽

London 2012 ◽

The Impact

This paper investigates the impact of the London 2012 Olympic and Paralympic Games on syndromic surveillance systems coordinated by Public Health England. The Games had very little obvious impact on the daily number of ED attendances and general practitioner consultations both nationally, and within London. These results provide valuable lessons learned for future mass gathering events.

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Proposing a Minimum Data Set for Mass Gathering Health

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19000980 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s40-s41

Author(s):

Malinda Steenkamp ◽

Paul Arbon ◽

Adam Lund ◽

Sheila Turris ◽

Jamie Ranse ◽

...

Keyword(s):

Public Health ◽

Minimum Data Set ◽

Data Repository ◽

Mass Gathering ◽

Data Set ◽

Mass Gatherings ◽

Modified Delphi ◽

Minimum Data ◽

Safety Considerations ◽

Data Elements

Introduction:There is currently no standardized approach to collecting mass gathering health data, which makes comparisons across or between events challenging. From 2013 onward, an international team of researchers from Australia and Canada collaborated to develop a Minimum Data Set (MDS) for Mass Gathering Health (MGH).Aim:The process of developing the MDS has been reported on previously at the 2015 and 2017 World Congresses on Disaster and Emergency Medicine, and this presentation will present a final MDS on MGH.Methods:This study drew from literature, including the 2015 Public Health for Mass Gatherings key considerations, previous event/patient registry development, expert input, and the results of the team’s work. The authors developed an MDS framework with the aim to create an online MGH data repository. The framework was populated with an initial list of data elements using a modified Delphi technique.Results:The MDS includes the 41 data elements in the following domains: community characteristics, event characteristics, venue characteristics, crowd characteristics, event safety considerations, public health considerations, and health services. Also included are definitions and preliminary metadata.Discussion:The development of an MGH-MDS can grow the science underpinning this emerging field. Future input from the international community is essential to ensure that the proposed MDS is fit-for-purpose, i.e., systematic, comprehensive, and rigorous, while remaining fluid and relevant for various users and contexts.

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Using State and National Surveillance Systems during World Equestrian Games in NC

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v11i1.9691 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Lana Deyneka ◽

Zachary Faigen ◽

Anne Hakenwerth ◽

Nicole Lee ◽

Amy Ising ◽

...

Keyword(s):

Public Health ◽

Syndromic Surveillance ◽

Urgent Care ◽

Poison Center ◽

Surveillance Systems ◽

Mass Gathering ◽

Mass Gatherings ◽

Epidemic Intelligence ◽

Polk County ◽

Ed Visits

ObjectiveTo describe surveillance activities and use of existing state (NC DETECT) and national (NSSP) syndromic surveillance systems during the International Federation for Equestrian Sports (FEI) World Equestrian Games (WEG), in Mill Spring, NC from September 11 to September 23, 2018MethodsNC DETECT collects statewide data from hospital emergency department (ED) visits and Carolinas Poison Center (CPC) calls. NC DETECT also collects data from select Urgent Care Centers (UCC) in the Charlotte area. CPC data are updated hourly, while ED data are updated twice a day. NC DETECT data were monitored daily for census (total ED visits), communicable disease syndromes, injury syndromes, and other occurrences of public health significance related to the event. The geographic areas monitored were Polk County (the location of the main event), the counties where the guests were lodging in the Western NC Region (Henderson, Transylvania, Buncombe, Rutherford, McDowell, and Cleveland), the Charlotte Metropolitan area, and statewide. Because of the large number of people from other states and countries who attended, ED surveillance was mainly conducted by hospitals so that visits were captured for all patients and not just NC residents. WEG dashboards containing ED data were created prior to the event using NC DETECT and NSSP ESSENCE systems, and were accessible to epidemiologists at the state level. NSSP syndrome queries were shared with the neighboring state (SC) public health agency. Surveillance began two weeks prior to the event to establish baseline levels for all ED visits for hospitals in Polk County and the Western NC Region. Surveillance occurred daily before the event, during the event, and for two weeks following the event to account for incubation periods of potential diseases.ResultsThe 2018 Equestrian games in Western NC were affected by heavy rain and heat. The weather led to low attendance and cancellation of a few competitions. During the observation period, ED admissions and most of the mass gathering related syndromes in both NC DETECT and NSSP systems were at baseline. ED admissions for motor vehicle collisions and dehydration syndromes were above baseline for 09/19 and 09/21/18 (Figures 3-4). CPC calls and UC admissions for selected UC centers in the Charlotte area were also monitored, and were at baseline.ConclusionsNC DETECT and NSSP Dashboards provided effective and timely surveillance for the WEG event to assist local public health in the rural NC area with epidemiologic investigations and appropriate response. NC DETECT’s CPC and UC data provided additional valuable information, and complemented ED surveillance during the mass gathering event. Syndromic surveillance became essential during WEG, as NC DPH deployment plans and resource availability changed when Hurricane Florence bore down on the region.References1. Joseph S. Lombardo, Carol A. Sniegoski, Wayne A. Loschen, Matthew Westercamp, Michael Wade, Shandy Dearth, and Guoyan Zhang Public Health Surveillance for Mass Gatherings Johns Hopkins APL Technical Digest , Volume 27, Number 4 (2008)2. Kaiser R, Coulombier D. Epidemic intelligence during mass gatherings. Euro Surveill. 2006;113. Ising A, Li M, Deyneka L, Vaughan-Batten H, Waller A. Improving syndromic surveillance for nonpower users: NC DETECT dashboards. Emerging Health Threats Journal 2011, 4: 11702 - DOI: 10.3402/ehtj.v4i0.11702

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Risk Assessment tool for Religious Mass Gathering Events of India

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v11i1.9929 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Upasana Sharma ◽

Sankara Sarma

Keyword(s):

Public Health ◽

Risk Assessment ◽

Content Validity ◽

Tamil Nadu ◽

Assessment Tool ◽

Risk Assessment Tool ◽

Mass Gathering ◽

Planning Stage ◽

Mass Gatherings ◽

Special Events

ObjectiveTo develop a risk assessment tool to assess the public health and environmental risks associated with religious mass gathering events of Tamil Nadu, a state in the southern part of IndiaIntroductionIn spite of the fact that mass gatherings are an undeniably regular element of our society attended by huge crowds yet such occasions are not very well understood. Even though such gatherings are accumulations of "well people", vast number of people associated with mass gatherings can put a serious strain on the entire health care system1.The public health implications of mass gathering events include a potential increased risk for disease transmission because of the variability and mobility of those attending the event and increased media attention. Risk assessment for mass gathering events is crucial to identify the potential health hazards which aids in planning and response activities specific to the event2. Preparing for mass gatherings offer an opportunity to improve health service delivery, enhance health promotion and strengthen public health systems3.In India, many of the religious festivals are observed with mass gatherings and prayers. Large crowd participate in such festivals as participants to observe the unique rituals and also as spectators. Literature indicates that in India, we might be well equipped for response activities but the scientific concept of risk assessment i.e., to understand the existing risks, identify the risks, characterize the risks and plan for risk reduction strategies accordingly are at an infant stage .The little that has been done in the field of mass gatherings has generally focused on description of preparedness activities of single event, crowd control, prevention of stampedes with little attention to public health preparedness. The present project is an attempt to systemize the process of risk assessment by developing a risk assessment tool consisting of characteristics peculiar to planned religious mass gatherings of Indian context.MethodsQualitative approach was followed to identify the risks associated with mass gathering events and to identify the domains and items to be included in the risk assessment tool. Firstly, an extensive review of literature about the risks associated with the mass gathering events was done. Secondly, Key Informants (n=20) involved in planning and management of religious mass gathering events in the State of Tamil Nadu, India were purposively identified and interviewed using a semi structured interview guide. Principle of redundancy was followed. Content/Thematic analysis was done using Atlas.ti software. Currently, the project is in the phase of obtaining content validity of the developed tool. Followed by this, a mobile application based upon the validated tool will be developed which will be further field tested for feasibility in a selected mass gathering event in Tamil Nadu. Using a self administered content validity questionnaire, the experts will be asked to assess the relevance of the items of the tool. Agreement proportions between the experts will be calculated. S-CVI (Scale Content Validity Index), index for inter-rater agreement (agreement proportion) and Kappa agreement coefficient will be calculated.ResultsA sum total of 48 unique health risks have been identified. Stampedes, fire accidents, structural collapse, drowning, outbreak of communicable diseases, exacerbation of existing medical illnesses (like cardiac diseases, asthma etc) etc are the some of the health risks identified. Six domains (characteristics related to event, participant, environment, disaster preparedness, medical service preparedness and pre event planning activities) and 21 items have been generated from the content analysis of key informant interviews and literature review.ConclusionsSome special events and unforeseen events occur in places of mass gatherings besides fixed places of worshipping .Such events cause more damage to human beings and property. Special events like idol procession, chariot pulling, fire walking, animal sacrificing happen pulling larger crowds within the mass gatherings. In order to inform all planning and delivery activities it is essential to understand the mass gathering context and risk assessments. This tool can be used by public health managers to identify key public health and environmental risks at the planning stage before the event takes off. At the planning stage, use of this tool will help in putting the required measures in place in order to address the potential risks identified. The tool can be used as a guiding instrument during and after the event as well. The investigators further plan to develop a mobile based app from this risk assessment tool and test it out in a selected mass gathering event of the state of Tamil Nadu located in southern part of India. Feedback from public health managers about the mobile based risk assessment tool can be instrumental in further modifying the tool. By contributing to public health preparedness activities during mass gathering events in a country with poor resources like India, this research activity is an initiative that is expected to lead to health systems strengthening.References1. Arbon P. The development of conceptual models for mass-gathering health. Prehospital and Disaster Medicine. 2004 Sep;19(3):208-12.2. World Health Organization. Public health for mass gatherings: Key considerations. Geneva: WHO; 2015.3. Tam JS, Barbeschi M, Shapovalova N, Briand S, Memish ZA, Kieny MP. Research agenda for mass gatherings: a call to action. The Lancet infectious diseases. 2012 Mar 31; 12(3):231-9.

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Introduction to Health Law

Studies in Health Technology and Informatics - Health Information Management: Empowering Public Health ◽

10.3233/shti200660 ◽

2020 ◽

Author(s):

Dede Onisoyonivosekume ◽

Nour Mahrouseh ◽

Orsolya Varga

Keyword(s):

Public Health ◽

Infectious Disease ◽

Personal Health Information ◽

Individual Rights ◽

Health Law ◽

Infected People ◽

Public Health Agencies ◽

The Public ◽

The Government ◽

Set Up

In early February of 2020, attention was drawn to the increased number of deaths and the new cases of coronavirus infection. The epicentre of the outbreak was Wuhan in the People’s Republic of China. In order to control the outbreak, Chinese leaders called on the city authorities in Wuhan to set up mass quarantine centres for infected people. The Chinese government took this step to protect the public against infectious disease. This is an example of the conflicts between public health and civil liberties/individual rights. Government authority is the pillar of the public health law. The government retains the power to achieve and maintain common good by restricting – within solid international and national limits – individual rights concerning autonomy, privacy, association, and liberty. Public health agencies have the right to collect, use, and disclose a considerable amount of personal health information and to enforce certain vaccinations, medical examinations, and treatments. In addition to the power to isolate individuals to protect the public against the spread of infectious disease, their powers can be used to control businesses and professions. There are several legal interventions to prevent injury and disease and promote the public’s health. Among these tools are taxing policies, which encourage engaging in beneficial behaviour (fruit consumption) and disincentives to engage in high-risk activities (smoking).

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(A225) Lessons Learned at the Commonwealth Games: A Mass-Gathering Sporting Event in New Delhi, India

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11002111 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s61-s61

Author(s):

A. Madan

Keyword(s):

Public Health ◽

Mass Casualty ◽

Lessons Learned ◽

Mitigation Strategies ◽

New Delhi ◽

Sporting Events ◽

Mass Gathering ◽

Outbreak Response ◽

Mass Gatherings ◽

Commonwealth Games

Mass gatherings can be religious, political, socio-cultural, or sporting events, and vary in the form of processions, car races, conferences, fairs, etc. New Delhi hosted the 2010 Commonwealth Games, a mass gathering spread over a duration of 10 days with different venues and a high density of participants, spectators, security personnel, volunteers, and high-profile guests. Various organizations were involved in the planning and implementation of the games which called for a collaborative and coordinated effort to make the event a success. Security coverage was required for 23 sporting, 32 training, and seven non-sporting venues. Security arrangements were of utmost importance and required training, mobilization, and deployment of army, police, and other emergency workers, as well as establishing Standard Operating Procedures for responses to chemical, biological, radioactive, and nuclear events and availing specialized equipment. Areas of public health interventions in mass gathering include mass-casualty preparedness, disease surveillance and outbreak response, safety of water, food, and venues, health promotion, public health preparedness and response, pest and vector control, coordination and communication, healthcare facility capacity, and medical supplies. Methods adopted for the study included interviews with the stakeholders of the Commonwealth Games and use of secondary data to cite examples and support arguments. Existing knowledge must be documented and made available for use in planning for future mass gatherings. The size, duration, and interest of such events demands special attention toward preparedness and mitigation strategies to prevent or minimize the risk of ill health and maximizing the safety of people involved.

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Public health aspects of the world’s largest mass gathering: Kumbh Mela 2019 Prayagraj Uttar Pradesh, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213043 ◽

2021 ◽

Vol 8 (8) ◽

pp. 4046

Author(s):

Anurag Gautam ◽

S. K. Singh ◽

Uday Mohan ◽

Manish Manar ◽

Kiran Gautam

Keyword(s):

Public Health ◽

Waste Disposal ◽

Health Risks ◽

Uttar Pradesh ◽

Medical Services ◽

Clean Water ◽

Mass Gathering ◽

Mass Gatherings ◽

Public Health Risks ◽

Large Numbers

The influx of large numbers of people to mass gathering events may give rise to specific public health risks. Kumbh-Mela is internationally famous religious mass gathering. It creates the substantial challenge of creating a temporary city in which millions of pilgrims/visitors can stay for a defined period of time. The arrangements need to allow this very large number of people to reside with proper medical services, adequate supplies of food, electricity, waste disposal, clean water and transportation etc. Understanding the Kumbh-Mela can highlight the health challenges faced and provide the crucial lessons for the management of mass gatherings.

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ED and poison center surveillance for the Great American Solar Eclipse in Oregon

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v10i1.8797 ◽

2018 ◽

Vol 10 (1) ◽

Author(s):

Laurel Boyd ◽

Sandy Giffin ◽

Melissa Powell

Keyword(s):

Public Health ◽

Health Risks ◽

Solar Eclipse ◽

Public Health Surveillance ◽

Health Surveillance ◽

Health Conditions ◽

Poison Center ◽

Mass Gathering ◽

Mass Gatherings ◽

Snake Bites

ObjeciveIdentify surveillance priorities for emergency department (ED) and Oregon Poison Center (OPC) data ahead of the 2017 Great American Solar Eclipse gatherings in Oregon and create a suite of queries for use in the Health Intelligence Section of the Oregon Public Health Division (OPHD) Incident Management Team (IMT).IntroductionOregon’s statewide syndromic surveillance system (Oregon ESSENCE) has been operational since 2012. Non-federal emergency department data (and several of their associated urgent care centers) are the primary source for the system, although other data sources have been added, including de-identified call data from OPC in 2016 (1).OPHD epidemiologists have experience monitoring mass gatherings (2) and have a strong relationship with OPC, collaborating on a regular basis for routine and heightened public health surveillance. Nevertheless, surveillance for the Great American Solar Eclipse (August 2017) presented a challenge due to the 107 reported simultaneous statewide eclipse-watching events planned for the day of the eclipse (some with estimated attendance of greater than 30,000 people and most in rural or frontier regions of the state).Scientific literature is limited on mass gathering surveillance in the developed world (3), particularly in rural settings (4), so OPC and OPHD worked together to develop a list of health conditions of interest, including some that would warrant both an ED visit and a call to OPC (e.g., snake bites). Monitoring visits in both data sources in would allow for assessment of total burden on the healthcare system, especially in the case of snake bites where only specific bites require administration of anti-venom.MethodsAhead of the planned mass gatherings, OPHD Health Intelligence and OPC compiled a list of expected risks from the literature (4,5) and input from members of the IMT including the Public Information Officer, who monitored media for stories about health. Priority health conditions presented a clear risk to public health (e.g., limited supply of snake anti-venom warranted surveillance of snake bites) or were the subject of substantial media coverage. Query development focused on risks that had specific, well-defined health effects and that would be captured by syndromic ED and OPC data.During an enhanced surveillance period (8/18-8/24), OPHD Health Intelligence reviewed and interpreted trends in common queries with OPC and disseminated a daily statewide surveillance report.ResultsOPHD and OPC created four new queries for both ED and OPC data streams: snake bites, psychedelic mushrooms, 2nd and 3rd degree body burns and eye-related calls and visits. ED queries used chief complaint, discharge diagnosis, or triage note. OPC queries used generic code, therapy and clinical effect.From 8/18-8/22, OPHD Health Intelligence distributed daily surveillance reports to the OPHD IMT and external partners. An increased in eye-related injuries was identified on the day after the eclipse, prompting OPHD Health Intelligence to consult with OPC. ED surveillance data indicated that the increase in eye-related visits was likely a seasonal trend. OPC staff reviewed the charts of patient calls captured by the query and concluded the calls were not related to retinal issues from looking at the sun. No other trends were noted in the joint OPHD/OPC queries.ConclusionsOPHD Health Intelligence piloted four new queries for surveillance during this mass gathering event and exercised the process for disseminating trend information from OPC and ED data. The eclipse event was fairly quiet and very few trends of note were captured by surveillance. Prior to this event, OPC data had not been a part of the Health Intelligence surveillance plan. However, assessing trends in OPC data provides an opportunity to better understand trends seen in ED data (e.g., whether or not a surge in ED visits for snake bites is accompanied by a surge in OPC calls for anti-venom is meaningful). By building a process to review disparate data in tandem, OPHD and OPC strengthened regional surveillance for this event. Applicable queries will continue to be used for planned event surveillance and several additional queries are currently under development.References1. Laing R, Powell M. Integrating Poison Center Data into Oregon ESSENCE using a Low-Cost Solution. 2017;9(1):2579.2. Jagger MA, Jaramillo S, Boyd L, Johnson B, Reed KR, Powell M. Mass Gathering Surveillance : New ESSENCE Report and Collaboration Win Gold in OR. 2017;9(1):2579.3. Steffen R, Bouchama A, Johansson A, Dvorak J, Isla N, Smallwood C, et al. Non-communicable health risks during mass gatherings. Lancet Infect Dis. 2012;12(2):142–9.4. Polkinghorne BG, Massey PD, Durrheim DN, Byrnes T, MacIntyre CR. Prevention and surveillance of public health risks during extended mass gatherings in rural areas: The experience of the Tamworth Country Music Festival, Australia. Public Health [Internet]. 2013;127(1):32–8. Available from: http://dx.doi.org/10.1016/j.puhe.2012.09.0145. Lombardo JS, Sniegoski CA, Loschen WA, Westercamp M, Wade M, Dearth S, et al. Public health surveillance for mass gatherings. Johns Hopkins APL Tech Dig (Applied Phys Lab. 2008;27(4):347–55.

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