Public health at multi-day youth-focused mass gathering events: a scoping review of the evidence

Objectives: Multi-day mass gathering events (MGE) attended primarily by young people present unique public health challenges. This scoping review examines reported public health hazards at these events and the associated recommendations for public health preparedness and response.

Study design: Scoping review.

Methods: A systematic search identified 247 unique records. Following a multi-step dual screening process, 23 records met the inclusion criteria and underwent data extraction. Records were included if they reported a multi-day MGE attended predominantly by young people. Data were narratively synthesised to identify key public health hazards and recommendations.

Results: The 23 included records, published between 1993 and 2022, reported on 19 distinct multi-day MGE across various countries. Events ranged in duration from two to 45 days (mean: 8.8 days, SD: 9.7), with attendance ranging from 350 to 10 million people. The primary emergency identified was infectious disease outbreaks (n = 13, 68.4 %), commonly caused by influenza (30.8 %), measles (23.1 %), and Neisseria meningitidis (15.4 %). Foodborne outbreaks were reported at four events (21.1 %), linked to bacterial or viral agents. Public health recommendations emphasised pre-event planning, collaboration between event organizers and health authorities, enforcement of food safety protocols, vaccination strategies, and outbreak containment measures.

Conclusions: Infectious disease outbreaks remain the dominant public health threat at multi-day, youth-focused MGE. Strengthening immunisation programs, enforcing hygiene protocols, and enhancing event-based surveillance are critical for mitigating risks and ensuring public health safety at future MGE. Standardised minimum dataset requirements for MGE incident reporting are recommended.