SRA-E Lisbon 2017

In public health context, a Mass Gathering Event (MGE) should be defined as any occasion, whether organized or spontaneous, which attracts a sufficient number of people to increase host community, city or nation's resources of planning and response. Among the common characteristics of these events it can be emphasized: it occurs during an specific time, it has specific location and it can be unpredictable (World Health Organization, 2008). However, MGE events are activities that are at increased risk of transmission of infectious diseases and outbreaks (Abubakar et al. 2012), and government actions are needed to identify, monitor and fast response to these situations (World Health Organization, 2008). Due to the increasing frequency of MGE in Brazil, some actions related to risk analysis were performed. Two actions will be mentioned. First, the elaboration process of a risk-based instrument to evaluate the hygienic and sanitary conditions and grading of food services of the 2014 FIFA World Cup. Twenty-four Brazilian experts were invited for this elaboration. They were asked to determine the likelihood of different food handling situations that could lead to an outbreak. The nominal group technique was used for this purpose. A draft of the evaluation instrument was then created, based on Brazilian good manufacturing practices regulation and the opinion of the food safety experts. The draft evaluation instrument was used to evaluate 354 food services located in 10 cities that will host games as part of the 2014 FIFA World Cup and 141 food services in seven state capitals that will not host the games. In 25 establishments, two health surveillance auditors conducted the application of the evaluation instrument at the same time to measure the inter-rater reliability using the kappa statistic. For each item a raw score was determined by the experts and adjusted based on the results of a factor analysis (Da Cunha et al. 2014). The second was the elaboration of the "Guide for health surveillance in Mass Gathering events: guidelines for risk management". The objective of this guide was to assist in the management and orientation of the multiprofessional teams of Sanitary Surveillance in MGE, aiming at a strategic and harmonized action. The preparation of the document was structured following technical-scientific methodological procedures and included the participation of Sanitary Surveillance representatives in the different spheres of government (Agência Nacional de Vigilância Sanitária, 2016). This guide was used during the Rio de Janeiro Olympics in 2016.