UEFA Euro 2020: lessons from the first multi-city international mass gathering during the COVID-19 pandemic.

Mass gatherings (MG) present a number of challenges to public health authorities and governments across the world with sporting events, tournaments, music festivals, religious gatherings and all other MG having historically posed a risk to the spread and amplification of a range of infectious diseases. Transmission of gastrointestinal, respiratory, waterborne and sexually transmitted infectious diseases pose a particular risk: all have been linked to MG events [-]. Infection risk often depends on the nature of the mass gathering, and on the profile and behaviour of its participants. The interaction between environmental, psychological, biological and social factors plays a vital part. The risk of outbreaks particularly as a result of respiratory transmission remains high at MG, with the majority of outbreaks over the last two decades resulting from a variety of respiratory and vaccine preventable pathogens [-]. Concerns about the spread of infectious diseases at MG are often focussed on crowding, lack of sanitation and the mixing of population groups from different places. Sporting events, which have in recent decades become more complex and international in nature, pose a challenge to the control of communicable disease transmission []. Despite this, large scale outbreaks at sporting events have been rare in recent decades, particularly since the rise of more robust public health planning, prevention, risk assessment and improved health infrastructures in host countries [].

Impact of Rotavirus Vaccine Introduction and Vaccine Effectiveness in the Republic of Moldova.

BACKGROUND: The Republic of Moldova was the first low- to middle-income country in the World Health Organization European Region to introduce rotavirus vaccine (July 2012). We aimed to assess the impact of the rotavirus vaccine program and estimate vaccine effectiveness (VE). METHODS: Surveillance for rotavirus gastroenteritis was conducted in 2 hospitals in the capital city of Chisinau starting in September 2009. Monthly rotavirus admissions by age were examined before and after introduction of rotavirus vaccination using interrupted time-series analyses. We performed a case-control study of VE by comparing rotavirus case patients with test-negative controls. RESULTS: Coverage with at least 1 dose of vaccine increased from 35% in year 1 to 55% in year 2 for children <1 year of age. The percentage of hospital admissions positive for rotavirus fell from 45% in the prevaccine period to 25% (rate reduction, 36%; 95% confidence interval [CI], 26%-44%) and 14% (rate reduction, 67%; 95% CI, 48%-88%) in the first and second years after vaccine introduction, respectively, among children aged <5 years. Reductions were most pronounced among those aged <1 year. Significant reductions among cohorts too old to be vaccinated suggest indirect benefits. Two-dose VE was 79% (95% CI, 62%-88%) against rotavirus hospitalization and 84% (95% CI, 64%-93%) against moderate to severe rotavirus. CONCLUSIONS: These results consistently point to profound direct and herd immunity impacts of the rotavirus vaccine program in young children in the Republic of Moldova. Vaccine coverage was modest in these early years following introduction, so there remains potential for further disease reductions.

Informing the pandemic response: the role of the WHO's COVID-19 Weekly Epidemiological Update.

On 31 December 2019, the Municipal Health Commission of Wuhan, China, reported a cluster of atypical pneumonia cases. On 5 January 2020, the WHO publicly released a Disease Outbreak News (DON) report, providing information about the pneumonia cases, implemented response interventions, and WHO's risk assessment and advice on public health and social measures. Following 9 additional DON reports and 209 daily situation reports, on 17 August 2020, WHO published the first edition of the COVID-19 Weekly Epidemiological Update (WEU). On 1 September 2023, the 158th edition of the WEU was published on WHO's website, marking its final issue. Since then, the WEU has been replaced by comprehensive global epidemiological updates on COVID-19 released every 4 weeks. During the span of its publication, the webpage that hosts the WEU and the COVID-19 Operational Updates was accessed annually over 1.4 million times on average, with visits originating from more than 100 countries. This article provides an in-depth analysis of the WEU process, from data collection to publication, focusing on the scope, technical details, main features, underlying methods, impact and limitations. We also discuss WHO's experience in disseminating epidemiological information on the COVID-19 pandemic at the global level and provide recommendations for enhancing collaboration and information sharing to support future health emergency responses.

Hotspots and social background of urban traffic crashes: A case study in Cluj-Napoca (Romania).

Mobility practices have changed dramatically in Romanian towns over the last 25 years, following the collapse of socialist mobility restrictions. Urban areas like Cluj-Napoca are facing both increasing immigration and car mobility, and therefore increasing levels of road traffic crashes. The analysis of traffic crashes is one of the most important elements for improving the road safety policy. This paper is divided in two parts. In the first one, the authors focus on identifying the traffic crash hotspots along the street network, while in the second part they discuss the social background of road traffic crash occurrence. The first step in analyzing traffic crashes is to determine crash hotspots. A four-year record (2010-2013) provided by the Traffic Department of the General Inspectorate of Romanian Police (GIRPTD) was used. As a method of hotspot determination, the Kernel Density Estimation tool was employed, in the frame of the spatial analysis along network (SANET). The outcome was the hotspot map of traffic crashes in Cluj-Napoca. The results have revealed 4 categories of street segments: not-dangerous, low-dangerous, medium-dangerous and high-dangerous. Based on this classification, at least 4 dangerous areas were identified, located at the city entrances-exits (in the West, North-West and East) and the city center (the most dangerous zone). The second part of the paper focuses on social groups involved in car crashes. The following are considered: age, gender and blood alcohol concentration of the person (driver or pedestrian) found guilty for every individual crash.

Обзорная оценка Национальной программы по туберкулезу в Республике Молдова: 4–15 февраля 2013 года

Республика Молдова входит в число 18 приоритетных стран для борьбы с туберкулезом (ТБ) в Европейском регионе ВОЗ и 27 стран мира с высоким бременем ТБ с множественной лекарственной устойчивостью (МЛУ-ТБ). Согласно классификации Глобального фонда для борьбы со СПИДом, туберкулезом и малярией, Республика Молдова занимает второе место среди 110 стран по уровню средств, выделяемых на душу населения. Вторая фаза реализации консолидированного гранта в рамках раундов 8 и 9 была одобрена в декабре 2012 года с условием представления на следующем этапе обзорной оценки Национальной программы по туберкулезу и стратегического плана (на основе этой обзорной оценки) по усилению приверженности лечению и снижению числа пациентов, результаты лечения которых неизвестны. Серьезную озабоченность вызывал тот факт, что, как показала оценка, осуществление мер вмешательства и поддержка оказали лишь ограниченное воздействие на улучшение результатов лечения. В октябре 2012 года Министерство здравоохранения обратилось в Европейское региональное бюро ВОЗ с просьбой обеспечить координацию обзорной оценки Национальной программы по туберкулезу.

Review of the National Tuberculosis Programme in the Republic of Moldova: 4–15 February 2013

The Republic of Moldova is among the WHO European Region’s 18 high-priority countries for tuberculosis (TB) control and among the world’s 27 high multidrug-resistant TB (MDR-TB) burden countries. The Global Fund to Fight AIDS, Tuberculosis and Malaria ranks the Republic of Moldova second among 110 countries by level of funds provided per capita. The second phase of implementation of its consolidated Round 8 and 9 TB grant was approved in December 2012 with a request to submit, at a later stage, a review of the National TB Programme and a strategic plan (based on the review) to improve treatment compliance and reduce loss to treatment follow up. A major concern highlighted was that supported interventions have shown only a limited impact in improving treatment success. In October 2012 the Ministry of Health asked the WHO Regional Office for Europe to coordinate the review of the National TB Programme.The review took place from 4 to 15 February 2013. Twelve international and seven national experts participated, visiting 18 districts and three municipalities, the autonomous region of Gagauzia and the Transnistria region. The review team developed a strategic plan to improve treatment compliance and reduce loss to treatment follow up immediately after the review; this appears as part of the roadmap attached to this report (Annex 1). The team members conveyed their key findings and recommendations at the end of the mission to the Minister of Health.

Joint tuberculosis control programme review mission to the Republic of Moldova

The WHO Regional Office for Europe organized a comprehensive national tuberculosis programme (NTP) reviewmission in the Republic of Moldova on 7–11 September and 22–29 November 2009. The review focused on achievementsand issues in the treatment of tuberculosis (TB) based on the WHO Stop TB Strategy components, including politicalcommitment, case detection and diagnosis, directly observed treatment, drug supply, monitoring and evaluation.A separate review focused on the management of HIV-TB coinfection in the context of multidrug resistance, healthsystem strengthening, empowerment of TB patients, civil society engagement and cross-sector cooperation betweenvarious health care providers, including the prison system and the Transnistria region. The structure of TB services inthe health system was investigated in detail, alongside a thorough analysis of the epidemiological situation. For eachcomponent, strengths and remaining gaps were identified, and relevant and specific areas for action suggested. Thereview’s conclusions and recommendations pave the way for the development of the new NTP of 2011–2015.

Analiza comună a programului naţional de profilaxie şi combatere a tuberculozei din Republica Moldova

Biroul Regional European al OMS a organizat o evaluare exhaustivă a programului naţional pentru profilaxia şi controlul tuberculozei (PNT) în Republica Moldova în perioada 7–11 septembrie şi 22–29 noiembrie 2009. evaluarea s-a axat pe realizările şi aspectele de tratament ale tuberculozei (TBC) pe baza componentelor Strategiei Stop TB a OMS, inclusiv angajamentul politic, detectarea cazurilor şi diagnostic, tratamentul direct observat, aprovizionarea cu medicamente, monitorizare şi evaluare. O evaluare separată a vizat conduita co-infecţiei HIV-TBC în contextul rezistenţei la medicamente multiple, fortificarea sistemului de sănătate, împuternicirea pacienţilor bolnavi de TBC, implicarea sectorului asociativ şi cooperarea intersectorială între diverşii prestatori de asistenţă medicală, inclusiv cu sistemul penitenciar şi regiunea Transnistreană. A fost examinată detaliat structura serviciilor TBC din sistemul sănătăţii, de rând cu o analiză aprofundată a situaţiei epidemiologice. Pentru fiecare componentă în parte au fost identificate avantajele şi lacunele restante, la fel ca şi domeniile specifice şi relevante pentru acţiune sugerate. Constatările şi recomandările oferite în cadrul evaluării constituie fundamentul pentru elaborarea noului PNT pentru anii 2011–2015.