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Effectiveness of public health measures and strategies to reduce risk of spread of respiratory pathogens at sporting mass gatherings

Systematic literature review

Bibliographic Data

ID22085776
AuthorsLucia Mullen (0009-0004-6699-3313, Johns Hopkins University, corresponding author), Amanda Kobokovich Mui (Johns Hopkins University), Crystal Watson (0000-0001-6716-2467, Johns Hopkins University), David Heymann (0000-0001-9964-0304, London School of Hygiene & Tropical Medicine), Brian McCloskey (0000-0001-7788-894X, Chatham House), Gwenda Hughes (0000-0003-2090-7702, London School of Hygiene & Tropical Medicine), Chris Bonell (0000-0002-6253-6498, Royal Society of Tropical Medicine and Hygiene)
Year2026
Volume14
Pages1789413-1789413
Publication date2026-04-08
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1789413
PMID42027925
OpenAlexW7151848958
LanguageEN
References cited69

Objectives: To determine the type and effectiveness of public health interventions implemented at sporting mass gatherings to mitigate respiratory infectious disease spread and understand how feasible and acceptable the interventions were to implement. Design: Systematic review. Data sources: Medline, EMBASE, Cochrane Library, Scopus, Web of Science, Global Health, Epistemonikos, Global Index Medicus, WHO Library, WHO IRIS, IOC and FIFA were search in June 2023 and July 2025. Eligibility criteria for selecting studies: Studies that assessed public health strategies for sporting mass gatherings aiming to reduced respiratory infections were included. Publications prior to 2000, predictive modeling studies, commentaries, editorials, literature reviews, pre-prints and studies that did not retrospectively discuss official sporting events were excluded. Results: = 10). Almost all articles described multi-layered intervention packages including bubble approaches, routine testing, country entry screening, masking, physical distancing and/or isolation and quarantine. Based on an effectiveness framework developed for this study, 23 articles described effective intervention packages, three described non-effective packages and six were indeterminate. Feasibility concerns appeared a challenge for MGs with many spectators and linked to scalability issues. Acceptability factors were likely influenced by perceptions of increased work burden, compliance levels and stakeholder engagement. Conclusion: This systematic review provides the first opportunity to comprehensively map pre-pandemic and pandemic-era planning for sporting MGs and underscores the importance of multilayered, context-specific intervention packages which may meaningfully reduce the risk of respiratory disease spread. Systematic Review Registration: CRD42023433619

CINAHL · Mass gathering · MEDLINE · Psychological intervention · Public health · Public health interventions · Stakeholder · Systematic review · Infection Control and Ventilation · Infection Control in Healthcare · Travel-related health issues

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Highly citedNo

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