Health risk assessment at mass gatherings: a report of the camel festival in Saudi Arabia.

The King Abdel Aziz Camel Festival in Riyadh, Saudi Arabia, aims to showcase the socio-cultural and economic roles of camels in the Middle East, and attracts visitors from many countries in the Region.Potentially, the gathering of large numbers of people and animals within a specified geographical area during the annual festival has important implications for public safety, health security and legacy. Thus, the Ministry of Health through the Global Center for Mass Gathering Medicine, Saudi Arabia, conducted a health risk assessment for the 2017 Camel Festival. This paper summarizes the risk assessment process and highlights the findings and recommendations of the risk assessment.Using an all-hazard approach, the Jeddah tool (derived from the World Health Organization Eastern Mediterranean Regional Office's health emergency risk assessment tool) was adapted to conduct the risk assessment. The tool stipulates that risk is directly proportional to the product of hazard magnitude and vulnerability and inversely related to capacity.External causes of morbidity and mortality, such as fires and road traffic accidents, were categorized as high risk hazards. In contrast, brucellosis, foodborne diseases and Middle East Respiratory Syndrome were ranked moderate risk hazards. Rift Valley fever was ranked low risk hazard.The camel festival risk assessment highlights the need for an all-hazard approach to mass gatherings risk assessment. There is a need for multi-sectorial collaboration to strengthen the existing capacity, including disease surveillance.