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Mass Gathering at Sturgis: Preparedness, Surveillance and Whiplash

Posted By Lon Kightlinger, Friday, April 10, 2015
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South Dakota’s population will double this coming August—but the risk to public health will quadruple. The Sturgis Motorcycle Rally happens every year in the Black Hills of South Dakota attracting about 500,000 rally-goers. But this year, 2015, marks the rally’s mythical 75th anniversary and over a million Harley-stomping pilgrims are expected. Although not nearly as massive as India’s Kumbh Mela gathering, the Sturgis Rally presents vast challenges to public health surveillance and response.

Sturgis (normal population 6,600) is situated where the prairie’s endless horizon meets the Black Hills, sacred to the Lakota Sioux, home to Mount Rushmore and Crazy Horse monuments, and the winding roads cyclists love. South Dakota is a rural, conservative, no-frills state that welcomes the annual boisterous mass gathering of rumbling, kick-back fun. Rally-goers come from all over the world, including far-off, exotic places like California and Pennsylvania. Catering to the million motorcyclists is an army of temporary food and drink vendors, mechanics, ad hoc camp grounds, tattooists, musicians, masseuses and more, much more. Although most rally-goers are mild-mannered gentlefolks on their home turf, while in Sturgis they let their inner Easy Rider rage for the week-long party.

The South Dakota Department of Health recognizes the risk to public health a million raucous guests might encounter: summer heat, tainted food, West Nile mosquitoes, clunker drugs, excessive Natty Ice, prairie wind storms, bothered rattlesnakes, condom scarcity, daredevil cyclist traumas, no helmet laws, 80 mph speed limits, porta-potty insufficiency, forest and prairie fire alerts, contaminated water in campgrounds that are normally cattle pastures, and old men doing things not even young cowboys should attempt.

For some this is a week of grand cycling in the Wild West, but for us in public health it is an epidemiologic OK Corral. Before and during the rally we sample, test, and enforce drinking water standards; inspect and license food venders, tattooists, and body piercing artists; implement intensive disease surveillance; activate a mobile laboratory; maintain redundant communication channels; participate in the rally emergency operations center; monitor disease cases, syndromes, hospital beds, emergency department traffic, blood supply, and morgue space; and spray for mosquitoes. The capacity of the Department of Health is stretched and local health care is overextended, as are roads and normal infrastructure.

Surveillance and response networks have been long established and work well, but the glut of accidents, cases and sudden health events engulfs and strains the disease reporters and coders in the healthcare system so that even electronic syndromic surveillance triggers are less reliable. Disaster epidemiology tools used during floods, blizzards and tornadoes need to be enhanced and envisioned for a highly mobile, raucous, wittingly uncooperative crowd who would simply not allow an outbreak of diarrheal disease to disrupt the revelry.

Lon Kightlinger, MSPH, PhD is state epidemiologist at the South Dakota Department of Health.

Learn more about the various epidemiologic domains impacted by massive events, such as the Sturgis Rally, by joining a subcommittee in Surveillance and Informatics, Occupational Health, Injury, and Infectious Disease.

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