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. 2024 May 1;41(3):185-191.
doi: 10.4103/lungindia.lungindia_431_23. Epub 2024 Apr 30.

Managing risk of infectious disease transmission at religious mass gatherings: Insights from survey, COVID-19 PCR, and antibody tests from Arbaeen walkers in 2020

Farah Al-Ansari  1 , Basma Al-Ansari  1 , Mohammed S Abdulzahra  2 , Harunor Rashid  3 , Grant A Hill-Cawthorne  4 , Mohammad B Al-Ansari  5 , Sabah M Al-Fatlaw  6 , Mohammad Mawash  2 , Mustafa Al Ansari  1 , Katherine M Conigrave  1   7
Affiliations

Managing risk of infectious disease transmission at religious mass gatherings: Insights from survey, COVID-19 PCR, and antibody tests from Arbaeen walkers in 2020

Farah Al-Ansari et al. Lung India. .

Abstract

Background: Arbaeen in Iraq has been one of the largest mass gatherings during the COVID-19 pandemic with 14.5 million attendees in 2020. We set out to assess the prevalence of current or past COVID-19 among 2020 Arbaeen participants, and establish associations between COVID-19 test results, symptoms, and known recent exposure.

Methods: This was a cross-sectional study involving participants who joined Arbaeen walk in Iraq in October 2020. COVID-19 PCR and/or rapid antibody test were conducted among consented participants. A short questionnaire was administered. Rapid antibody testing was done onsite. Nasal and throat swab samples were transferred to the laboratory for PCR testing.

Results: A total of 835 (88.3% male; 11.7% female) participants were recruited. The most common symptom overall was cough (9.6%) followed by sore throat, fever, and loss of taste/smell (6.6%, 5.5%, and 5.0%, respectively). One in five (20.3%) participants reported close contact with a confirmed COVID-19 case in the past 14 days. Of the 237 participants with a PCR test, 18 (7.6%) were positive. Of the 765 participants with rapid antibody test, 19.3% tested positive for IgM, 39.3% for IgG, and 16.4% for both. Approximately 40% of the participants had evidence of current or past COVID-19 infection based on antibody and PCR.

Conclusions: The almost 1 in 10 COVID-19 cases within such a multimillion person gathering, illustrates the difficulty in limiting the participation of infectious individuals in religious mass gatherings. There is a pressing need to explore measures to reduce the risk of transmission of infectious diseases at major mass gathering events.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Number of walkers approached and who participated
Figure 2
Figure 2
PCR and rapid antibody test results for the 2020 Arbaeen study participants
See this image and copyright information in PMC

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