Incidence, risk factors, and whole-genome sequence of SARs-CoV-2 and
influenza virus among the Egyptian pilgrims returning Ramadan Umrah mass
gathering in Saudi Arabia, April-May 2022
Abstract
Background: Ramadan Umrah is the second largest Islamic pilgrimage with
2.75 million pilgrims allowed in 2022. This report presents the results
of survey among Egyptian pilgrims returning from Ramadan Umrah for
monitoring SARS-CoV-2 and influenza activity and to identify prevalent
SARS-CoV-2 variants after this mass gathering. Methods: Cross‐sectional
survey conducted at Cairo airport April 30-May 5, 2022. Pilgrims were
invited to participate voluntarily. After consenting, participants
interviewed using questionnaire including demographics, health status
and vaccination information and asked to provide NP/OP swabs for
SARS-CoV-2 and influenza testing by RT-PCR. Whole-genome sequencing
performed for 29 SARS-CoV-2 isolates. Incidence calculated, descriptive
data analysis performed, and SARS-CoV-2 patients were compared to
negatively tested participants using chi2 and p value<0.05.
Results: Overall, 1,003 subjects participated, their mean age 50.9±13
years, 594 (59.2%) were males. Of them, 76(7.6%) tested positive
including 67(6.7%) SARS-CoV-2, 7(0.7%) influenza and 2(0.2%)
SARS-CoV-2/influenza coinfection. Omicron sublineage BA.2 was the
prevalent variant with no difference in severity identified between BA.1
and BA.2. No difference identified between COVID-19 incidence among
receivers of different vaccine types or between fully vaccinated and
booster dose receivers. Conclusions: survey indicated a low incidence of
SARs-CoV-2 and influenza among Egyptian pilgrims returning from Ramadan
Umrah. Patients had mild or no symptoms with no hospitalization or
deaths reported. Full vaccination and booster doses of COVID-19 vaccines
proved equally effective. Enhancing COVID-19 and influenza vaccination
before mass gatherings and close monitoring of respiratory viruses among
pilgrims returning from Hajj and Umrah are crucial for outbreak early
detection and mitigation.