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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
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  • Amr Kandeel,
  • Manal Fahim,
  • Ola Deghedy,
  • Walaa Attia,
  • Wael Roshdy,
  • Mohamed Khalifa ,
  • Rabeh El-Shesheny,
  • Ahmed Kandil,
  • Amel Naguib,
  • Nancy Elguindy,
  • Mohammad Abdel Fattah,
  • Salma Afifi,
  • Amira Mohsen,
  • Khaled Abdel ghaffar
Amr Kandeel
Ministry of Health and Population in Egypt
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Manal Fahim
Ministry of Health and Population
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Ola Deghedy
Egypt Ministry of Health and Population
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Walaa Attia
Egypt Ministry of Health and Population
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Wael Roshdy
Egypt Ministry of Health and Population
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Mohamed Khalifa
Central Public Health Laboratory, Ministry of Health and Population
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Rabeh El-Shesheny
national research centre
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Ahmed Kandil
Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt.
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Amel Naguib
Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt.
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Nancy Elguindy
Egypt Ministry of Health and Population
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Mohammad Abdel Fattah
Egypt Ministry of Health and Population
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Salma Afifi
Egypt Ministry of Health and Population
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Amira Mohsen
WHO,Egypt, country office
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Khaled Abdel ghaffar
Egypt Ministry of Health and Population
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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.