Transmission of Coronavirus Disease 2019 Among Wedding Attendees in Karachi, Pakistan 2020: a Retrospective Cohort Study

  • Vaccine preventable diseases
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Background: On March 30, 2020, the rapid response team detected 5 COVID-19 cases in 1 household, who attended a wedding ceremony in Karachi, Pakistan during March 25–27, 2020. We investigated the cluster to understand the epidemiological characteristics and risk factors associated with the transmission at the wedding events.
Methods: We conducted a retrospective cohort study among 59 individuals who attended the wedding ceremony. A confirmed case was SARS-CoV-2 positive on reverse-transcription polymerase-chain-reaction (RT-PCR) within 2 weeks of the event. A close contact were those who interacted with COVID-19 case <6 feet for ≥15 minutes. All participants were identified by the family head and tested for SARS-CoV-2. Data were collected through a pre-structured questionnaire. Descriptive analysis was done and attack rates were computed. Risk factors were evaluated by applying logistic regression at CI=95% and p-value <0.05.
Results: Of the 59 attendees, 21 (35%) were confirmed cases (symptomatic 86%: n=18, asymptomatic 14%: n=03). One individual was hospitalized, no death was reported. Male to female ratio was 1:1 while the most affected age group was 15–44 years (48%, 10/21). The index case was a bride, who arrived from the United Kingdom on March 19, developed symptoms on March 24. The secondary attack rate was (90%, 9/10) among household contacts and (24%, 12/49) in non-household contacts. The median incubation period was 8 days (Interquartile range 7–10 days). Singing of songs in proximity had the highest AR (75%) followed by sharing of drinks (64%), hugging (50%), not using facemask (34%), and handshaking (32%). Singing of songs in proximity was found significantly associated (aRR=3.6; 95% CI=1.87–6.83).
Conclusions: Our study revealed that singing together has brought people closer to each other and is associated with the transmission. Positive cases were isolated and the rest of them were quarantined. It is recommended to limit social gathering and implement a monitoring system for such activities.

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