tetano
Editor, Senior Moderator
Commun Dis Intell (2018)
. 2020 Sep 16;44.
doi: 10.33321/cdi.2020.44.76.
High COVID-19 attack rate among attendees of wedding events in Bali, Indonesia, March 2020
Bhavi Ravindran[SUP] 1 [/SUP], Freya Hogarth[SUP] 2 [/SUP], Kirsten Williamson[SUP] 3 [/SUP], Rose Wright[SUP] 4 [/SUP], Martyn Kirk[SUP] 2 [/SUP], Craig Dalton[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Large gatherings are associated with the spread of coronavirus 2019 disease (COVID-19); however, transmission dynamics are not well understood. We investigated a cluster of COVID-19 cases in returning Australian residents who attended wedding events in Bali, Indonesia, during 15- 21 March 2020. Attendees participated in various social events and were in close proximity, providing multiple opportunities for transmission.
Methods: We conducted a retrospective cohort study of the 41 attendees, of whom 17 participated in a structured interview that included history of illness, risk exposures and event attendance. We obtained data for the remaining 24 participants through corroborative histories and public health unit case investigations.
Results: COVID-19 was identified in 56% of attendees (23/41), with illness onset between 21 March and 2 April 2020. One secondary case was identified in a household contact of an attendee. The median age of cases was 31 years (range 3-64). One case was hospitalised and did not require critical care. There were no deaths. No cases occurred among six attendees who left prior to the actual wedding day. Guests attended multiple events and participated in high-risk transmission behaviours such as shaking hands, kissing, dancing, sharing drinks and sharing shisha (water pipes). Attack rates ranged from 64% to 87% for different exposures. We could not identify a single risk exposure that accounted for all cases; it is therefore likely there were multiple episodes of transmission.
Conclusion: Our investigation identified a high attack rate of COVID-19 among a cohort of wedding event attendees. Attendees engaged in close physical contact, shared drinks and shisha, and were in close proximity during the wedding events, which may have contributed to the high attack rate. This outbreak highlights the significant role social events can play in transmission of COVID-19 and underscores why it is important to limit gatherings and close physical contact to control the spread of the virus.
Keywords: Australia; Indonesia; SARS virus; coronavirus disease 2019 (COVID-19); outbreak; public health; risk factors; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); shisha; smoking.
. 2020 Sep 16;44.
doi: 10.33321/cdi.2020.44.76.
High COVID-19 attack rate among attendees of wedding events in Bali, Indonesia, March 2020
Bhavi Ravindran[SUP] 1 [/SUP], Freya Hogarth[SUP] 2 [/SUP], Kirsten Williamson[SUP] 3 [/SUP], Rose Wright[SUP] 4 [/SUP], Martyn Kirk[SUP] 2 [/SUP], Craig Dalton[SUP] 1 [/SUP]
Affiliations
- PMID: 32938338
- DOI: 10.33321/cdi.2020.44.76
Abstract
Background: Large gatherings are associated with the spread of coronavirus 2019 disease (COVID-19); however, transmission dynamics are not well understood. We investigated a cluster of COVID-19 cases in returning Australian residents who attended wedding events in Bali, Indonesia, during 15- 21 March 2020. Attendees participated in various social events and were in close proximity, providing multiple opportunities for transmission.
Methods: We conducted a retrospective cohort study of the 41 attendees, of whom 17 participated in a structured interview that included history of illness, risk exposures and event attendance. We obtained data for the remaining 24 participants through corroborative histories and public health unit case investigations.
Results: COVID-19 was identified in 56% of attendees (23/41), with illness onset between 21 March and 2 April 2020. One secondary case was identified in a household contact of an attendee. The median age of cases was 31 years (range 3-64). One case was hospitalised and did not require critical care. There were no deaths. No cases occurred among six attendees who left prior to the actual wedding day. Guests attended multiple events and participated in high-risk transmission behaviours such as shaking hands, kissing, dancing, sharing drinks and sharing shisha (water pipes). Attack rates ranged from 64% to 87% for different exposures. We could not identify a single risk exposure that accounted for all cases; it is therefore likely there were multiple episodes of transmission.
Conclusion: Our investigation identified a high attack rate of COVID-19 among a cohort of wedding event attendees. Attendees engaged in close physical contact, shared drinks and shisha, and were in close proximity during the wedding events, which may have contributed to the high attack rate. This outbreak highlights the significant role social events can play in transmission of COVID-19 and underscores why it is important to limit gatherings and close physical contact to control the spread of the virus.
Keywords: Australia; Indonesia; SARS virus; coronavirus disease 2019 (COVID-19); outbreak; public health; risk factors; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); shisha; smoking.