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Alsayyad A, Chlif S, Mohamed A, Habbash F, Ayoob Z, Almarabheh A, Al Sayed K, Alsaleh A, Alhajeri M, Alzayani S, Abu Alfatah N, Ahmed J, Ben Salah A. Super-spreading social events for COVID-19 transmission: evidence from the investigation of six early clusters in Bahrain. Front Public Health 2023; 11:1216113. [PMID: 37744496 PMCID: PMC10513455 DOI: 10.3389/fpubh.2023.1216113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction This study aimed to characterize six early clusters of COVID-19 and derive key transmission parameters from confirmed cases that were traced between April and June 2020 in Bahrain. Methods Pairs of "infector-infectee" allowed us to map the clusters and estimate the incubation period serial interval as the secondary attack rate. The chi-squared test, with a p-value computed using the Monte Carlo test, measured associations between categorical variables. Statistical analysis was performed using R software and the "data.tree, tidyverse" libraries. Results From 9 April to 27 June 2020, we investigated 596 individuals suspected of COVID-19, of whom 127 positive cases were confirmed by PCR and linked in six clusters. The mean age was 30.34 years (S.D. = 17.84 years). The male-to-female ratio was 0.87 (276/318), and most of the contacts were of Bahraini citizenship (511/591 = 86.5%). Exposure occurred within the family in 74.3% (411/553), and 18.9% of clusters' cases were symptomatic (23/122 = 18.9%). Mapped clusters and generations increased after 24 May 2020, corresponding to "Aid El-Fitr." The mean incubation period was 4 days, and the mean serial interval ranged from 3 to 3.31 days. The secondary attack rate was 0.21 (95% C.I.) = [0.17-0.24]. Conclusion COVID-19 transmission was amplified due to the high number of families mixing during "Aid El Fitr" and "Ramadhan," generating important clusters. Estimated serial intervals and incubation periods support asymptomatic transmission.
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Affiliation(s)
- Adel Alsayyad
- Ministry of Health, Manama, Bahrain
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Sadok Chlif
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Institut Pasteur de Tunis, Tunis, Tunisia
| | | | - Fatema Habbash
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- King Abdullah University Medical Centre, Manama, Bahrain
| | | | - Amer Almarabheh
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | - Aseel Alsaleh
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | - Salman Alzayani
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | - Jamil Ahmed
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Afif Ben Salah
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Institut Pasteur de Tunis, Tunis, Tunisia
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