{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:44:26Z","timestamp":1792759466752,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Religious mass gatherings (MGs) such as Hajj, Umrah, Arba\u2019een and Kumbh Mela attract tens to hundreds of millions of participants annually, posing unique challenges for infectious disease control, surveillance and health system preparedness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a structured comparative analysis of these four MGs, evaluating attendance scale, participant demographics, governance structures, epidemiological risks and public health response strategies. Data were synthesized from international public health reports, peer-reviewed literature and national MG health policies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hajj attracts 1.8\u20133 million pilgrims annually from &amp;gt;\u2009180 countries, while Umrah draws ~\u200930 million yearly with similar global diversity. Arba\u2019een hosts 20\u201322 million participants mainly from Iraq, Iran and neighbouring nations. Kumbh Mela peaks at tens of millions overall, exceeding 50 million on high days, predominantly Indian nationals plus international visitors. Common threats across these mass gatherings include respiratory pathogens, water- and food-borne illnesses and vaccine-preventable diseases, amplified by crowding and diverse origins. Successful public health responses emphasize pre-event vaccination (e.g. meningococcal ACWY for Saudi MGs), real-time surveillance systems and multisectoral coordination among stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comparable yet distinct, these MGs require tailored risk-based frameworks emphasizing leadership, surveillance, prevention and surge capacity. Our analysis proposes a unified model to strengthen global MG policies and practices, enhancing health security for future events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taag025","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T11:41:55Z","timestamp":1775216515000},"source":"Crossref","is-referenced-by-count":5,"title":["Public health preparedness and infectious disease risk management across religious mass gatherings: a comparative analysis of Hajj, Umrah, Arba\u2019een and Kumbh Mela"],"prefix":"10.1093","volume":"33","author":[{"given":"Jaffar A","family":"Al-Tawfiq","sequence":"first","affiliation":[{"name":"Specialty Internal Medicine Division and Quality and Patient Safety Department, Johns Hopkins Aramco Healthcare , Dhahran ,","place":["Saudi Arabia"]},{"name":"Infectious Diseases Division, Department of Medicine, Indiana University School of Medicine , Indianapolis, IN ,","place":["USA"]},{"name":"Infectious Diseases Division, Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2286-5139","authenticated-orcid":false,"given":"Harunor","family":"Rashid","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health and Sydney Infectious Diseases Institute, The University of Sydney , Hawkesbury Road, Westmead, NSW, 2145 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3386-0974","authenticated-orcid":false,"given":"Salim","family":"Parker","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town , Main Road, Observatory, Cape Town 7925 ,","place":["South 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