Review Article

A Review of Infectious Diseases Associated with Religious and Nonreligious Rituals

Table 1

Rituals and infectious diseases.

RitualsAssociated infection

Self-flagellationHTLV-1 and hepatitis C
Ritualistic consumption raw mollusksAngiostrongylus cantonensis-related eosinophilic meningitis
Ritualistic animal sacrificeMycobacterium bovis, orf, brucellosis, cutaneous anthrax, and rift valley fever
Sprinkling of holy waterBacterial infections (surgical site, pneumonia)
Blood brotherhood and other rituals involving blood (e.g., group circumcision, skin scarification, bloodletting, and female genital mutilation)HIV, hepatitis B, hepatitis C, Clostridium tetani, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, Trichomonas vaginalis, herpes simplex virus
TattooingSporotrichosis, blood borne infections
Widow inheritance and similar ritualsHIV
Kumbha Mela (involving ritualistic bathing and dipping in rivers)Diarrheal disease including cholera, respiratory infection including COVID-19
Mortuary ritualsCholera, Ebola, kuru
Ritual side rollsCutaneous larva migrans
Circumcision in Jewish infantsHerpes simplex virus
Ablution (involving nasal irrigation)Naegleria fowleri meningoencephalitis
Mass gatherings (e.g., Haj)Various infections including meningococcal meningitis, cholera, influenza, viral hepatitis, COVID-19, and tuberculosis

HIV: human immunodeficiency virus; HTLV: human T cell leukemia virus.