BackgroundApproximately 80 000 Egyptians participate in Hajj pilgrimage annually. The purpose of this study was to estimate influenza virus and MERS‐CoV prevalence among Egyptian pilgrims returning from Hajj.StudyA cross‐sectional survey among 3 364 returning Egyptian pilgrims from 2012 to 2015 was conducted. Nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected from all participants. Sputum specimens were collected from participants with respiratory symptoms and productive cough at the time of their interview. Specimens were tested for influenza viruses, and a convenience sample of NP/OP specimens was tested for MERS‐CoV. Thirty percent of participants met the case definition for influenza‐like illness (ILI), 14% tested positive for influenza viruses, and none tested positive for MERS‐CoV. Self‐reported influenza vaccination was 20%.ConclusionsHigh prevalence of reported ILI during pilgrimage and confirmed influenza virus on return from pilgrimage suggest a continued need for influenza prevention strategies for Egyptian Hajj pilgrims. An evaluation of the Ministry of Health and Population's current risk communication campaigns to increase influenza vaccine use among pilgrims may help identify strategies to improve vaccine coverage.

During November 2014–April 2015, a total of 165 case-patients with influenza virus A(H5N1) infection, including 6 clusters and 51 deaths, were identified in Egypt. Among infected persons, 99% reported poultry exposure: 19% to ill poultry and 35% to dead poultry. Only 1 person reported wearing personal protective equipment while working with poultry.

Information on the prevalence of influenza, circulating virus subtypes and seasonality is essential for selecting strains for annual vaccines and for planning immunization programmes. Data were obtained from the 13 sentinel surveillance sites throughout Egypt during 2012-2015. Laboratory-confirmed influenza was found in 13% of cases of influenza-like illness (ILI) and 18% of cases of severe acute respiratory infection (SARI); positivity for influenza was similar in cases of ILI and SARI in patients up to 15 years of age but increased for SARI and decreased for ILI in people aged ≥ 15 years. The most commonly observed influenza virus subtypes were B followed by A/ H3 in ILI cases, and A/H1N1 followed by B in SARI cases. The seasonality of influenza in ILI cases was NovemberFebruary, and that in SARI cases was November-March, peaking in January. RÉSUMÉ Les informations sur la prévalence de la grippe, les sous-types circulants du virus et la saisonnalité sont essentielles pour la sélection des souches destinées aux vaccins annuels, ainsi que pour la planification des programmes de vaccination. Les données sont issues des 13 sites sentinelles de surveillance à travers l'Égypte pour la période 2012-2015. La présence de la grippe a été confirmée en laboratoire pour 13 % des cas ‫واألمــراض‬ ‫باإلنفلونــزا‬ ‫الشــبيهة‬ ‫األمــراض‬ ‫حــاالت‬ ‫لــدى‬ ‫اجلوالــة‬ ‫الفرعيــة‬ ‫واألنــواع‬ ‫اإلنفلونــزا‬ ‫فريوســات‬ ‫إجيابيــة‬

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