Circulation of respiratory pathogens at mass gatherings, with special focus on the Hajj pilgrimage

Benkouiten, Samir

doi:10.1016/b978-0-12-804543-5.00006-3

Cited by 3 publications

(4 citation statements)

References 80 publications

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“…Climatic conditions and air pollution in Mecca and surrounding holy sites during the Hajj [75] may also play a role. Recent follow-up studies thus evidenced a significant acquisition of respiratory viruses, particularly rhinovirus, influenza virus, and coronaviruses other than Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and of bacteria, including Streptococcus pneumonia, Hemophilus influenza, Staphylococcus aureus and Klesiella pneumonia by Hajj pilgrims upon their return from the Hajj [76,77]. Respiratory diseases are the most common diseases observed among pilgrims attending Mina primary health care centers [59] and a major cause of hospital admission during the Hajj [70], with pneumonia a leading cause of admission to intensive care units [62,68], where they are responsible for about half of the cases of sepsis [66].…”

Section: Discussionmentioning

confidence: 99%

Clinical respiratory infections and pneumonia during the Hajj pilgrimage: A systematic review

Benkouiten

Al‐Tawfiq

Memish

et al. 2019

Travel Medicine and Infectious Disease

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A B S T R A C TBackground: The Islamic Hajj pilgrimage to Mecca is one of the world's largest annual mass gatherings. Inevitable overcrowding during the pilgrims' stay greatly increases the risk of acquiring and spreading infectious diseases, especially respiratory diseases. Method: The MEDLINE/PubMed and Scopus databases were searched for all relevant papers published prior to February 2018 that evaluated the prevalence of clinical symptoms of respiratory infections, including pneumonia, among Hajj pilgrims, as well as their influenza and pneumococcal vaccination status. Results: A total of 61 papers were included in the review. Both cohort-and hospital-based studies provide complementary data, and both are therefore necessary to provide a complete picture of the total burden of respiratory diseases during the Hajj. Respiratory symptoms have been common among Hajj pilgrims over the last 15 years. In cohorts of pilgrims, cough ranged from 1.9% to 91.5%. However, the prevalence rates of the most common symptoms (cough, sore throat, and subjective fever) of influenza-like illness (ILI) varied widely across the included studies. These studies have shown variable results, with overall rates of ILI ranging from 8% to 78.2%. These differences might result from differences in study design, study period, and rates of vaccination against seasonal influenza that ranged from 1.1% to 100% among study participants. Moreover, the definition of ILI was inconsistent across studies. In hospitalized Hajj pilgrims, the prevalence of pneumonia, that remains a major concern in critically ill patients, ranged from 0.2% to 54.8%. Conclusions: Large multinational follow-up studies are recommended for clinic-based syndromic surveillance, in conjunction with microbiological surveillance. Matched cohorts ensure better comparability across studies. However, study design and data collection procedures should be standardized to facilitate reporting and to achieve comparability between studies. Furthermore, the definition of ILI, and of most common symptoms used to define respiratory infections (e.g., upper respiratory tract infection), need to be precisely defined and consistently used. Future studies need to address potential effect of influenza and pneumococcal vaccine in the context of the Hajj pilgrimage.

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Section: Discussionmentioning

confidence: 99%

Clinical respiratory infections and pneumonia during the Hajj pilgrimage: A systematic review

Benkouiten

Al‐Tawfiq

Memish

et al. 2019

Travel Medicine and Infectious Disease

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“…Pneumonia is the leading cause of hospitalisation during Hajj and the second or third most common cause of admission to the intensive care unit (ICU) during Hajj [ 5 ]. Furthermore, many airborne infections have emerged in recent decades, including severe acute respiratory syndrome (SARS) in 2003, the influenza A (H1N1)pdm09, the Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, and, more recently, the novel coronavirus disease 2019 (COVID-19) in 2019, presenting a major public health and infection control challenge for both the authorities in KSA and the national authorities in the pilgrims’ countries of origin [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Differences in Hajj-Acquired Airborne Infections in Pilgrims Arriving from Low and Middle-Income versus High-Income Countries: A Systematised Review

Mahdi,

Alluhidan,

Almohammed

et al. 2023

TropicalMed

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This systematised review aims to compare the epidemiological patterns of Hajj-acquired airborne infections among pilgrims from low and middle-income countries (LMIC) versus those from high-income countries (HIC). A PubMed search was carried out for all published articles before February 2023, using a combination of MeSH terms and text words. The Newcastle–Ottawa Scale (NOS) was used to assess data quality. From a total of 453 titles identified, 58 studies were included in the review (LMIC = 32, and HIC = 26). In the pooled sample, there were 27,799 pilgrims aged 2 days to 105 years (male: female = 1.3:1) from LMIC and 70,865 pilgrims aged 2 months to 95 years (male: female = 1:1) from HIC. Pilgrims from both HIC and LMIC had viral and bacterial infections, but pilgrims from HIC tended to have higher attack rates of viral infections than their LMIC counterparts. However, the attack rates of bacterial infections were variable: for instance, pilgrims from LMIC seemed to have higher rates of meningococcal infections (0.015–82% in LMIC vs. 0.002–40% in HIC) based on the study population, but not Mycobacterium tuberculosis (0.7–20.3% in LMIC vs. 38% in HIC). Targeted measures are needed to prevent the spread of airborne infections at Hajj.

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“…Several respiratory viruses have emerged over the last several years such as Middle East respiratory syndrome coronavirus (MERS-CoV), which posed a great public health threat to the Hajj pilgrimage; nevertheless, no major outbreaks have been documented to date [6]. For instance, studies revealed no detection of MERS-CoV infection in any samples tested for viral RTIs obtained from 81 returning pilgrims from Bangladesh and 202 from the UK who presented with symptoms of respiratory illness [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Hajj and other MGs not only amplify the risk of infections among participants but also accelerate the transmission of these infections among their close contacts, making MGs a significant risk to global health security [6,12]. Only a limited number of studies assessed the prevalence of RTIs among pilgrims after their home return.…”

Section: Introductionmentioning

confidence: 99%

Low Prevalence of Syndromic Respiratory Tract Infections among Returning Hajj Pilgrims Amidst the COVID-19 Pandemic: A Post-Hajj Survey

et al. 2022

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This study estimates the point prevalence of symptomatic respiratory tract infections (RTIs) among returned Hajj pilgrims and their contacts in 2021. Using the computer-assisted telephone interview (CATI) technique, domestic pilgrims were invited to participate in this cross-sectional survey two weeks after their home return from Hajj. Of 600 pilgrims approached, 79.3% agreed to participate and completed the survey. Syndromic definitions were used to clinically diagnose possible influenza-like illnesses (ILI) and COVID-19. Median with range was applied to summarise the continuous data, and frequencies and proportions were used to present the categorical variables. Simple logistic regression was carried out to assess the correlations of potential factors with the prevalence of RTIs. The majority of pilgrims (88.7%) reported receiving at least two doses of the COVID-19 vaccine before Hajj. Eleven (2.3%) pilgrims reported respiratory symptoms with the estimated prevalence of possible ILI being 0.2%, and of possible COVID-19 being 0.4%. Among those who were symptomatic, five (45.5%) reported that one or more of their close contacts had developed similar RTI symptoms after the pilgrims’ home return. The prevalence of RTIs among pilgrims who returned home after attending the Hajj 2021 was lower compared with those reported in the pre-pandemic studies; however, the risk of spread of infection among contacts following Hajj is still a concern.

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Circulation of respiratory pathogens at mass gatherings, with special focus on the Hajj pilgrimage

Cited by 3 publications

References 80 publications

Clinical respiratory infections and pneumonia during the Hajj pilgrimage: A systematic review

Clinical respiratory infections and pneumonia during the Hajj pilgrimage: A systematic review

Epidemiological Differences in Hajj-Acquired Airborne Infections in Pilgrims Arriving from Low and Middle-Income versus High-Income Countries: A Systematised Review

Low Prevalence of Syndromic Respiratory Tract Infections among Returning Hajj Pilgrims Amidst the COVID-19 Pandemic: A Post-Hajj Survey

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