Consensus recommendation for India and Bangladesh for the use of pneumococcal vaccine in mass gatherings with special reference to Hajj pilgrims

Abstract

Respiratory tract infections are prevalent among Hajj pilgrims with pneumonia being a leading cause of hospitalization. Streptococcus pneumoniae is a common pathogen isolated from patients with pneumonia and respiratory tract infections during Hajj. There is a significant burden of pneumococcal disease in India, which can be prevented. Guidelines for preventive measures and adult immunization have been published in India, but the implementation of the guidelines is low. Data from Bangladesh are available about significant mortality due to respiratory infections; however, literature regarding guidelines for adult immunization is limited. There is a need for extensive awareness programs across India and Bangladesh. Hence, there was a general consensus about the necessity for a rapid and urgent implementation of measures to prevent respiratory infections in pilgrims traveling to Hajj. About ten countries have developed recommendations for pneumococcal vaccination in Hajj pilgrims: France, the USA, Kuwait, Qatar, Bahrain, the UAE (Dubai Health Authority), Singapore, Malaysia, Egypt, and Indonesia. At any given point whether it is Hajj or Umrah, more than a million people are present in the holy places of Mecca and Madina. Therefore, the preventive measures taken for Hajj apply for Umrah as well. This document puts forward the consensus recommendations by a group of twenty doctors following a closed-door discussion based on the scientific evidence available for India and Bangladesh regarding the prevention of respiratory tract infections in Hajj pilgrims.

Seasonality of influenza and coseasonality with avian influenza in Bangladesh, 2010–19: a retrospective, time-series analysis

“…4,5 Bangladesh does not have a national influenza immunisation policy and vaccine uptake remains low; 6 however, vaccine campaigns have been recommended for specific high-risk subgroups including Hajj pilgrims. 7 Previous studies have reported a distinct seasonal influenza pattern in Bangladesh, 8,9 but long-term trends and subnational heterogeneity in seasonality have not been examined. A better understanding of regional influenza transmission patterns in Bangladesh could be used to bolster the development of immunisation policies, direct appropriate health resource planning and facility preparedness, and support diagnostic and treatment approaches.…”

Pneumococcal Vaccine Recommendations for Old-Age Home Indian Residents: A Literature Review

“…The consensus guidelines for India and Bangladesh for the use of pneumococcal vaccine in mass gatherings and for Hajj pilgrims recommend ( “Grants—Immunization Programme,” 2018 ; Mathai et al, 2016 )…”

Proportion of adult community-acquired pneumonia cases attributable to Streptococcus pneumoniae among Hajj pilgrims in 2016

“…Currently, pneumococcal vaccination is not one of the officially recommended/compulsory vaccinations in the Hajj health requirements set by the Saudi authorities (Saudi Ministry of Health, 2017). Although some countries have recommended pneumococcal vaccination for their Hajj pilgrims (Feldman et al, 2013;Mathai et al, 2016;Rashid et al, 2013), an evidence-based policy requires a better understanding of the clinical and economic burden of the disease associated with Hajj. This study is a first step in providing such data, by defining the burden of the disease in the Hajj season using a more reliable diagnostic test for pneumococcal pneumonia.…”