Infections in travellers returning to Turkey from the Arabian peninsula: a retrospective cross-sectional multicenter study

Erdem, Hakan; Ak, Özlem; Elaldı, Nazif; Demırdal, Tuna; Hargreaves, Sally; Nemli, Salih Atakan; Çağ, Yasemin; Ulug, Mehmet; Naz, Hasan; Günal, Özgür; Sırmatel, Fatma; Sıpahi, Oğuz Reşat; Alpat, Saygın Nayman; Ertem-Tuncer, G.; Sözen, Hamdi; Evlice, Oğuz; Meriç-Koç, Meliha; Doğru, Arzu; Koksaldi-Motor, V; Tekin, Recep; Özdemir, Davut; Öztürk-Engin, Derya; Savasci, Umit; Karagöz, Ergenekon; Çekli, Yavuz; İnan, Asuman

doi:10.1007/s10096-016-2614-z

Cited by 8 publications

(11 citation statements)

References 28 publications

(31 reference statements)

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“…A recent retrospective cross-sectional multicenter study of 185 Turkish inpatients (87.5% were pilgrims) who returned to Turkey from the Arabian Peninsula countries between 2012 and 2014 reported a slightly higher prevalence of acute tracheobronchitis (13.6%) [64]. In addition, in this study, pneumonia was among the most common clinical diagnosis among the hospitalized Hajj patients and represented about half of diagnoses [64]. As pneumonia remains a major concern in critically ill patients, most of them reported the prevalence of pneumonia among pilgrims [57,59,60,[62][63][64][65][66][67][68][69][70][71], with reported rates ranging from 0.2% in 2008 in 13 randomly selected Mina primary health care centers [59,60] to 54.8% in 2004 in two ICU in Mecca [68] (Table 3).…”

Section: Hospital-based Studies Addressing the Prevalence Of Respiratmentioning

confidence: 99%

“…On the contrary, lower prevalence rates of bronchitis were reported during the Hajj (1.4%-9.6%) [59][60][61][62][63]. A recent retrospective cross-sectional multicenter study of 185 Turkish inpatients (87.5% were pilgrims) who returned to Turkey from the Arabian Peninsula countries between 2012 and 2014 reported a slightly higher prevalence of acute tracheobronchitis (13.6%) [64]. In addition, in this study, pneumonia was among the most common clinical diagnosis among the hospitalized Hajj patients and represented about half of diagnoses [64].…”

Section: Hospital-based Studies Addressing the Prevalence Of Respiratmentioning

confidence: 99%

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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: Hospital-based Studies Addressing the Prevalence Of Respiratmentioning

confidence: 99%

Section: Hospital-based Studies Addressing the Prevalence Of Respiratmentioning

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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“…More importantly, most global MERS cases were linked to travel to the Arabian peninsula. Although all surveillance studies during Hajj did not reveal any MERS‐CoV infection among pilgrims, serological testing showed positivity in one Turkish pilgrim who suffered from severe pneumonia and died upon ICU admission in Turkey . Similarly, confirmed cases were reported from Dutch pilgrims returning home from the minor pilgrimage “Umrah” .…”

Section: Introductionmentioning

confidence: 97%

“…Another important driver of spreading and acquiring respiratory pathogens during Hajj is the great diversity of inbound viruses from around the world that can potentially spread among the immunologically naive hosts. In fact, acute respiratory infections are very common during Hajj and represent the leading cause of the most hospitalizations . It has been suggested that more than one‐third of pilgrims will suffer from respiratory symptoms during Hajj mostly due to the respiratory viruses .…”

Section: Introductionmentioning

confidence: 99%

MERS‐CoV, influenza and other respiratory viruses among symptomatic pilgrims during 2014 Hajj season

Hashem

Alsubhi

Badroon

et al. 2019

Journal of Medical Virology

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More than two million Muslims visit Makkah, Saudi Arabia, annually to perform the religious rituals of Hajj where the risk of spreading respiratory infections is very common. The aim here was to screen symptomatic pilgrims for Middle East respiratory syndrome coronavirus (MERS‐CoV) and other viral etiologies. Thus, 132 nasopharyngeal samples were collected from pilgrims presenting with acute respiratory symptoms at the healthcare facilities in the holy sites during the 5 days of the 2014 Hajj season. Samples were tested using real‐time reverse transcription polymerase chain reactions and microarray. Demographic data including age, sex, and country of origin were obtained for all participants. While we did not detect MERS‐CoV in any of the samples, several other viruses were detected in 50.8% of the cases. Among the detected viruses, 64.2% of the cases were due to a single‐virus infection and 35.8% were due to the coinfections with up to four viruses. The most common respiratory virus was influenza A, followed by non‐MERS human coronaviruses, rhinoviruses, and influenza B. Together, we found that it was not MERS‐CoV but other respiratory viruses that caused acute respiratory symptoms among pilgrims. The observed high prevalence of influenza viruses underscores the need for more effective surveillance during the Hajj and adoption of stringent vaccination requirements from all pilgrims.

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“…A multicenter study conducted in Turkey by Erdem et al [60] investigated infections diagnosed in pilgrims who traveled to Arabia. Respiratory tract infections (91%) and gastroenteritis (7%) were the most common diagnoses.…”

Section: Approach To Posttravel Infectionsmentioning

confidence: 99%

What to Know About Travel Related Infections

Pepe¹,

Akıncı²,

Bodur³

2019

mjima

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International travel has increased as a result of social development, advances in information and communication technologies, and improved life standards. Reports from the World Tourism Organization indicate that the global number of international tourists reached 1.2 billion in 2015, an increase of 4.6% from the previous year [1]. Tourism is also growing steadily in Turkey. According to the Turkish Statistical Institute, the number of passengers using airports for international departures reached 71 million in 2016 [2]. Increases in tourism also bring increases in travel-related diseases. Depending on the destination, 22-64% of tourists experience health problems [3]. Most of the conditions associated with infection are self-limiting diseases such as diarrhea and respiratory and skin infections [4,5]. Less than 1% of patients require hospitalization [6]. Noninfectious health problems that may occur during travel include car sickness, jet lag, venous thrombosis,

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Infections in travellers returning to Turkey from the Arabian peninsula: a retrospective cross-sectional multicenter study

Cited by 8 publications

References 28 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

MERS‐CoV, influenza and other respiratory viruses among symptomatic pilgrims during 2014 Hajj season

What to Know About Travel Related Infections

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