Influenza A and B Viruses but Not MERS-CoV in Hajj Pilgrims, Austria, 2014

Aberle, Judith H.; Popow‐Kraupp, Theresia; Kreidl, Peter; Laferl, Hermann; Heinz, Franz X.; Aberle, Stephan W.

doi:10.3201/2104.141745

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…Transmission of MERS‐CoV during mass gatherings events such as Hajj or Umrah could lead to global spread and devastating outcomes as seen in South Korea in 2015. In addition to the current study, the several previous reports from countries such as France, India, Egypt, Saudi Arabia, Ghana, Jordan, China, Austria, the UK, and Iran have shown no record of MERS‐CoV infection and/or transmission in pilgrims during Hajj suggesting that it is not MERS‐CoV but other respiratory viruses that are responsible for most respiratory infections during Hajj . This is also in accordance with the suggestion that MERS‐CoV can not be efficiently transmitted outdoors compared with indoor settings such as hospitals and homes where exposure to infectious cases is prolonged .…”

Section: Discussionsupporting

confidence: 91%

“…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%

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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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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 97%

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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“…Despite a high prevalence of acute respiratory illness (ARI) among returning pilgrims from Saudi Arabia, none of the 300 (one-sided 97.5% CI 1.2) study participants with ARI tested positive for MERS-CoV.. Although we only screened one-third of ill travelers, our data is compatible with earlier reports in which no MERS-CoV cases were identified in Hajj returnees [12] , [13] in other countries outside of India. In another large study involving 5235 adult Hajj pilgrims from 22 countries, including 3 with reports of MERS Co—V and those with geographic proximity to Saudi Arabia, there was no evidence of MERS-CoV nasal carriage among Hajj pilgrims (3210 pre-Hajj, 2025 post-Hajj) which could supporting poor or moderate interhuman transmission, despite the pilgrims having stayed in close contact with persons with respiratory symptoms [14] .…”

Section: Discussionsupporting

confidence: 87%

Influenza not MERS CoV among returning Hajj and Umrah pilgrims with respiratory illness, Kashmir, north India, 2014–15

Koul

Mir

Saha³

et al. 2017

Travel Medicine and Infectious Disease

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Background The increasing reports of Middle East Respiratory Syndrome (MERS) caused by MERS coronavirus (MERS-CoV) from many countries emphasize its importance for international travel. Muslim pilgrimages of Hajj and Umrah involve mass gatherings of international travellers. We set out to assess the presence of influenza and MERS-CoV in Hajj/Umrah returnees with acute respiratory infection. Methods Disembarking passengers (n = 8753) from Saudi Arabia (October 2014 to April 2015) were interviewed for the presence of respiratory symptoms; 977 (11%) reported symptoms and 300 (age 26 –90, median 60 years; 140 male) consented to participate in the study. After recording clinical and demographic data, twin swabs (nasopharyngeal and throat) were collected from each participant, pooled in viral transport media and tested by real-time RT PCR for MERS-CoV and influenza A and B viruses and their subtypes. Results The participants had symptoms of 1–15 days (median 5d); cough (90%) and nasal discharge (86%) being the commonest. None of the 300 participants tested positive for MERS-CoV; however, 33 (11%) tested positive for influenza viruses (A/H3N2 = 13, A/H1N1pdm09 = 9 and B/Yamagata = 11). Eighteen patients received oseltamivir. No hospitalizations were needed and all had uneventful recovery. Conclusion Despite a high prevalence of acute respiratory symptoms, MERS coV was not seen in returning pilgrims from Hajj and Umrah. However detection of flu emphasises preventive strategies like vaccination.

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“…Several surveillance studies on MERS‐CoV in pilgrims returning from the annual Hajj have been performed after the emergence of MERS‐CoV. In none of these studies, conducted during the last three Hajj seasons in 2012, 2013 and 2014, was MERS‐CoV detected .…”

Section: Discussionmentioning

confidence: 99%

High prevalence of common respiratory viruses and no evidence of Middle East Respiratory Syndrome Coronavirus in Hajj pilgrims returning to Ghana, 2013

Annan

Owusu

Marfo

et al. 2015

Tropical Med Int Health

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Abstractobjective The Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012 on the Arabian Peninsula and has caused severe respiratory disease with more than 800 laboratoryconfirmed cases. The return of infected pilgrims to their home countries with a putative spread of MERS-CoV necessitates further surveillance. conclusions The prevalence of viral respiratory infections among Hajj pilgrims in both symptomatic and asymptomatic subjects was high. Although it is reassuring that MERS-CoV was not detected in the tested population, there is a need for active surveillance of Hajj pilgrims.

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Influenza A and B Viruses but Not MERS-CoV in Hajj Pilgrims, Austria, 2014

Cited by 5 publications

References 8 publications

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

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

Influenza not MERS CoV among returning Hajj and Umrah pilgrims with respiratory illness, Kashmir, north India, 2014–15

High prevalence of common respiratory viruses and no evidence of Middle East Respiratory Syndrome Coronavirus in Hajj pilgrims returning to Ghana, 2013

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