Relative risk for influenza like illness in French Hajj pilgrims compared to non-Hajj attending controls during the 2009 influenza pandemic

Travel Medicine and Infectious Disease

2018

Section: Discussionmentioning

confidence: 99%

A systematic review of emerging respiratory viruses at the Hajj and possible coinfection with Streptococcus pneumoniae

Al‐Tawfiq

Benkouiten

Travel Medicine and Infectious Disease

2018

“…Other studies of different sizes (from 129 to 468) and design were conducted from 2007 through 2014 among different populations of pilgrims using a common ILI definition (the association of cough, sore throat, and subjective fever). These studies have shown variable results, with overall rates of ILI ranging from 8% to 78.2% [14][15][16]18,19,[21][22][23]25,26,31,35,37]. Thus, during the 2013 Hajj season, while the highest prevalence of ILI was observed among Malaysian pilgrims, with a prevalence estimated at 78.2% [25], a lower prevalence was observed among French pilgrims (47.3%) [18,21].…”

Section: Cohort Studies Addressing the Prevalence Of Respiratory Tracmentioning

confidence: 99%

“…Coverage of seasonal influenza vaccination among pilgrims was evaluated in many studies, which have yielded varying results, with reported rates of influenza vaccination ranged from 1.1% to 100% [14,15,18,[21][22][23]25,26,28,29,[31][32][33][34]36,37,[41][42][43][44][45][46][47][48][49][50][51][53][54][55][56]. A variation over time in influenza vaccination coverage was observed, as exemplified by a rate of 10.5% observed in a survey of pilgrims from Riyadh in 2003 [43], but 94.4% in a similar survey in 2010 [32,33,36].…”

Section: Cohort Studies Addressing the Prevalence Of Respiratory Tracmentioning

confidence: 99%

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

Benkouiten

Al‐Tawfiq

Travel Medicine and Infectious Disease

et al. 2019

Self Cite

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.

“…The presence of such a large number of pilgrims from across the globe in close contact creates conditions where the potential for transmission of infectious organisms is high [7,8], including those related to severe diseases such as pneumonia. Pneumonia is one of the leading causes of hospitalization and intensive care unit care among pilgrims in Saudi hospitals during Hajj [9,10].…”

Section: Introductionmentioning

confidence: 99%

Impact of the hajj on pneumococcal transmission

Clinical Microbiology and Infection

Assiri

Almasri

et al. 2015

Over two million Muslim pilgrims assemble annually in Mecca and Medina, Saudi Arabia, to complete the Hajj. The large number of people in a crowded environment increases the potential for pneumococcal carriage amplification. We evaluated pneumococcal carriage prevalence with four cross-sectional studies conducted at beginning-Hajj (Mecca) and end-Hajj (Mina) during 2011 and 2012. A questionnaire was administered and a nasopharyngeal swab was collected. The swab was tested for pneumococcus, serotype and antibiotic resistance. A total of 3203 subjects (1590 at beginning-Hajj and 1613 at end-Hajj) originating from 18 countries in Africa or Asia were enrolled. The overall pneumococcal carriage prevalence was 6.0%. There was an increase in carriage between beginning-Hajj and end-Hajj cohorts for: overall carriage (4.4% versus 7.5%, prevalence ratio (PR) 1.7, 95% CI 1.3-2.3), and carriage of 23-valent pneumococcal polysaccharide vaccine serotypes (2.3% versus 4.1%, PR 1.8, 95% CI 1.2-2.7), 13-valent pneumococcal conjugate vaccine (PCV) serotypes (1.1% versus 3.6%, PR 3.2, 95% CI 1.9-5.6), 10-valent PCV serotypes (0.6% versus 1.6%, PR 2.6, 95% CI 1.2-5.3), antibiotic non-susceptible isolates (2.5% versus 6.1%, PR 2.5, 95% CI 1.7-3.6) and multiple non-susceptible isolates (0.6% versus 2.2%, PR 3.8, 95% CI 1.8-7.9). Fifty-two different serotypes were identified, most commonly serotypes 3 (17%), 19F (5%) and 34 (5%). These results suggest that the Hajj may increase pneumococcal carriage-particularly conjugate vaccine serotypes and antibiotic non-susceptible strains, although the exact mechanism remains unknown. The Hajj may therefore provide a mechanism for the global distribution of pneumococci.