MERS‐CoV, influenza and other respiratory viruses among symptomatic pilgrims during 2014 Hajj season. Issue 6 (20th February 2019)

• Record Type: Journal Article
• Authors: Hashem, Anwar M.; Al‐Subhi, Tagreed L.; Badroon, Nassrin A.; Hassan, Ahmed M.; Bajrai, Leena Hussein M.; Banassir, Talib M.; Alquthami, Khalid M.; Azhar, Esam I.
• Is Part Of: Journal of medical virology. Volume 91:Issue 6(2019)
• Page Start: 911
• Page End: 917
• Publication Date: 2019-02-20
• Subjects: Hajj -- influenza -- Middle East respiratory syndrome‐coronavirus -- respiratory infections -- Saudi Arabia -- viruses; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.25424
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract: 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. Highlights: There is no evidence of MERS‐CoV circulation during Hajj. The most common circulating respiratory virus among pilgrims were influenza A and B viruses, non‐MERS human coronaviruses and rhinoviruses. The high risk of influenza infection among pilgrims underscoring the need for targeted, active and continuous surveillance and more stringent vaccination requirements. Enhanced and active surveillance is critical to identify pathogens involved in Hajj epidemics and to implement proper infection control measures.