Respiratory viruses and bacteria among pilgrims during the 2013 Hajj

Abstract

Pilgrims returning from the Hajj might contribute to international spreading of respiratory pathogens. Nasal and throat swab specimens were obtained from 129 pilgrims in 2013 before they departed from France and before they left Saudi Arabia, and tested by PCR for respiratory viruses and bacteria. Overall, 21.5% and 38.8% of pre-Hajj and post-Hajj specimens, respectively, were positive for ≥1 virus (p = 0.003). One third (29.8%) of the participants acquired ≥1 virus, particularly rhinovirus (14.0%), coronavirus E229 (12.4%), and influenza A(H3N2) virus (6.2%) while in Saudi Arabia. None of the participants were positive for the Middle East respiratory syndrome coronavirus. In addition, 50.0% and 62.0% of pre-Hajj and post-Hajj specimens, respectively, were positive for Streptococcus pneumoniae (p = 0.053). One third (36.3%) of the participants had acquired S. pneumoniae during their stay. Our results confirm high acquisition rates of rhinovirus and S. pneumoniae in pilgrims and highlight the acquisition of coronavirus E229.

Figure 1

Patterns of respiratory viruses detected among 64 pilgrims who were positive for viruses during the study period before departing from France and before leaving Saudi Arabia, 2013 Hajj. FLUA, influenza A(H3N2) virus; FLUB, influenza B virus; FLUC, influenza C virus; A/H1N1, A(H1N1)pdm09 virus; HAdV, human adenovirus; HBoV, human bocavirus; HCMV, human cytomegalovirus; HCoV, human coronaviruses; EV, human enterovirus; HMPV, human metapneumovirus; HPeV, human parechovirus; HPIV, human parainfluenza virus; HRV, human rhinovirus; RSV, human respiratory syncytial virus;

Figure 2

Detection of Streptococcus pneumoniae among 92 pilgrims who were positive for viruses during the study period before departing from France and before leaving Saudi Arabia, 2013 Hajj.