Hajj-associated acute respiratory infection among hajjis from Riyadh.

ABSTRACT A prospective cohort study was conducted to estimate the incidence of acute respiratory infections (ARI) among hajjis registered at primary health care centres of Riyadh. Out of 1027 hajjis, 39.8% developed symptoms of ARI. The incidence of ARI was not statistically significantly associated with age, sex, educational status or smoking. The risk of illness was significantly higher among diabetics, hajjis who stayed longer in the hajj area and who prayed at Namera mosque. Use of a facemask by men, but not use of a facecover by women, was a significant protective factor against ARI.

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    ABSTRACT: PURPOSE OF REVIEW: Mass gatherings such as religious pilgrimages, sporting events and music concerts are becoming larger and more frequent. The scale and frequency of large-scale international events pose substantial risks to the spread of infectious diseases. The available literature on respiratory tract infections at the Hajj pilgrimage - annually attended by 3 million pilgrims from all over the globe - are reviewed. RECENT FINDINGS: The most common respiratory tract infection viruses are influenza and rhinovirus. Despite the occurrence of the Hajj during the 2009 H1N1 pandemic the available literature did not show an increased rate of infection. In hospitalized patients, pneumonia is a significant cause of admission accounting for 20-50% of such admissions. SUMMARY: The use of masks may reduce exposure to droplet nuclei, the main mode of transmission of most respiratory tract infections. The practice of social distancing, hand hygiene, and contact avoidance was associated with reduced risk of respiratory illness. In addition, utilizing the recommended vaccines would decrease the risk of acquiring respiratory tract pathogens.
    Current opinion in pulmonary medicine 02/2013; DOI:10.1097/MCP.0b013e32835f1ae8 · 2.96 Impact Factor
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    ABSTRACT: All mass gatherings can place travelers at risk for infectious diseases, but the size and density of the annual Hajj pilgrimage to the Kingdom of Saudi Arabia (KSA) present important public health and infection control challenges. This survey of protective practices and respiratory illness among US travelers to the 2009 Hajj was designed to evaluate whether recommended behavioral interventions (hand hygiene, wearing a face mask, cough etiquette, social distancing, and contact avoidance) were effective at mitigating illness among travelers during the 2009 Hajj. US residents from Minnesota and Michigan completed anonymous surveys prior to and following travel to the 2009 Hajj. Surveys assessed demographics, knowledge, attitudes, and practices (KAP) related to influenza A(H1N1), vaccination, health-seeking behaviors, sources of health information, protective behaviors during the Hajj, and respiratory illness during and immediately after the Hajj. Pre- and post-travel surveys were completed by 186 participants. Respiratory illness was reported by 76 (41.3%) respondents; 144 (77.4%) reported engaging in recommended protective behaviors during the Hajj. Reduced risk of respiratory illness was associated with practicing social distancing, hand hygiene, and contact avoidance. Pilgrims who reported practicing more recommended protective measures during the Hajj reported either less occurrence or shorter duration of respiratory illness. Noticing influenza A(H1N1) health messages during the Hajj was associated with more protective measures and with shorter duration of respiratory illness. Recommended protective behaviors were associated with less respiratory illness among US travelers to the 2009 Hajj. Influenza A(H1N1) communication and education in KSA during the Hajj may also have been an effective component of efforts to mitigate illness. Evaluations of communication efforts and preventive measures are important in developing evidence-based public health plans to prevent and mitigate disease outbreaks at the Hajj and other mass gatherings.
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    ABSTRACT: Overcrowding during the yearly Hajj mass gatherings is associated with increased risk of spreading infectious diseases, particularly respiratory diseases. Non-pharmaceutical interventions (e.g., hand hygiene, wearing face masks, social distancing) are known to reduce the spread of respiratory viruses from person to person and are therefore recommended to pilgrims by public health agencies. The implementation of effective public health policies and recommendations involves evaluating the adherence to and effectiveness of these measures in the specific context of the Hajj. This review summarizes the evidence related to the effectiveness of non-pharmaceutical interventions in preventing the spread of respiratory infectious diseases during the Hajj. Overall, although hand hygiene compliance is high among pilgrims, face mask use and social distancing remain difficult challenges. Data about the effectiveness of these measures at the Hajj are limited, and results are contradictory, highlighting the need for future large-scale studies.
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May 27, 2014