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

• Type of Material: Article
• Authors: Jaffar A. Al-Tawfiq, Johns Hopkins University; Samir Benkouiten, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; Ziad Memish, Emory University
• Language: English
• Date: 2018-05-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2018 Elsevier Ltd. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.tmaid.2018.04.007
• Title of Journal or Parent Work: Travel Medicine and Infectious Disease
• Volume: 23
• Start Page: 6
• End Page: 13
• Grant/Funding Information: None
• Keywords: Islam; Streptococcus pneumonia; Respiratory Tract Infections; Hajj; Respiratory viruses; Mass gatherings; Saudi Arabia; Travel; Humans; Pneumococcal Infections; Streptococcus pneumoniae
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology; Biology, Virology

Abstract

Background: The annual Hajj to the Kingdom of Saudi Arabia attracts millions of pilgrims from around the world. International health community's attention goes towards this mass gathering and the possibility of the development of any respiratory tract infections due to the high risk of acquisition of respiratory viruses. Method: We searched MEDLINE/PubMed and Scopus databases for relevant papers describing the prevalence of respiratory viruses among Hajj pilgrims. Results: The retrieved articles were summarized based on the methodology of testing for these viruses. A total of 31 studies were included in the quantitative/qualitative analyses. The main methods used for the diagnosis of most common respiratory viruses were polymerase chain reaction (PCR), culture and enzyme-linked immunosorbent assay (ELISA). Influenza, rhinovirus and parainfluenza were the most common viruses detected among pilgrims. Coronaviruses other than MERS-CoV were also detected among pilgrims. The acquisition of MERS-CoV remains very limited and systematic screening of pilgrims showed no infections. Conclusions: Well conducted multinational follow-up studies using the same methodology of testing are necessary for accurate surveillance of respiratory viral infections among Hajj pilgrims. Post-Hajj cohort studies would further evaluate the impact of the Hajj on the acquisition of respiratory viruses.