Camel Milk-Associated Infection Risk Perception and Knowledge in French Hajj Pilgrims

Abstract

Cases of brucellosis have been recently reported in Hajj pilgrims following camel milk consumption. With the aim of evaluating French pilgrim's potential risk for raw camel milk-associated diseases, we conducted a knowledge, attitude, and practice study among 331 pilgrims departing to the 2011 Hajj. A proportion of 8.2% have drunk camel milk before, mostly in North Africa (62.9%) and Saudi Arabia (18.5%). A proportion of 13.9% declared they knew that drinking raw camel milk could cause diseases and 40.6% said that they would drink it if offered during the pilgrimage. Given that camel milk consumption in the Middle East is associated with several zoonotic infections in man, we recommend that Hajj pilgrims be cautioned against consuming unpasteurized dairy products.

Methodologies for measuring travelers' risk perception of infectious diseases: A systematic review

“…Sample sizes ranged from 119 to 6633 participants. A total of 23 studies were conducted among the general population of travelers [8,12,15e17,20,22e25,28e33,35e39,41e44]; other studies were conducted among specific populations of travelers, including Hajj pilgrims (n Z 6) [6,7,9,11,14,24], business travelers (n Z 3) [13,21,40], students (n Z 2) [19,27], missionary personnel and their families (n Z 1) [45], ethnic Africans visiting their country of origin (n Z 1) [34], backpackers (n Z 1) [26], airline crews (n Z 1) [18] and public health professionals (n Z 1) [10].…”

“…There were 15 studies conducted in travelers recruited at airports [8,15e17,20,22,31e33,35e39,43,44] and one onboard flight [41], in Europe [8,15e17,32,37,39], Asia [20,33,36], Australia [36], US [22,38] and Canada [41] before flying abroad or at airports in Africa [31,35,43,44] and Asia [31] before flying back home. Thirteen studies included travelers recruited at travel clinics when seeking travel advice [7,9e12,14,23,24,28,29,34,40,42] in Europe [7,11,12,14,23,24,28,34,40], Australia [9], US [10], Canada [42] and Asia [29]. Travelers were also recruited through travel agencies (n Z 5) [7,25,29,30,34] in Europe [7,25,34] and Asia [29,30], business corporations in Europe (n Z 2) [13,21], universities (n Z 2) in Australia [19] and the US [27], a commercial airline in the US (n Z 1) [18], a Japanese embassy in Africa (n Z 1) [29], post-Hajj seminars or social ...…”

“…Some studies combined several sources of recruitment [7,29,34]. A total of 14 studies focused on a group of selected infectious diseases, including notably malaria, hepatitis A and B and HIV infection [12,13,19,25,27,30,32,35e39,41,42]; 13 focused on malaria only [10,15,16,18,20,21,26,29,31,33,34,40,43,44], 2 on respiratory tract infections [9,24], 2 on influenza [22,23], 2 on rabies [28,45], and 1 each on Ebola [6], pneumococcal disease [7], hepatitis A [17], hepatitis B [8], infections transmitted through camel milk consumption [11] and Middle East respiratory syndrome [14]. Key findings are reported in Table 1 and show an overall underestimation of risks.…”

Be vigilant: New MERS-CoV outbreaks can occur in the Kingdom of Saudi Arabia

“…First of all, as the authors stated, there is a concern about in-flight transmission of the syndrome in recent years. Khan It should be noted that a number of pilgrims sacrifice camels and some other pilgrims drink camel's milk during the Hajj [5]. Therefore, testing camels for MERS e CoV may be a good preventative measure.…”

Middle East Respiratory Syndrome (MERS) coronavirus. What travel health advice should be given to Hajj pilgrims?

“…The presence of MERS-CoV neutralizing antibodies in dromedary camels have been described in Oman and Canary Islands providing a clue as to a potential source for human infection [18]. French team in Marseille, recently investigated the attitude of pilgrims toward raw-Camel milk consumption, if offered during their stay in Saudi Arabia; 41% said that they would drink it if offered during the pilgrimage [19]. Given that camel milk consumption in the Middle East is associated with several zoonotic infections in man, it is recommended that Hajj pilgrims be cautioned against consuming unpasteurized dairy products.…”