Cross‐sectional survey and surveillance for influenza viruses and MERS‐CoV among Egyptian pilgrims returning from Hajj during 2012‐2015

Abstract

BackgroundApproximately 80 000 Egyptians participate in Hajj pilgrimage annually. The purpose of this study was to estimate influenza virus and MERS‐CoV prevalence among Egyptian pilgrims returning from Hajj.StudyA cross‐sectional survey among 3 364 returning Egyptian pilgrims from 2012 to 2015 was conducted. Nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected from all participants. Sputum specimens were collected from participants with respiratory symptoms and productive cough at the time of their interview. Specimens were tested for influenza viruses, and a convenience sample of NP/OP specimens was tested for MERS‐CoV. Thirty percent of participants met the case definition for influenza‐like illness (ILI), 14% tested positive for influenza viruses, and none tested positive for MERS‐CoV. Self‐reported influenza vaccination was 20%.ConclusionsHigh prevalence of reported ILI during pilgrimage and confirmed influenza virus on return from pilgrimage suggest a continued need for influenza prevention strategies for Egyptian Hajj pilgrims. An evaluation of the Ministry of Health and Population's current risk communication campaigns to increase influenza vaccine use among pilgrims may help identify strategies to improve vaccine coverage.

Influenza vaccination among Saudi Hajj pilgrims: Revealing the uptake and vaccination barriers

“…However, the vaccination uptake was better than that of some other Arab countries. For instance, pilgrims from Egypt had a vaccination coverage of 9%, 30% and 19% during 2013-2015 respectively [32]. These findings concur with data from a recent vaccine coverage survey in the Gulf Cooperation Council (GGC) countries, showing an influenza vaccination rate of 15% to 24% [45], indicating the need for enhancing vaccination uptake among pilgrims from Arab countries.…”

“…Several studies measuring influenza vaccination rate among French pilgrims revealed vaccine uptake that fluctuated generally between 26% and 46% over the years 2006 to 2013, with extremes of up to 97% in 2009 and zero in 2013 (due to unavailability of vaccine before Hajj) [27][28][29][30][31]. A large study among Egyptian pilgrims (who represent about 4% of the total pilgrims) revealed low influenza vaccination rates of between 9% and 30% in the years 2012 to 2015 [32].…”

Influenza is more common than Middle East Respiratory Syndrome Coronavirus (MERS-CoV) among hospitalized adult Saudi patients

“…Similarly, in the United States the 2014-2015 season was predominated by pandemic H1N1 and H3N2 was more common during the 2016-2017 season [34,35].We found that influenza rather than MERS-CoV was more common among the tested patients. The findings are also consistent with other studies among travelers and pilgrims where influenza far exceeded MERS [36][37][38][39][40]. Similarly, in a small study in Saudi Arabia, influenza viruses were detected in 16% of 182 patients [29].…”

MERS: Progress on the global response, remaining challenges and the way forward

“…Since 2012, event-based surveillance among pilgrims returning from Hajj, Umrah and other religious events in KSA has been conducted by KSA and countries sending pilgrims. While many return reporting respiratory symptoms, no MERS-CoV infections have been identified among returning pilgrims (Muraduzzaman et al, 2018;Barasheed et al, 2014;Atabani et al, 2016;Koul et al, 2017;Annan et al, 2015;Ma et al, 2017;Memish et al, 2014aMemish et al, , 2014bRefaey et al, 2017;Al-Abdallat et al, 2017;Matthew et al, 2015;Alqahtani et al, 2016;Win et al, 2016;Yavarian et al, 2018;Kapoor et al, 2014).…”