title: Pandemic 2009 influenza A (H1N1) infection among 2009 Hajj Pilgrims from Southern Iran: a real-time RT-PCR-based study.
abstract: BACKGROUND
  Hajj is a mass gathering undertaken annually in Mecca, Saudi Arabia. The 2009 Hajj coincided with both the pandemic influenza A/H1N1 2009 (A(H1N1)pdm09) and seasonal types of influenza A viruses. The interaction between pandemic influenza and Hajj could cause both a high level of mortality among the pilgrims and the spread of infection in their respective countries upon their return home.
  
  
  OBJECTIVE
  The present study attempted to determine the point prevalence of A(H1N1)pdm09 among returning Iranian pilgrims, most of whom had been vaccinated for seasonal influenza but not A(H1N1)pdm09.
  
  
  METHODS
  Pharyngeal swabs were collected from 305 pilgrims arriving at the airport in Shiraz, Iran. RNA was extracted from the samples and A(H1N1)pdm09 and other seasonal influenza A viruses were detected using TaqMan real-time PCR. For A(H1N1)pdm09-positive samples, the sensitivity to oseltamivir was also evaluated.
  
  
  RESULTS
  Subjects included 132 (43.3%) men and 173 (56.7%) women, ranging in age from 24 to 65 years. The A(H1N1)pdm09 virus was detected in five (1.6%) pilgrims and other influenza A viruses in eight (2.6%). All the A(H1N1)pdm09 were sensitive to oseltamivir.
  
  
  CONCLUSIONS
  Only five cases were found to be positive for A(H1N1)pdm09, and it seems unlikely that the arrival of infected pilgrims to their homelands would cause an outbreak of a new wave of infection there. Thus, the low morbidity and mortality rates among the pilgrims could be attributed to the characteristics of A(H1N1)pdm09, which causes morbidity and mortality in a way similar to the seasonal influenza infections, absence of high-risk individuals among the Iranian pilgrims, and the instructions given to them about contact and hand hygiene, and respiratory etiquette.
authors.affiliation: Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mazyar
authors.initials: M
authors.lastname: Ziyaeyan
authors.forename: Abdolvahab
authors.initials: A
authors.lastname: Alborzi
authors.forename: Marziyeh
authors.initials: M
authors.lastname: Jamalidoust
authors.forename: Mahsa
authors.initials: M
authors.lastname: Moeini
authors.forename: Gholam R
authors.initials: GR
authors.lastname: Pouladfar
authors.forename: Bahman
authors.initials: B
authors.lastname: Pourabbas
authors.forename: Mandana
authors.initials: M
authors.lastname: Namayandeh
authors.forename: Mohsen
authors.initials: M
authors.lastname: Moghadami
authors.forename: Kamran
authors.initials: K
authors.lastname: Bagheri-Lankarani
authors.forename: Talat
authors.initials: T
authors.lastname: Mokhtari-Azad
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology; D003441:Crowding; D024882:Drug Resistance, Viral; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000494:pharmacology; D010614:Pharynx / Q000821:virology; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012529:Saudi Arabia; D014195:Travel
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D053139:Oseltamivir