title: Circulation of respiratory viruses among pilgrims during the 2012 Hajj pilgrimage.
abstract: BACKGROUND
  The Hajj is the oldest and largest annual mass gathering in the world and may increase the risk of spread of respiratory viruses.
  
  
  METHODS
  We performed a prospective survey among a cohort of pilgrims departing from Marseille, France, to Mecca in the Kingdom of Saudi Arabia (KSA) for the 2012 Hajj season. Nasal swabs were collected from participants and tested for 11 respiratory viruses by real-time reverse transcription polymerase chain reaction.
  
  
  RESULTS
  Of 165 participants sampled before departing to the KSA, 8 (4.8%) were positive for at least 1 virus (5 rhinovirus, 1 influenza C, 1 adenovirus, and 1 enterovirus). Seventy symptomatic pilgrims underwent additional nasal swabs during their pilgrimage in the KSA, of which 27 (38.6%) were positive for at least 1 virus (19 rhinovirus, 6 influenza A, 1 influenza C, 1 respiratory syncytial virus B, 1 metapneumovirus, 1 adenovirus, and 1 enterovirus). This was significantly higher than the 4.8% who were positive before departing for the KSA (P < .001). Of 154 pilgrims sampled before leaving the KSA, 17 (11%) were positive for at least 1 virus (13 rhinovirus, 3 adenovirus, 2 influenza B, and 1 enterovirus), which was also significantly higher than the percentage of positive pilgrims (4.8%), before departing for the KSA (P = .040).
  
  
  CONCLUSIONS
  This study suggests a rapid acquisition of respiratory viruses among pilgrims during their stay in the KSA, most notably rhinovirus, and highlights the potential of spreading these infections in the pilgrims' home countries upon their return.
authors.affiliation: Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Unité Mixte de Recherche (UMR) 63, Centre National de la Recherche Scientifique (CNRS) 7278, Institut de Recherche pour le Développement (IRD) 198, Institut National de la Santé et de la Recherche Médicale (INSERM) 1095.
authors.forename: Samir
authors.initials: S
authors.lastname: Benkouiten
authors.forename: Rémi
authors.initials: R
authors.lastname: Charrel
authors.forename: Khadidja
authors.initials: K
authors.lastname: Belhouchat
authors.forename: Tassadit
authors.initials: T
authors.lastname: Drali
authors.forename: Nicolas
authors.initials: N
authors.lastname: Salez
authors.forename: Antoine
authors.initials: A
authors.lastname: Nougairede
authors.forename: Christine
authors.initials: C
authors.lastname: Zandotti
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
authors.forename: Malak
authors.initials: M
authors.lastname: al Masri
authors.forename: Catherine
authors.initials: C
authors.lastname: Gaillard
authors.forename: Philippe
authors.initials: P
authors.lastname: Parola
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007514:Islam; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000821:virology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D012529:Saudi Arabia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014195:Travel / Q000706:statistics & numerical data*; D014780:Viruses / Q000145:classification / Q000302:isolation & purification*
keywords: Hajj; cohort study; epidemiology; respiratory tract infections; viruses