title: Infections in travellers returning to Turkey from the Arabian peninsula: a retrospective cross-sectional multicenter study.
abstract: Mass gatherings pooling people from different parts of the world-the largest of which is to Mecca, Saudi Arabia, for Hajj-may impose risks for acquisition and dissemination of infectious diseases. A substantial number of pilgrims to Hajj and Umrah are Turkish citizens (456,000 in 2014) but data are lacking on scale of the problem. We did a retrospective cross-sectional multicenter study in Turkey to explore the range of infections among inpatients who had recently returned from the Arabian Peninsula. Our inclusion criteria were patients who had acquired an infection during their trip to an Arabian Peninsula country, or who became symptomatic within 1 week of their return. The data were collected retrospectively for January 1, 2013 and March 1, 2015. 185 Turkish patients were recruited to the study across 15 referral centers with travel associated infectious diseases after returning from Arabian Peninsula countries (predominantly Saudi Arabia 163 [88.1 %] for religious purposes 162 [87.5 %]). Seventy four (40.0 %) of them were ≥ 65 years old with numerous comorbidities including diabetes (24.3 %) and COPD (14.1 %). The most common clinical diagnosis was respiratory tract infections (169 [91.5 %]), followed by diarrheal diseases (13 [7 %]), and there was one case of MERS-CoV. Patients spent a median of 5 (3-7) days as hospital inpatients and overall mortality was 1.1 %. Returning travellers from the Arabian Peninsula present as inpatients with a broad range of infectious diseases similar to common community acquired infections frequently seen in daily medical practices in Turkey.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey. hakanerdem1969@yahoo.com.
authors.forename: H
authors.initials: H
authors.lastname: Erdem
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Ak
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Elaldi
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Demirdal
authors.affiliation: International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, Commonwealth Building, Hammersmith Campus, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hargreaves
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey.
authors.forename: S A
authors.initials: SA
authors.lastname: Nemli
authors.affiliation: Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Cag
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Private Umit Hospital, Eskisehir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ulug
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Kocaeli State Hospital, Kocaeli, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Naz
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Gunal
authors.affiliation: School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Sirmatel
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: O R
authors.initials: OR
authors.lastname: Sipahi
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Osmangazi University School of Medicine, Eskisehir, Turkey.
authors.forename: S N
authors.initials: SN
authors.lastname: Alpat
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Ertem-Tuncer
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Sozen
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Evlice
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Izmit, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Meric-Koc
authors.affiliation: Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Dogru
authors.affiliation: Tayfur Ata Sokmen School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University, Hatay, Turkey.
authors.forename: V
authors.initials: V
authors.lastname: Koksaldi-Motor
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey.
authors.forename: R
authors.initials: R
authors.lastname: Tekin
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Duzce University School of Medicine, Konuralp, Duzce, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Ozdemir
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Ozturk-Engin
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey.
authors.forename: U
authors.initials: U
authors.lastname: Savasci
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Military Hospital, Van, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Karagoz
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Cekli
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Inan
mesh_terms: D015897:Comorbidity; D003422:Critical Care; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D007362:Intensive Care Units; D008297:Male; D008828:Microbiological Techniques; D008877:Middle East; D012189:Retrospective Studies; D012698:Serologic Tests; D014195:Travel; D014421:Turkey