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



A 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%.



High 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.
Egyptian Ministry of Health and Population (MOHP), Cairo, Egypt.
Samir
S
Refaey
Egyptian Ministry of Health and Population (MOHP), Cairo, Egypt.
Marwa Mohamed
MM
Amin
Influenza Division, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Katherine
K
Roguski
Influenza Division, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Eduardo
E
Azziz-Baumgartner
Influenza Division, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Timothy M
TM
Uyeki
Egyptian Ministry of Health and Population (MOHP), Cairo, Egypt.
Manal
M
Labib
Egyptian Ministry of Health and Population (MOHP), Cairo, Egypt.
Amr
A
Kandeel
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000821:virology; D003430:Cross-Sectional Studies; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D007514:Islam; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000302:isolation & purification*; D009305:Nasopharynx / Q000821:virology; D009975:Orthomyxoviridae / Q000302:isolation & purification*; D012529:Saudi Arabia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
Egypt; Hajj; MERS-Coronavirus; influenza