Document Detail

Prevention of influenza at Hajj: applications for mass gatherings.
MedLine Citation:
PMID:  23761581     Owner:  NLM     Status:  MEDLINE    
Outbreaks of infectious diseases that spread via respiratory route, e.g. influenza, are common amongst Hajj congregation in Mecca, Saudi Arabia. The Saudi Arabian authority successfully organized the Hajj 2009 amidst fear of pandemic influenza. While severe influenza A(H1N1)pdm09 was rare, the true burden of pandemic influenza at Hajj that year remains speculative. In this article we review the latest evidence on influenza control and discuss our experience of influenza and its prevention at Hajj and possible application to other mass gatherings. Depending on study design the attack rate of seasonal influenza at Hajj has ranged from 6% in polymerase chain reaction or culture confirmed studies to 38% in serological surveillance. No significant effect of influenza vaccine or the use of personal protective measures against influenza has been established from observational studies, although the uptake of the vaccine and adherence to face masks and hand hygiene has been low. In all, there is a relatively poor evidence base for control of influenza. Until better evidence is obtained, vaccination coupled with rapid antiviral treatment of symptomatic individuals remains the mainstay of prevention at Hajj and other mass gatherings. Hajj pilgrimage provides a unique opportunity to test the effectiveness of various preventive measures that require a large sample size, such as testing the efficacy of plain surgical masks against laboratory-confirmed influenza. After successful completion of a pilot trial conducted among Australian pilgrims at the 2011 Hajj, a large multinational cluster randomized controlled trial is being planned. This will require effective international collaboration.
Elizabeth Haworth; Osamah Barasheed; Ziad A Memish; Harunor Rashid; Robert Booy
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the Royal Society of Medicine     Volume:  106     ISSN:  1758-1095     ISO Abbreviation:  J R Soc Med     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-13     Completed Date:  2013-08-12     Revised Date:  2013-11-14    
Medline Journal Info:
Nlm Unique ID:  7802879     Medline TA:  J R Soc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  215-23     Citation Subset:  IM    
The Department of Public Health, Oxford University, Oxford OX3 7LF, UK.
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MeSH Terms
Disease Outbreaks*
Infection Control / methods*
Influenza, Human / epidemiology,  prevention & control*,  transmission
Saudi Arabia / epidemiology
Comment In:
J R Soc Med. 2013 Oct;106(10):386   [PMID:  24097962 ]

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