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Editors: Andrew Sails. Hardcover ISBN: Imprint: Academic Press. Published Date: 15th October Page Count: Print - Hardcover Delivery may take up to 10 days.

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Institutional Subscription. Free Shipping Free global shipping No minimum order. The first comprehensive and accessible reference on molecular medical microbiology Full color presentation througout In-depth discussion of individual pathogenic bacteria in a system-oriented approach Includes a clinical overview for each major bacterial group Presents the latest information on vaccine development, molecular technology, and diagnostic technology More than chapters covering all major groups of bacteria Written by an international panel of authors who are experts in their respective disciplines. Subtilis and S.

Aureus References Part 3: Genetics Chapter Pseudomallei Molecular Biology of B. Diarrhoeagenic Escherichia coli Escherichia coli Enterotoxigenic E.

Listeria monocytogenes Introduction L. Klebsiella pneumoniae and Pseudomonas aeruginosa Klebsiella pneumoniae Pseudomonas aeruginosa Conclusion References Chapter Corynebacterium spp. Powered by. You are connected as. Connect with:. Use your name:. Thank you for posting a review! We value your input. Share your review so everyone else can enjoy it too. Your review was sent successfully and is now waiting for our team to publish it.

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Reviews 0. Updating Results. Respiratory viruses, especially influenza virus, are the most common cause of acute respiratory infections among pilgrims 8 — We recently reported the acquisition of rhinovirus 5 and Streptococcus pneumoniae infections 12 by French pilgrims during the Hajj season and highlighted the potential for spread of these infections to home countries of pilgrims upon their return. In this study, we collected paired nasal and throat swab specimens from adult pilgrims departing from Marseille, France to Mecca, Saudi Arabia, for the Hajj season. The primary objective was to determine the prevalence of the most common respiratory viruses and bacteria upon return of pilgrims from the Hajj.

The secondary objective was to evaluate the potential yearly variation of the acquisition of these respiratory pathogens by comparing results from the and Hajj seasons. Pilgrims who planned to participate in the Hajj were recruited on September 15, , at a private specialized travel agency in Marseille, France, which organizes travel to Mecca.

In this prospective cohort study, participants were sampled and followed up before departing from France on October 2, and immediately before leaving Saudi Arabia on October 24, Upon inclusion in the study, participants were interviewed by Arabic-speaking investigators who used a standardized pre-travel questionnaire that collected information on the demographic characteristics and medical history of each participant. A post-travel questionnaire that collected clinical data and information on vaccination status and compliance with preventive measures was completed during a face-to-face interview 2 days before the pilgrims returned to France by a single investigator who joined the pilgrims after the Hajj.

Influenza-like illness ILI was defined as the presence of cough, sore throat, and subjective fever The study was performed in accordance with the good clinical practices recommended by the Declaration of Helsinki and its amendments. All participants gave written informed consent. Paired nasal and throat swab specimens were collected from each participant by using rigid cotton-tipped swab applicators Medical Wire and Equipment, Corsham, UK 10 days September 22, before participants departed from France pre-Hajj specimens and only 1 day October 23, before they left Saudi Arabia post-Hajj specimens.

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Nasal and throat swab specimens collected from participants were placed in viral transport media Virocult and Transwab, respectively; Sigma, St. Throat swab samples were independently tested as described 12 by using quantitative real-time PCRs for Streptococcus pneumoniae , Neisseria meningitidis , Bordetella pertussis , and Mycoplasma pneumoniae. Sequences of all primers and probes have been reported A total of persons were invited to participate in the study.

All persons agreed to participate in the study and responded to the pre-travel questionnaire. The participants were 77 women Although most More than half of the participants All post-travel questionnaires were completed. During the 3-week stay in Saudi Arabia October 3—24, , most Onset of respiratory symptoms peaked in the second week week 41 after the arrival of the pilgrims in Mecca and decreased thereafter.

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However, 90 Only 1 pilgrim 0. No deaths occurred.

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Regarding preventive measures, None had received the influenza vaccine before departing for the Hajj, but During the stay in Saudi Arabia, ILI symptoms were less frequently reported by persons who reported receiving the influenza vaccine in compared with reports by unvaccinated persons In contrast, none of the other preventive measures was found to be effective in preventing ILI symptoms during the stay in Saudi Arabia.

Figure 1. Patterns of respiratory viruses detected among 64 pilgrims who were positive for viruses during the study period before departing from France and before leaving Saudi Arabia, Hajj. Pre-Hajj and post-Hajj nasal swab specimens were obtained from A total of 26 Moreover, 36 Of 19 participants whose post-Hajj specimens were positive for HRV, 17 The prevalence of influenza A and B viruses was significantly higher in post-Hajj specimens than in pre-Hajj specimens 7. Also, of 79 participants whose post-Hajj specimens were negative for respiratory viruses, 74 None of the preventive measures was found to be effective in preventing respiratory viruses in post-Hajj specimens.

Pre-Hajj and post-Hajj throat swab specimens were obtained from None of the participants were positive for N. Figure 2. Detection of Streptococcus pneumoniae among 92 pilgrims who were positive for viruses during the study period before departing from France and before leaving Saudi Arabia, Hajj. A total of 63 Of 80 participants whose post-Hajj specimens were positive for S. In addition, of 63 participants whose pre-Hajj specimens were positive for S. Among 66 participants who reported having received a pneumococcal vaccination in the 5 years before traveling to Saudi Arabia, 37 The prevalence of S.

Of 49 participants whose post-Hajj specimens were negative for S. For the second consecutive year, we conducted a prospective longitudinal study of respiratory viruses and bacteria in respiratory specimens collected from a single cohort of pilgrims before departing from Marseille, France, to Mecca, Saudi Arabia, for the Hajj and immediately before leaving Saudi Arabia.

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By collecting samples from pilgrims before their departure from Saudi Arabia, we were able to rule out acquisition of infections acquired as a result of travel through the international airports of Jeddah, Saudi Arabia, and Istanbul, Turkey, as part of the return trip to Marseille. Close monitoring for respiratory symptoms and compliance with preventive measures was also performed by the investigators accompanying the group.

In this study, we confirmed that performing the Hajj pilgrimage is associated with an increased occurrence of respiratory symptoms in most pilgrims; 8 of 10 pilgrims showed nasal or throat acquisition of respiratory pathogens. This acquisition may have resulted from human-to-human transmission through close contact within the group of French pilgrims because many of them were already infected with HRV or S. Alternatively, the French pilgrims may have acquired these respiratory pathogens from other pilgrims, given the extremely high crowding density to which persons from many parts of the world are exposed when performing Hajj rituals.

Finally, contamination originating from an environmental source might have played a role. Sequencing of these pathogens would be required to determine how often new infections were acquired during the stay in Saudi Arabia. However, detection of nasal carriage of coronaviruses other than MERS-CoV and influenza A and B viruses in only the post-Hajj specimens supports the hypotheses that infection occurred during the Hajj. We confirmed the predominance of HRV and S.

In and , results of screening for MERS-CoV infection in different cohorts of pilgrims, including the present cohort, were negative 13 , 14 , Finally, we found that compared with acquisition of HRV and HCoV-E, influenza viruses were acquired at a lower frequency among pilgrims. The present study is a continuation of our previous study in 5.

We extended the investigation to additional viruses, including human bocavirus, human cytomegalovirus, coronaviruses, human parechoviruses, and HPIV, and showed a high frequency of HCoV-E infection in pilgrims returning from the Hajj. The prevalence of HRV was lower in than in , both before departing from France 3. This protocol may have resulted in degradation of genetic material, which probably contributed to underestimation of frequencies of infection in However, in the study, nasal swab specimens were collected from participants instead of throat swab specimens, which were used in the study.

In addition, the period of the storage of samples before freezing differed between the and the studies, as mentioned earlier in this report. Our results confirm that various respiratory viruses might be acquired by pilgrims during their stay in Saudi Arabia and introduced into home countries of pilgrims on their return, thus contributing to potential international spread of these viruses.