Background

Viral respiratory tract infections are known to be common in Hajj pilgrims while the role of bacteria is less studied.

Methods

Clinical follow-up, adherence to preventive measures and PCR-based pharyngeal bacterial carriage pre- and post-Hajj, were assessed in a cohort of 119 French Hajj pilgrims.

Results

55% had an indication for pneumococcal vaccination. Occurrence of respiratory symptoms was 76.5%, with cough (70.6%) and sore throat (44.5%) being the most frequent; fever was reported by 38.7% pilgrims and 42.0% took antibiotics. Respiratory symptoms, fever and antibiotic intake were significantly more frequent in pilgrims with indication for vaccination against pneumococcal infection. The prevalence of S. pneumoniae carriage (1.8% pre-, 9.8% post-Hajj), H. influenzae carriage (0.9%, 45.4%) and K. pneumoniae (2.8%, 9.8%) significantly increased post-Hajj. Pilgrims vaccinated with conjugate pneumococcal vaccine were seven time less likely to present S. pneumoniae carriage post-Hajj compared to those not vaccinated (3.2% vs. 18.0%, OR = 0.15; 95% CI [0.03–0.74], p = 0.02).

Conclusions

Pilgrims at risk for pneumococcal disease are more likely to suffer from febrile respiratory symptoms at the Hajj despite being immunized against pneumococcal disease and despite lowered S. pneumoniae carriage and should be targeted for reinforced prevention against respiratory infections.

中文翻译：

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法国朝圣者的细菌呼吸道运输以及肺炎球菌疫苗和其他个体预防措施的影响：一项前瞻性队列研究。

背景

朝圣者中病毒性呼吸道感染是常见的，而细菌的作用则研究较少。

方法

在119名法国朝圣者的队列中评估了临床随访，对预防措施的依从性以及基于PCR的哈吉之前和之后的咽部细菌运输。

结果

55％的人有肺炎球菌疫苗接种的迹象。呼吸道症状的发生率为76.5％，其中最常见的是咳嗽（70.6％）和喉咙痛（44.5％）；38.7％的朝圣者报道了发烧，42.0％的患者服用了抗生素。朝圣者的呼吸系统症状，发烧和抗生素摄入明显增加，并有接种肺炎球菌感染疫苗的迹象。的患病率肺炎链球菌滑架（1.8％预，9.8％后朝觐），流感嗜血菌滑架（0.9％，45.4％）和肺炎克雷伯菌（2.8％，9.8％）显著增加后朝觐。接种复合肺炎球菌疫苗的朝圣者出现肺炎链球菌的可能性降低了七倍 与未接种疫苗的人相比，Hajj后的携带者（3.2％vs. 18.0％，OR = 0.15； 95％CI [0.03-0.74]，p = 0.02）。

结论

尽管已经针对肺炎球菌疾病进行了免疫接种并且肺炎链球菌携带量降低，但有发生肺炎球菌疾病风险的朝圣者更有可能在朝j遭受高热的呼吸道症状，因此，应该针对性地加强针对呼吸道感染的预防。