The dynamics and interactions of respiratory pathogen carriage among French pilgrims during the 2018 Hajj
Open Access
- 1 January 2019
- journal article
- research article
- Published by Informa UK Limited in Emerging Microbes & Infections
- Vol. 8 (1), 1701-1710
- https://doi.org/10.1080/22221751.2019.1693247
Abstract
We conducted this study to describe the dynamics of the acquisition of respiratory pathogens, their potential interactions and risk factors for possible lower respiratory tract infection symptoms (LRTI) among French pilgrims during the 2018 Hajj. Each participant underwent four successive systematic nasopharyngeal swabs before and during their stay in Saudi Arabia. Carriage of the main respiratory pathogens was assessed by PCR. 121 pilgrims were included and 93.4% reported respiratory symptoms during the study period. The acquisition of rhinovirus, coronaviruses and Staphylococcus aureus occurred soon after arrival in Saudi Arabia and rates decreased gradually after days 5 and 6. In contrast, Streptococcus pneumoniae and Klebsiella pneumoniae carriage increased progressively until the end of the stay in Saudi Arabia. Haemophilus influenzae and Moraxella catarrhalis carriage increased starting around days 12 and 13, following an initial clearance. Influenza viruses were rarely isolated. We observed an independent positive mutual association between S. aureus and rhinovirus carriage and between H. influenzae and M. catarrhalis carriage. Dual carriage of H. influenzae and M. catarrhalis was strongly associated with S. pneumoniae carriage (OR = 6.22). Finally, our model showed that M. catarrhalis carriage was negatively associated with K. pneumoniae carriage. Chronic respiratory disease was associated with symptoms of LRTI. K. pneumoniae, M. catarrhalis-S. aureus and H. influenzae-rhinovirus dual carriage was associated with LRTI symptoms. Our data suggest that RTIs at the Hajj are a result of complex interactions between a number of respiratory viruses and bacteria.Keywords
Funding Information
- Région Provence Alpes Côte d’Azur
This publication has 40 references indexed in Scilit:
- Circulation of Respiratory Viruses Among Pilgrims During the 2012 Hajj PilgrimageClinical Infectious Diseases, 2013
- Associations between Pathogens in the Upper Respiratory Tract of Young Children: Interplay between Viruses and BacteriaPLOS ONE, 2012
- Travel Reported by Pilgrims From Marseille, France Before and After the 2010 Hajj: Table 1Journal of Travel Medicine, 2012
- RNA and DNA Bacteriophages as Molecular Diagnosis Controls in Clinical Virology: A Comprehensive Study of More than 45,000 Routine PCR TestsPLOS ONE, 2011
- Divergent Mechanisms for Passive Pneumococcal Resistance to β-Lactam Antibiotics in the Presence of Haemophilus influenzaeThe Journal of Infectious Diseases, 2011
- Microbial Interactions during Upper Respiratory Tract InfectionsEmerging Infectious Diseases, 2008
- Coinfection can trigger multiple pandemic wavesJournal of Theoretical Biology, 2008
- Evidence from Multiplex Molecular Assays for Complex Multipathogen Interactions in Acute Respiratory InfectionsJournal of Clinical Microbiology, 2008
- Quantitative Detection of Moraxella catarrhalis in Nasopharyngeal Secretions by Real-Time PCRJournal of Clinical Microbiology, 2003
- Nasal Carriage as a Source ofStaphylococcus aureusBacteremiaThe New England Journal of Medicine, 2001