Skip to main content

Influenza A and B Among Pilgrims Attending Makkah and Al-Mashaer Hospitals During Hajj 1440H (2019)


Around 2-3 million pilgrims gather annually in Makkah, Saudi Arabia. Overcrowding imposes great risks of transmissions of respiratory infections. Published data show acute respiratory infections (ARIs) are the commonest diseases transmitted during Hajj. Influenza viruses are among the commonest pathogens that cause ARIs, however, almost all published studies on Influenza were conducted post-Hajj among returning pilgrims of certain nationalities or groups. We investigated the prevalence of Influenza A and Influenza B and their associated factors among all ARIs patients attending hospitals during Hajj.


We conducted a cross-sectional study among Pilgrims with ARIs attending Makkah and Al-Mashaer hospitals during the Hajj period 1440H (19 July to 16 August 2019). All patients meeting the criteria of acute onset of fever (>=38C) and cough within the previous ten days were included and nasopharyngeal swabs collected for reverse transcription PCR (RT-PCR) for Influenza A and B. Cases were identified from Makkah Preventive Medicine Department surveillance system (HESN). We used descriptive statistics to present distributions, comparisons, and associations.


The total number of participants was 734 with a total of 94 (12.8%) cases were diagnosed with Influenza. Most of them Influenza A (H1N1) with total cases of 89 (94%). The mean age of Influenza cases was 59.38 ± (11.5) years. Most of them 41 (44%) were found in the 60-69 age group. 45 (47%) of cases were critical at the time of admission with a total hospital stay of 608 days. All deaths among Influenza cases 14 (15%) occurred among international Hajjis.


The Hajj pilgrimage provides a unique opportunity to annual monitoring of influenza viruses, and other respiratory viruses (e.g. rhinovirus, corona viruses), is needed to increase our understanding of the epidemic patterns of respiratory virus infections among Hajj pilgrims.