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Serotypes of influenza during Hajj season 1424 (2004)


Study was conducted with the objectives to identify the serotypes of influenza cases presenting to MOH-KSA health care facilities during Hajj season in Makkah and Mina, to improve the understanding of epidemiology of influenza in Hajj.


A cross sectional study was conducted during Hajj period 1424H within the MOH health care facilities in Makkah and Mina. The case was defined as any patient who developed from fever of at least 38°C within last 72 hours, in combination with either cough or sore throat. Throat swabs of 415 suspected influenza cases, which fulfilled the criteria of case definition, taken and analyzed at virology laboratory in King Abdul Aziz University in Jeddah.


The mean age of the cases and standard deviation was 39.3± 15.65 years. 86.7% of cases were Hajjis, 32.5% were domestic and 67.5% were international. They were of 36 nationalities, majority of them (24.1%) were Pakistani, 26.4% had onset of fever before they came to Saudi Arab. The clinical features which are reported by the suspected influenza cases were fever which reported by all cases, then sore throat(80.2%) and the least one is blocked nose (21.1%). 2.2% were vaccinated, and 16.1% used antibiotics. Confirmed influenza cases 13.3% of suspected influenza cases were confirmed by lab to have influenza virus. The mean age and standard deviation of the cases was 37.13±14.96 years. 83.6% were Hajjis, 32.7% were domestic, 67.3% international, cases were of 18 nationalities, majority of them from Egypt. The clinical features were fever (100%), cough (85.5%), and the least was blocked nose. None of the cases were vaccinated against influenza. 27.27% of the confirmed influenza cases had influenza type A viruses, and 72.73% had influenza type B viruses, and the most predominant serotype among the confirmed influenza isolates was flu B Sichuan which accounted for 70.91%, followed by flu A not typed which accounted for 14.55%, and the least was flu B Hong Kong.


Influenza viruses are important pathogens during Hajj season, and the influenza serotypes which spread there are the same as those which spread all over the world and those which are known by the World Health Organization (WHO), and Centers for Disease Control and Prevention (CDC) and these serotypes are included in the influenza vaccine for 2004-05 season. So this infection can be prevented by giving the influenza vaccine especially to the high risk groups, and to those who are going to Hajj.