[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Prevalence of MERS-CoV nasal carriage and compliance with the Saudi health recommendations among pilgrims attending the 2013 Hajj

Ziad A. Memish 1, Abdullah Assiri 2, Malak Almasri 2, Rafat F. Alhakeem 2, Abdulhafeez Turkestani 3, Abdullah A. Al Rabeeah 2, Jaffar A. Al-Tawfiq 4, Abdullah Alzahrani 2, Essam Azhar 5, Hatem Q. Makhdoom 6, Waleed H. Hajomar 7, Ali Alshingiti 8 and Saber Yezli 2

Author Affiliations: <SUP>1</SUP>Global Centre for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh, Kingdom of Saudi Arabia (KSA)& College of Medicine, Alfaisal University, Riyadh, KSA <SUP>2</SUP>GCMGM, Ministry of Health, Riyadh, KSA <SUP>3</SUP>Makkah Regional Health Affairs, Ministry of Health, Jeddah, KSA <SUP>4</SUP>Saudi Aramco Medical Services Organization, Dhahran, KSA and Indiana University School of Medicine, Indianapolis, IN (USA) <SUP>5</SUP>King Abdualziz University, Special Infectious Diseases Unit, King Fahad Medical Research Center, Jeddah, KSA <SUP>6</SUP>Jeddah Regional Laboratory and Blood Bank, Ministry of Health, Jeddah, KSA <SUP>7</SUP>Riyadh Regional Laboratory and Blood Bank, Ministry of Health, Riyadh, KSA <SUP>8</SUP>General Directorate of Laboratory Services, Ministry of Health, Riyadh, KSA

Corresponding author's details: Ziad A. Memish. Global Centre for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh, 11176, KSA. Email: zmemish@yahoo.com. Tel:+966-11-2124052 Fax:+96611-2125052.

<CITE><ABBR>J Infect Dis.</ABBR> (2014) doi: 10.1093/infdis/jiu150 - </CITE>First published online: March 11, 2014



Saudi Arabia is annually the host of the Hajj mass gathering. We aimed to determine the MERS-CoV nasal carriage rate among pilgrims performing the 2013 Hajj and to describe the compliance with the Saudi Ministry of Health (MoH) vaccine recommendations.


Nasopharyngeal samples were collected from 5235 adult pilgrims from 22 countries and screened for MERS-CoV using RT-PCR. Information regarding the participants' age, gender, country of origin, medical conditions as well as vaccination history were obtained.


The mean age of the screened population was 51.8 years (range: 18-93 years) with a male/female ratio of 1.17:1. MERS-CoV was not detected in any of the samples tested (3210 pre-Hajj and 2025 post-Hajj screening). According to the vaccination documents, all participants had received meningococcal vaccination and the majority of those from at risk countries were vaccinated against yellow fever and polio. Only 22% of the pilgrims, 17.5% of those ≥65 years and 36.3% of diabetics, had flu vaccination and 4.4% had pneumococcal vaccination.


There was no evidence of MERS-CoV nasal carriage among Hajj pilgrims. While rates of compulsory vaccinations uptake were high, uptake of pneumococcal and flu seasonal vaccinations were low including amongst the high risk population.

Received February 11, 2014. Revision received February 28, 2014. Accepted March 3, 2014.

? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.