Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France; Thai Binh University of Medicine and Pharmacie, Viet Nam.
Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France; Service de Parasitologie-Mycologie, Faculté de médecine, Unversité Cheikh Anta Diop, Dakar, Senegal.
Travel Med Infect Dis. 2019 Jul-Aug;30:32-38. doi: 10.1016/j.tmaid.2019.03.003. Epub 2019 Mar 8.
Viral respiratory tract infections are frequent among Hajj pilgrims. However, it is still not known whether viruses are responsible for the symptoms observed in sick pilgrims or whether they only colonize sick and asymptomatic pilgrims.
A prospective cohort study was conducted among French Hajj pilgrims in 2016. Medical follow-up and systematic nasal swabbing were performed pre- and post-Hajj. Additional samples were obtained per-Hajj, at symptom onset in ill pilgrims. Viruses were identified using the BioFire FilmArray Respiratory multiplex qualitative PCR panel.
109 pilgrims were included. 83.5% presented respiratory symptoms during Hajj and 39.5% were still symptomatic on return. 5.5% of pre-Hajj, 95.2% of per-Hajj (at symptom onset) and 46.5% of post-Hajj samples tested positive (p < 0.0001). Acquisition rates of rhinovirus/enterovirus, coronavirus 229E and influenza A virus were respectively 38.6%, 19.8% and 2.0%. Although rhinovirus/enterovirus, coronavirus 229E and influenza A clearance were respectively 70.6%, 71.4% and 100% on return, overall virus carriage proportion on return was 75.0% in pilgrims with influenza-like illness and 44.0% in those who have never experienced this symptoms or resolved it (OR = 4.05, 95% CI [1.02-16.02]).
Viruses likely play some role in the pathogenesis of the respiratory tract infections at the Hajj. Point of care-rapid multiplex PCR assays are valuable diagnosis tools in this context when used at respiratory symptom onset or soon after.
呼吸道病毒感染在朝觐者中很常见。然而，目前尚不清楚病毒是否是导致患病朝觐者出现症状的原因，还是它们只是定植于患病和无症状的朝觐者中。
本研究为前瞻性队列研究，纳入了 2016 年的法国朝觐者。在朝觐前后进行了医学随访和系统的鼻拭子采样。在患病朝觐者出现症状时，每批朝觐者都进行额外的采样。使用生物梅里埃 FilmArray Respiratory 呼吸道多重 PCR 定性检测试剂盒来鉴定病毒。
共纳入 109 例朝觐者。83.5%的朝觐者在朝觐期间出现呼吸道症状，39.5%的朝觐者在返回时仍有症状。在朝觐前、每批朝觐期间（症状出现时）和返回时，分别有 5.5%、95.2%和 46.5%的样本检测呈阳性（p＜0.0001）。鼻病毒/肠道病毒、冠状病毒 229E 和甲型流感病毒的检出率分别为 38.6%、19.8%和 2.0%。尽管鼻病毒/肠道病毒、冠状病毒 229E 和甲型流感病毒在返回时的清除率分别为 70.6%、71.4%和 100%，但在有流感样症状的朝觐者中，返回时病毒携带率仍高达 75.0%，而在从未有过此类症状或已痊愈的朝觐者中，病毒携带率为 44.0%（OR=4.05，95%CI [1.02-16.02]）。
病毒可能在朝觐期间的呼吸道感染发病机制中起一定作用。在这种情况下，当在呼吸道症状出现或出现后不久时，床边快速多重 PCR 检测试剂盒是一种有价值的诊断工具。
