Changes in the prevalence of influenza-like illness and influenza vaccine uptake among Hajj pilgrims: A 10-year retrospective analysis of data

Mohammad Alfelali; Osamah Barasheed; Mohamed Tashani; Mohammad Irfan Azeem; Haitham El Bashir; Ziad A Memish; Leon Heron; Gulam Khandaker; Robert Booy; Harunor Rashid; Hajj Research Team

doi:10.1016/j.vaccine.2015.04.006

Changes in the prevalence of influenza-like illness and influenza vaccine uptake among Hajj pilgrims: A 10-year retrospective analysis of data

Vaccine. 2015 May 21;33(22):2562-9. doi: 10.1016/j.vaccine.2015.04.006. Epub 2015 Apr 14.

Authors

Collaborators

Hajj Research Team:
Elizabeth Haworth, Al-Mamoon Badahdah, Hamid Bokhary, Nedal Almasri, Jassir Alshehri, Ghassan Matbouly, Jamil Samkari, Nadeen Kalantan, Mohammed Alhefzi, Hisham Alqari, Mukhtaar Sayid, Yahya Alghamdi, Daliya Alansari, Amani Al Hetairshi, Maria Chow, Duaa Sakabumi, Samah Melebari, Nada Dibi, Amani Al Beladi, Duaa Tashkandi, Wadha Al Otaiby, Reham Abu Zahirah, Samah Alhadramy, Ziyad Siyam, Mohamad Bakhaidar, Ahmad Basalamah, Suhaib Jiman, Abdullah Alotaibi, Musab Hijan, Saeed Abuzidbarabwan, Mousab Alsudais, Saad Alghamdi, Saeed Alghamdi, Mohamud Sheikh, Thamer Almalki, Ayed Alaklubi, Meshari Alzahrani, Abdulaziz Alharthi, Amjad Alrashed, Osama Jamal, Abdullah Qasim, Ibrahim Alhomoud, Ali Alqahtani, Hammam Akil, Hawthan Alzahrani, Sami Alsaedi, Majid Alsubeiy, Muhannad Alhazmi, Abdulsallam Alfawzan, Yasser Alharbi, Raed Alharbi, Yousef Alobeisy, Abdulaziz Aljohani, Ibtihal Malawi, Ebtehal Matar, Abrar Tawakoul, Abrar ALnami, Atheer Alshareif, Israa Kalantan, Asal Arbaeen, Eatimad Alalawi, Afnan AlGhamdi, Amani Koshak, Ameerah Alkhaldi, Inaam Al-Nami, Anwar Howsawi, Bashaier Fairaq, Bushra Maghrabi, Tafaol Murad, Hanan Alzahrani, Kholood Almehmadi, Doaa Milibari, Rehab Hafiz, Rawdhah Kalantan, Shahad Al-Ansari, Aeshah Rajab, Anood Alfahmy, Ghaida Ali, Fatimah Abu naji, Lujin Hassan, Lulwah Althumali, Layla Farhat, Najlaa Baddour, Hibh Alandanusi, Waad Alqurashi, Sumayyah Fallata, Azhar Alharbi, Joud Bahakeem, Abrar Alshareef, Badr Rawa, Daniah Alnemari, Mawaddah Hariri, Ahmed Alghamdi, Ahmed Muqadimi, Ahmad Bimah, Osama Alamri, Jehad Qutub, Abdulrahman Al-Ghamdi, Abdur-rahman Mirza, Abdulghafur Alandijani, Omar Qoqandi, Faisal Mandourah, Muhammad Alghamdi, Mohammed Mahboob, Mohannad Alsulami, Moayyd Hinnawi, Naif Hawsawi, Nawaf Dhabab, Ahmed Balamash, Mohammed Bawazir, Raif Nassir, Mohammed AlAsmari, Faisal Alzahrani, Abdulrahman Alomari, Ahmad Makeen, Ibraheem Almani, Ahmed Baabdullah, Osama Alamoudi, Ahmed Alzhrani, Ahmed Bagabas, Ahmad Ahmad, Anwar Alammari, Ayman Alghamdi, Badr Alaifan, Badr Al Dahlawi, Turki Almalki, Thamer Zughbi, Hussam Patwa, Hasan Ghannam, Hussien Alkully, Samir Alsulaimani, Samee Al Heraki, Saad AlGhamdi, Sultan AlBalawi, Sultan Albukhari, Saleh Algamdi, AbdululahAlsolami, Abdullah Alghanmi, Abdulellah Alturkistani, Abdullrhman Alayad, Abdulrahman Althagafi, Abdulrahman Makki, Abdulrahman Khinkar, Abdulaziz Alalawi, Abdu-laziz Alhoqail, Abdulaziz Alshoaibi, Abdullah Aldour, Abdulhadi Towairqi, Ali Ali, Ali Alshubaily, Firas Atwah, Majed Daqeeq, Mohammed Aljunaid, Mohammed Alghamdi, Mohammed Alsefri, Mohammed Alamoudi, Mohammed Alghamdi, Mohammad Melibary, Mohammad Bakhaidar, Mohammad Albogami, Mohammed Almoflihi, Mahmoud Chaker, Muaath AlGhamdi, Mutaz Abdulhaq, Monther Farghali, Mohannad Khyyat, Moayad Banjar, Wael Almaghthawi, Wael Khalifa, Yasser Halabi, Mohanad Aljohani, Riyadh Alharbi, Moayad Sumnudi, Sultan Al Jaid, Rayan Makeen, Mahmoud Eid, Mohammed Alaryn, Abdulrahman Qahtani, Saud Bakhsh, Turki Alkharji, Ahmed Qadah, Albraa Kashegari, Ahmad Alabbasi, Abdulmohsen Al-Sofi, Meshary Alhassni, Nawaf Alharbi, Ahmad Al Ahdal, Abdulghani Alserafi, Ibrahim Alomry, Mohammed Kadi, Abdul-rahman Almalki, Bassel Katib, Ibrahim Sameer, Fares Alnajjar, Mohammed Hawsawi, Rayan Sendi, Ebtihal Turkistani, Abrar Tawakoul, Arwa Bajabaa, Areej Alzaidi, Ashar Almusallam, Esra Turkestani, Asmaa Alattas, Alshaima Alghamdi, Esraa Kashkari, Elaf Altowairqi, Elaf Alrehaili, Elaf Khalifa, Inas Magharbil, Abrar Salloma, Arwa Alzaidi, Arej Fadel, Asmah Al-Dobashi, Afnan A L Gothami, Amal Al-Saedi, Amal Faheem, Alaa Bin Afif, Alaa Binsalman, Aya Kutbi, Baraah Tatwany, Basmah Fallata, Bashayer Al Mutairi, Bashaer Alrefaie, Bashayer Al-huthali, Bashayer Alsaati, Bashaer ALzahrani, Bushra Fallatah, Bushra Alattas, Bushra Alhajjaji, Banan Almalki, Bayan Zamil, Tamador Alghamdi, Tahani Al-Ghamdi, Jenan Jawi, Haneen Sibieh, Kholoud Natto, Duaa Eid, Reem Alamoodi, Sumaia Felimban, Etaf Kassem, Faten Althobaiti, Fadya Althobaiti, Maria AL-Jehani, Muneerah Al-youbi, Nadeen Bugis, Duaa Aiash, Duaa Assaqaf, Duaa Almouallimi, Rania Iraqi, Rahma Al-Ghamdi, Rasha Qurashi, Rasha Baqis, Raghad Jamal Aldeen, Refal AzizAlrahman, Ruqaiah Baharoon, Ranad Medhir, Renad Gashlan, Renad Aljohani, Randa Al-Bloushy, Raneen Abu Saadah, Rahaf Shafi, Rawan Gaafar, Rowaynah Aziz Alrahman, Reem Alshareef, Zahra Othman, Sara Aljuaid, Sara Al-Ghfari, Salma Sait, Samaa Sangouf, Samah AlQurashi, Samar Alsubhi, Sahar Alharbi, Samar Al-harbi, Sana'a Kelantan, Shahad Aldor, Shahd Alshareef, Shaimaa Halabi, Shaimaa Hawsawi, Seba AlHarbi, Azzah Azzouz, Alyaa Idris, Fatimah Alosaimi, Fatimah Alsomali, Lujain Al-Thakafi, Lujain Abdalwassie, Lama Alarabi, Lina Alsaiari, Majedah Alshammari, Mahacen Alnadwi, Mada Abdulhaq, Mada Al Zahrani, Maradi Murad, Maram AlShareef, Marwah Hadidi, Marium Iqbal, Nojoud Benhli, Najwa Mohammad, Nedaa Karami, Nada Almuqati, Noor Alessa, Noura Bakhsh, Nuran Sultan, Norah Alotaibi, Heba Waez, Heba Al-Qethami, Heba Alsheikh, Hebah Alwafi, Hoda Al-Sayid, Hadeel Khoj, Wejdan Makeen, Wed Jawa, Woud AlMusallam, Waed Yaseen, Wafa Sohail, Sara Fallata

Affiliations

¹ National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: [email protected].
² National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, NSW, Australia; King Abdullah Medical City, Makkah, Saudi Arabia.
³ National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, NSW, Australia.
⁴ Al Maha Children Unit, Hamad Medical Corporation, Doha, Qatar.
⁵ Ministry of Health, and College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
⁶ National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Sydney, Australia.

PMID: 25887084
DOI: 10.1016/j.vaccine.2015.04.006

Abstract

Background: Influenza is an important health hazard among Hajj pilgrims. For the last ten years, pilgrims are being recommended to take influenza vaccine before attending Hajj. Vaccination coverage has increased in recent years, but whether there has been any change in the prevalence of influenza-like illness (ILI) is not known. In this analysis, we examined the changes in the rate of ILI against seasonal influenza vaccine uptake among Hajj pilgrims over the last decade.

Method: Data for this analysis is a synthesis of raw and published data from eleven Hajj seasons between 2005 and 214. For seven Hajj seasons the data were obtained from studies involving pilgrims of UK, Saudi Arabia and Australia; and for the remaining four Hajj seasons data were abstracted from published studies involving pilgrims from multiple countries. The data from both sources were synthesised to estimate the relative risk (RR) of acquisition of ILI in vaccinated versus unvaccinated pilgrims.

Results: The pooled sample size of the included studies was 33,213 with most pilgrims being in the age band of 40-60 years (range: 0.5 to 95 years) and a male to female ratio of 1.6. The pilgrims originated, in order of frequency, from Iran, Australia, France, UK, Saudi Arabia, Indonesia, India, Algeria, Ivory Coast, Nigeria, Somalia, Turkey, Syria, Sierra Leone and USA. Except for one year (2008), data from individual years did not demonstrate a noticeable change in the rate of ILI against influenza vaccine coverage, however the combined data from all studies suggest that the prevalence of ILI decreased among Hajj pilgrims as the vaccine coverage increased over the last decade (RR 0.2, P<0.01).

Conclusion: This analysis suggests that influenza vaccine might be beneficial for Hajj pilgrims. However, controlled trials aided by molecular diagnostic tools could confirm whether such an effect is real or ostensible.

Keywords: Hajj; Influenza; Influenza-like illness; Mass gathering; Travel; Vaccine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Australia / epidemiology
Child
Child, Preschool
Female
Humans
Infant
Influenza Vaccines / administration & dosage*
Influenza, Human / epidemiology*
Influenza, Human / prevention & control*
Islam*
Male
Meta-Analysis as Topic
Middle Aged
Prevalence
Respiratory Tract Infections / epidemiology
Respiratory Tract Infections / prevention & control*
Retrospective Studies
Risk
Saudi Arabia / epidemiology
Time Factors
Travel
United Kingdom / epidemiology
Young Adult

Substances

Influenza Vaccines