Enteric Infections Circulating during Hajj Seasons, 2011–2013

Moataz Abd El Ghany, Mona Alsomali, Malak Almasri, Eriko Padron Regalado, Raeece Naeem, AbdulHafeez Tukestani, Abdullah Asiri, Grant A. Hill-Cawthorne, Arnab Pain, Ziad A. Memish

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Hajj, the annual Muslim pilgrimage to Mecca, Saudi Arabia, is a unique mass gathering event that raises public health concerns in the host country and globally. Although gastroenteritis and diarrhea are common among Hajj pilgrims, the microbial etiologies of these infections are unknown. We collected 544 fecal samples from pilgrims with medically attended diarrheal illness from 40 countries during the 2011-2013 Hajj seasons and screened the samples for 16 pathogens commonly associated with diarrheal infections. Bacteria were the main agents detected, in 82.9% of the 228 positive samples, followed by viral (6.1%) and parasitic (5.3%) agents. Salmonella spp., Shigella/enteroinvasive Escherichia coli, and enterotoxigenic E. coli were the main pathogens associated with severe symptoms. We identified genes associated with resistance to third-generation cephalosporins approximate to 40% of Salmonella- and E. coli-positive samples. Hajj-associated foodborne infections pose a major public health risk through the emergence and transmission of antimicrobial drug-resistant bacteria.
Original languageEnglish (US)
Pages (from-to)1640-1649
Number of pages10
JournalEmerging Infectious Diseases
Issue number10
StatePublished - Sep 13 2017

Bibliographical note

KAUST Repository Item: Exported on 2020-10-01
Acknowledged KAUST grant number(s): BAS/1/1020-01-01
Acknowledgements: This work was supported by the Saudi Ministry of Health (Z.M.) and King Abdullah University of Science and Technology (faculty baseline funding [BAS/1/1020-01-01] to A.P.), and Marie Bashir Institute and Sydney Medical School Foundation (M.A. and G.H.).


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