The dynamics and interactions of respiratory pathogen carriage among French pilgrims during the 2018 Hajj

Van-Thuan Hoang (1) , Thi-Loi Dao (1) , Tran Duc Anh Ly (1) , Khadidja Belhouchat (1) , Kamel Larbi Chaht (1) , Jean Gaudart (2) , Bakridine Mmadi Mrenda (3) , Tassadit Drali (1) , Saber Yezli (4) , Badriah Alotaibi (4) , Pierre-Edouard Fournier (1) , Didier Raoult (5) , Philippe Parola (1) , Vincent Pommier de Santi (6, 1) , Philippe Gautret (1)

1 VITROME - Vecteurs - Infections tropicales et méditerranéennes
2 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
3 CESPA - Centre d'épidémiologie et de santé publique des armées [Marseille]
4 Ministry of Health [Riyadh]
5 MEPHI - Microbes évolution phylogénie et infections
6 French Armed Forces medical health service [Cayenne]

We conducted this study to describe the dynamics of the acquisition of respiratory pathogens, their potential interactions and risk factors for possible lower respiratory tract infection symptoms (LRTI) among French pilgrims during the 2018 Hajj. Each participant underwent four successive systematic nasopharyngeal swabs before and during their stay in Saudi Arabia. Carriage of the main respiratory pathogens was assessed by PCR. 121 pilgrims were included and 93.4% reported respiratory symptoms during the study period. The acquisition of rhinovirus, coronaviruses and Staphylococcus aureus occurred soon after arrival in Saudi Arabia and rates decreased gradually after days 5 and 6. In contrast, Streptococcus pneumoniae and Klebsiella pneumoniae carriage increased progressively until the end of the stay in Saudi Arabia. Haemophilus influenzae and Moraxella catarrhalis carriage increased starting around days 12 and 13, following an initial clearance. Influenza viruses were rarely isolated. We observed an independent positive mutual association between S. aureus and rhinovirus carriage and between H. influenzae and M. catarrhalis carriage. Dual carriage of H. influenzae and M. catarrhalis was strongly associated with S. pneumoniae carriage (OR = 6.22). Finally, our model showed that M. catarrhalis carriage was negatively associated with K. pneumoniae carriage. Chronic respiratory disease was associated with symptoms of LRTI. K. pneumoniae, M. catarrhalis-S. aureus and H. influenzae-rhinovirus dual carriage was associated with LRTI symptoms. Our data suggest that RTIs at the Hajj are a result of complex interactions between a number of respiratory viruses and bacteria.

Mots clés: Hajj; pilgrims; respiratory tract infections; pathogen interaction

Domaines: Bactériologie; Virologie; Parasitologie; Cardiologie et système cardiovasculaire; Maladies émergentes; Maladies infectieuses

Van-Thuan Hoang, Thi-Loi Dao, Tran Duc Anh Ly, Khadidja Belhouchat, Kamel Larbi Chaht, et al.. The dynamics and interactions of respiratory pathogen carriage among French pilgrims during the 2018 Hajj. Emerging microbes & infections, 2019, 8 (1), pp.1701-1710. ⟨10.1080/22221751.2019.1693247⟩. ⟨hal-02447212⟩