Gastrointestinal symptoms and the acquisition of enteric pathogens in Hajj pilgrims: a 3-year prospective cohort study

AbstractThe acquisition of enteric pathogens and risk factors for Hajj-associated diarrhea in Hajj pilgrims is poorly documented. Pilgrims from Marseille participating in the Hajj in 2016 –2018 underwent successive systematic rectal swabbing before and after their travel. Carriage of the main enteric pathogens was assessed by real-time PCR. Baseline demographics, adherence to individual preventive measures, gastrointestinal symptoms, and treatments were recorded. A total of 376 pil grims were included. The median age was 62.0 years. During the Hajj, 18.6% presented at least one gastrointestinal symptom, 13.8% had diarrhea, and 36.4% had acquired at least one enteric pathogen. EnteropathogenicEscherichia coli (EPEC) and EnteroaggregativeE. coli (EAEC) were the pathogens most frequently acquired by pilgrims (17.6% and 14.4%, respectively). Being female was associated with increased frequency of gastrointestinal symptoms during the pilgrimage (aOR  = 2.38,p = 0.004). EnterohemorrhagicEscherichia coli (EHEC) acquisition was associated with a four-fold higher risk of reporting at least one gastrointestinal symptom and diarrhea (aOR  = 3.68 andp = 0.01 and aOR = 3.96 andp = 0.01, respectively). Pilgrims who suffered from diarrhea were more likely to wash their hands more often (aOR = 2.07,p = 0.03) and to be either overweight (aOR = 2.71,p = 0.03) or obese (aOR = 2.51,p = 0.05). Enteric bacteria such asE. coli that are frequently a...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research