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High risk of Mycobacterium tuberculosis infection during the Hajj pilgrimage

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Summary Introduction 

Annually more than 2 million pilgrims from all over the world attend the Hajj in Saudi Arabia. Overcrowding during this pilgrimage leads to a high risk of transmission of airborne infectious diseases. Tuberculosis (TB) is common among hospitalized pilgrims, but the overall risk of acquiring Mycobacterium tuberculosis infection during this pilgrimage is not known. We conducted a prospective study to assess the risk of M. tuberculosis infection among Hajj pilgrims. Methods 

We measured the immune response to TB antigens using a whole-blood assay (QuantiFERON TB assay) prior to departure and 3 months after return from the Hajj pilgrimage. Results 

Of 357 paired assays, 149 pilgrims were negative prior to the Hajj and 15 (10%) of these had a significant rise in immune response to TB antigens. Conclusions 

Pilgrims may be at high risk of acquiring M. tuberculosis infection during the Hajj. This has significant public health implications for TB control in countries with large Muslim populations.
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Keywords: Hajj pilgrims; QuantiFERON TB assay; cell-mediated gamma-interferon response to tuberculosis antigens; latent tuberculosis infection

Document Type: Research Article

Affiliations: 1: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 2: Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore

Publication date: April 1, 2005

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