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Protective practices and respiratory illness among US travelers to the 2009 Hajj.
J Travel Med. 2012 May-Jun; 19(3):163-8.JT

Abstract

BACKGROUND

All mass gatherings can place travelers at risk for infectious diseases, but the size and density of the annual Hajj pilgrimage to the Kingdom of Saudi Arabia (KSA) present important public health and infection control challenges. This survey of protective practices and respiratory illness among US travelers to the 2009 Hajj was designed to evaluate whether recommended behavioral interventions (hand hygiene, wearing a face mask, cough etiquette, social distancing, and contact avoidance) were effective at mitigating illness among travelers during the 2009 Hajj.

METHODS

US residents from Minnesota and Michigan completed anonymous surveys prior to and following travel to the 2009 Hajj. Surveys assessed demographics, knowledge, attitudes, and practices (KAP) related to influenza A(H1N1), vaccination, health-seeking behaviors, sources of health information, protective behaviors during the Hajj, and respiratory illness during and immediately after the Hajj.

RESULTS

Pre- and post-travel surveys were completed by 186 participants. Respiratory illness was reported by 76 (41.3%) respondents; 144 (77.4%) reported engaging in recommended protective behaviors during the Hajj. Reduced risk of respiratory illness was associated with practicing social distancing, hand hygiene, and contact avoidance. Pilgrims who reported practicing more recommended protective measures during the Hajj reported either less occurrence or shorter duration of respiratory illness. Noticing influenza A(H1N1) health messages during the Hajj was associated with more protective measures and with shorter duration of respiratory illness.

CONCLUSIONS

Recommended protective behaviors were associated with less respiratory illness among US travelers to the 2009 Hajj. Influenza A(H1N1) communication and education in KSA during the Hajj may also have been an effective component of efforts to mitigate illness. Evaluations of communication efforts and preventive measures are important in developing evidence-based public health plans to prevent and mitigate disease outbreaks at the Hajj and other mass gatherings.

Authors+Show Affiliations

Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA. vbalaban@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22530823

Citation

Balaban, Victor, et al. "Protective Practices and Respiratory Illness Among US Travelers to the 2009 Hajj." Journal of Travel Medicine, vol. 19, no. 3, 2012, pp. 163-8.
Balaban V, Stauffer WM, Hammad A, et al. Protective practices and respiratory illness among US travelers to the 2009 Hajj. J Travel Med. 2012;19(3):163-8.
Balaban, V., Stauffer, W. M., Hammad, A., Afgarshe, M., Abd-Alla, M., Ahmed, Q., Memish, Z. A., Saba, J., Harton, E., Palumbo, G., & Marano, N. (2012). Protective practices and respiratory illness among US travelers to the 2009 Hajj. Journal of Travel Medicine, 19(3), 163-8. https://doi.org/10.1111/j.1708-8305.2012.00602.x
Balaban V, et al. Protective Practices and Respiratory Illness Among US Travelers to the 2009 Hajj. J Travel Med. 2012;19(3):163-8. PubMed PMID: 22530823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Protective practices and respiratory illness among US travelers to the 2009 Hajj. AU - Balaban,Victor, AU - Stauffer,William M, AU - Hammad,Adnan, AU - Afgarshe,Mohamud, AU - Abd-Alla,Mohamed, AU - Ahmed,Qanta, AU - Memish,Ziad A, AU - Saba,Janan, AU - Harton,Elizabeth, AU - Palumbo,Gabriel, AU - Marano,Nina, PY - 2012/4/26/entrez PY - 2012/4/26/pubmed PY - 2012/10/2/medline SP - 163 EP - 8 JF - Journal of travel medicine JO - J Travel Med VL - 19 IS - 3 N2 - BACKGROUND: All mass gatherings can place travelers at risk for infectious diseases, but the size and density of the annual Hajj pilgrimage to the Kingdom of Saudi Arabia (KSA) present important public health and infection control challenges. This survey of protective practices and respiratory illness among US travelers to the 2009 Hajj was designed to evaluate whether recommended behavioral interventions (hand hygiene, wearing a face mask, cough etiquette, social distancing, and contact avoidance) were effective at mitigating illness among travelers during the 2009 Hajj. METHODS: US residents from Minnesota and Michigan completed anonymous surveys prior to and following travel to the 2009 Hajj. Surveys assessed demographics, knowledge, attitudes, and practices (KAP) related to influenza A(H1N1), vaccination, health-seeking behaviors, sources of health information, protective behaviors during the Hajj, and respiratory illness during and immediately after the Hajj. RESULTS: Pre- and post-travel surveys were completed by 186 participants. Respiratory illness was reported by 76 (41.3%) respondents; 144 (77.4%) reported engaging in recommended protective behaviors during the Hajj. Reduced risk of respiratory illness was associated with practicing social distancing, hand hygiene, and contact avoidance. Pilgrims who reported practicing more recommended protective measures during the Hajj reported either less occurrence or shorter duration of respiratory illness. Noticing influenza A(H1N1) health messages during the Hajj was associated with more protective measures and with shorter duration of respiratory illness. CONCLUSIONS: Recommended protective behaviors were associated with less respiratory illness among US travelers to the 2009 Hajj. Influenza A(H1N1) communication and education in KSA during the Hajj may also have been an effective component of efforts to mitigate illness. Evaluations of communication efforts and preventive measures are important in developing evidence-based public health plans to prevent and mitigate disease outbreaks at the Hajj and other mass gatherings. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/22530823/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/j.1708-8305.2012.00602.x DB - PRIME DP - Unbound Medicine ER -