Survey teams worked with as many arriving groups as possible, interviewing and swabbing as many pilgrims as possible in each group after they passed through immigration. In each survey, pilgrims were asked for their consent to participate. A nasopharyngeal and throat swab were obtained after the interview. The questionnaire in the arrival
survey included questions about pilgrims’ demographics (age, gender, occupation, and nationality), medical history (chronic disease and smoking), vaccination history (including Histone Methyltransferase inhibitor separate questions about vaccination against pandemic influenza A(H1N1) and against seasonal influenza), knowledge about H1N1 influenza (symptoms, transmission, and ways to avoid), and compliance with wearing face masks. The questionnaire used in the departure survey included only questions about age, gender, and pandemic influenza A(H1N1) vaccination history. Respiratory specimens were placed in viral transport media (VTM) at the point of collection and transported to Jeddah Regional Laboratory where they were stored at −80°C before testing. Specimens selected for analysis were thawed and subjected to total nucleic acid extraction using Corbett X-tractor Gene (Qiagen, Hilden, Germany) and RNA DNA CorProtocol 25101 (Qiagen). Extracts were then tested using the xTAG Respiratory Viral Panel (RVP) FAST assay (Luminex Molecular Diagnostics Inc.,
Toronto, Canada) per manufacturer’s instructions. The xTAG RVP FAST is a qualitative Linsitinib in vivo multiplex amplification assay allowing the simultaneous detection of multiple viral nucleic acid targets. In addition to influenza A and B, this test can detect respiratory syncytial virus, parainfluenza virus 1, 2, 3, and 4; rhino-enterovirus, adenovirus, and minor respiratory viruses: coronaviruses, metapneumovirus, and bocavirus. Amplification of specific matrix target was used to detect influenza A and B. Seasonal influenza H1 and H3 subtypes were detected after amplification with hemagglutinin-specific primers and probes. Specimens positive for influenza A but negative for seasonal H1 and H3 were subjected learn more to additional PCR amplification to detect pandemic H1 and avian H5 (Qiagen
Artus Influenza/H1 RG/LC for H1N1 and TIB MOLBIOL, LightMix kit, Berlin, Germany for H5N1). Demographics, medical history, vaccination history, knowledge of H1N1 influenza, and compliance with infection control practices among arriving pilgrims were analyzed as frequency distributions. Differences in the prevalence of respiratory viruses between the arriving and departing pilgrims were examined using chi-square test or Fisher exact, as appropriate. Differences in the prevalence of respiratory viruses between potential confounding groups such as age groups and getting pandemic influenza A(H1N1) vaccine were examined using chi-square test or Fisher exact, as appropriate. All p values were two-tailed. p Value <0.05 was considered as significant. SPSS (release 17.