Incidence of Hajj-associated febrile cough episodes among French pilgrims: a prospective cohort study on the influence of statin use and risk factors

• Published in: Clinical microbiology and infection Vol. 15; no. 4; pp. 335 - 340
• Main Authors: Gautret, P., Yong, W., Soula, G., Gaudart, J., Delmont, J., Dia, A., Parola, P., Brouqui, P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier Ltd 01.04.2009; Blackwell Publishing Ltd; Wiley-Blackwell; European Society of Clinical Infectious Diseases. Published by Elsevier Ltd
• Subjects: Acute respiratory infection; Adult; Aged; Anticholesteremic Agents - therapeutic use; Biological and medical sciences; Cohort Studies; Female; France - epidemiology; Hajj; Humans; Incidence; Infectious diseases; La Mecca; Male; Medical sciences; Middle Aged; pilgrim; Pneumology; Prospective Studies; Respiratory system : syndromes and miscellaneous diseases; Respiratory Tract Infections - drug therapy; Respiratory Tract Infections - epidemiology; Risk Factors; Saudi Arabia - epidemiology; Socioeconomic Factors; Statin; Surveys and Questionnaires; Travel; Treatment Outcome; Young Adult; France; Europe; Saudi Arabia; Acute respiratory infection; La Mecca; Hajj; pilgrim; Statin; Acute; Statin derivative; Epidemiology; Fever; Cough; Incidence; Infection; Respiratory tract; Cohort study; Risk factor; Antilipemic agent
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1111/j.1469-0691.2009.02816.x

A prospective epidemiological study was conducted to evaluate the incidence of febrile cough episodes among adult Muslims travelling from Marseille to Saudi Arabia during the Hajj pilgrimage and to assess if use of statin had an influence on this incidence. In total, 580 individuals were presented with a questionnaire. A significant proportion of individuals had chronic medical disorders, e.g. diabetes mellitus (132, 22.8%) and hypertension (147, 25.3%). Pilgrims had a low level of education and a low employment rate. Sixty (10.3%) were treated with statins for hypercholesterolemia. Four hundred and fourty-seven pilgrims were presented a questionnaire on returning home. A total of 74 travellers (16.6%) experienced fever during their stay in Saudi Arabia (67 attended a doctor) and 271 (60.6%) had cough (259 attended a doctor); 70 travellers with cough were febrile (25.9%). Seventy per cent of the travellers who suffered cough episodes developed their first symptoms within 3 days, suggesting a human to human transmission of the responsible pathogen, with short incubation time as evidenced by a bimodal distribution of cough in two peaks at a 24 h interval. None of demographical and socioeconomic characteristics, underlying diseases or vaccination against influenza significantly affected the occurrence of cough. Diabetes correlated with an increased risk of febrile cough (OR = 2.02 (1.05–3.89)) as well as unemployment (OR = 2.22 (0.91–5.53)). Use of statins had no significant influence on the occurrence of cough and/or fever during the pilgrimage. This result suggests that while treatment with a statin has been demonstrated to reduce the mortality from severe sepsis associated with respiratory tract infections, it probably does not play a role in the outcome of regular febrile cough episodes as observed in the cohort studied here.