Acute febrile respiratory infection symptoms in Australian Hajjis at risk of exposure to Middle East respiratory syndrome coronavirus

Harunor Rashid, Osamah Barasheed and Robert Booy
Med J Aust 2013; 199 (7): . || doi: 10.5694/mja13.10984
Published online: 7 October 2013

To the Editor: Originating in Saudi Arabia in June 2012, the Middle East respiratory syndrome coronavirus (MERS-CoV), a virus similar to the severe acute respiratory syndrome (SARS) coronavirus, has reached nine countries and affected 130 people, of whom 58 (45%) have died.1 The threat of this epidemic to Australia is uncertain. During the SARS epidemic, Australia was the “lucky country” — it had just six probable SARS cases and no known fatalities.2 However, about 4500 pilgrims from Australia travel to Mecca, Saudi Arabia, for Hajj each year. About 50–150 people share a large tent (Box) and sleep in close proximity to each other for 5 days, which increases the risk of viral transmission.

  • 1 National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children’s Hospital at Westmead, Sydney, NSW.
  • 2 Sydney Emerging Infections and Biosecurity Institute, Sydney, NSW.

Competing interests:

Robert Booy has received funding from Baxter, CSL Limited, GlaxoSmithKline, Merck, Novartis, Pfizer, Roche and Sanofi Pasteur for the conduct of sponsored research, travel to present at conferences and consultancy work. All this funding is directed to research accounts at the Children’s Hospital at Westmead.

  • 1. World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV) — update. (accessed Sep 2013).
  • 2. Jauncey ME, Armstrong PK, Morgan EL, McAnulty JM. Australia was indeed the “lucky country” in the recent worldwide SARS epidemic [letter]. Med J Aust 2004; 181: 229-230. <MJA full text>
  • 3. Deris ZZ, Hasan H, Sulaiman SA, et al. The prevalence of acute respiratory symptoms and role of protective measures among Malaysian hajj pilgrims. J Travel Med 2010; 17: 82-88.
  • 4. Gautret P, Charrel R, Belhouchat K, et al. Lack of nasal carriage of novel corona virus (HCoV-EMC) in French Hajj pilgrims returning from the Hajj 2012, despite a high rate of respiratory symptoms. Clin Microbiol Infect 2013; 19: E315-E317.
  • 5. Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2011; (7): CD006207.


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