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Pharyngeal carriage rate of Neisseria meningitidis before and after the Hajj pilgrimage, in Zahedan (southeastern Iran), 2012.

BACKGROUND/AIM
The annual Hajj pilgrimage to Mecca, which attracts more than 3 million Muslim pilgrims from around the world, has played a role in the global spread of meningococcal infection. We aimed to compare pharyngeal carriage of Neisseria meningitidis in Hajj pilgrims before departure and after returning to Iran, Zahedan.


MATERIALS AND METHODS
This prospective and cross-sectional study was conducted among Hajj pilgrims in Zahedan (southeast Iran) in 2012. We studied all pilgrims who agreed to participate in this study and who met the inclusion criteria. Sampling was done by swabbing the posterior pharyngeal wall through the mouth with direct plating or keeping transport time to below 5 h. Specific culture, oxidase test, and carbohydrates tests were done on the positive samples.


RESULTS
Among 422 pilgrims (42.2% male, 57.8% female; with age range 21-95 years), 6 (1.4%) were positive for N. meningitidis after the Hajj pilgrimage. Nobody was positive before departure. During the Hajj 58.5% of the participants received antibiotics.


CONCLUSION
According to the results of our study, the prevalence of pharyngeal carriage of N. meningitidis in pilgrims after returning to Zahedan was low (1.4%). The quadrivalent meningococcal vaccine and antibiotic therapy were effective in reducing the number of carriers among pilgrims after travel.