Journal of travel medicine
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Moslems from all over the world go to Mecca and Medina in Saudi Arabia for two types of pilgrimage: the major pilgrimage (hajj) and the minor (umra). An international outbreak of meningococcal disease with serogroup W-135 occurred in association with hajj pilgrimage in the years 2000 and 2001, and it has been shown that pharyngeal carriage of a single W-135 strain was high in returning hajj pilgrims. We investigated the meningococcal carriage in umra pilgrims to determine the extent of circulation of this strain, during the minor pilgrimage. ⋯ Meningococcal carriage during the umra pilgrimage was significantly lower compared with the hajj pilgrimage in the year 2001. No carriage of N. meningitidis W-135 was documented in umra pilgrims, whereas this was the predominant serogroup in hajj pilgrims. Public health measures to reduce the potential introduction of N. meningitidis W-135 into the countries of origin of returning pilgrims need to be prioritized for the hajj pilgrimage.
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Comparative Study
Avoiding misdiagnosis of imported malaria: screening of emergency department samples with thrombocytopenia detects clinically unsuspected cases.
Misdiagnosis of imported malaria is not uncommon and even abnormal routine laboratory tests may not trigger malaria smears. However, blind screening of all thrombocytopenic samples might be a possible way to detect clinically unsuspected malaria cases in the accident and emergency department (AED). ⋯ The problem of clinically unsuspected malaria seems to be more common than generally expected and is dependent on the local incidence of malaria as well as clinical and laboratory expertise. The blind screening of all thrombocytopenic samples with <100,000/microL may be a cost-effective way to reduce the misdiagnosis of imported malaria.