Saudi Arabian expatriate worker fitness-screening programme: a review of 14 years of data

Expatriate workers must be medically examined in their country of origin at accredited centres prior to their arrival in any Gulf Cooperation Council [GCC] country and are reexamined when they enter the country. This review investigated the epidemiological profile of registered expatriate workers in Saudi Arabia who were found medically unfit to work. A descriptive analysis was performed on 4 272 480 records of a Ministry of Health database from 1997 to 2010. The greatest proportion of workers was from Indonesia [34.3%]. The total proportion of unfit expatriate workers was low [0.71%]. The highest rate of unfitness was among workers from Ethiopia [4.06%], followed by Somalia [2.41%]. Hepatitis B infection was the most common cause [57.5%], followed by noncommunicable diseases [21.2%] and hepatitis C infection [17.4%]. This review suggests that the total number of workers registered in the Saudi Ministry of Health was underestimated, and the rate of unfit workers was lower than for other GCC countries, suggesting that standards and quality assurance in Saudi laboratories require revision

Highlights and conclusions from the technical consultative meeting on novel coronavirus infection, Cairo,Egypt, 14-16 January 2013

The emergence of a novel strain of coronavirus in the Arabian Peninsula raised a global health concern in 2012, partly because the majority of human infections were fatal and partly due to its presumed animal origin. An urgent meeting of scientific and public health experts was convened by WHO in January 2013 in view of the limited knowledge available on the epidemiological and natural history of infection with this novel virus. The meeting reviewed current evidence and identified critical knowledge gaps to improve better understanding of the public health risk associated with the virus so as to improve preparedness and to safeguard and protect global health

Emerging respiratory and novel coronavirus 2012 infections and mass gatherings

Mass gatherings are attended by an increasingly global audience and thus raise the concern of possible acute public health risks not normally encountered by the host population. The potential acute risks to individual and population health include communicable diseases. The communicable disease risks include emerging and re-emerging diseases in host and visiting populations. In this review, we provide an overview of the literature on respiratory infections at mass gatherings, then describe the impact of novel coronavirus 2012 [nCoV], an emerging respiratory disease virus, on the preparations for mass gathering. Although, nCoV emerged prior to the 2012 Hajj pilgrimage season, Muslims completed their religious duty without acquiring infections by nCoV. Clearly, the global nature of mass gatherings and their potential risks to international health make it imperative that research on such events and guidelines produced for their management are relevant to diverse contexts and are a collaborative effort between global experts

Saudi Arabia and the emergence of a novel coronavirus

The novel coronavirus disease outbreak in Saudi Arabia in 2012 predominately affected males and those living in urban areas. Since September and October 2012, when the first 2 cases were published, a total of 15 confirmed cases have been reported. All but 2 have been linked to countries of the Arabian peninsula; Saudi Arabian nationals accounted for a majority, 8 in all, and only 1 case was female. Seven patients had severe pneumonia; 2 survived-1 with mild disease and 1 with significant underlying illness. Although transmission of the virus to health-care workers was suspected in Jordan's April 2012 outbreak, similar clusters have not been found in Saudi Arabia's hospitals, nor have additional cases been identified through retrospective tracing of exposed health-care workers. Two family clusters have been identified, 1 in Riyadh and 1 in Manchester, England. A second Riyadh family cluster is being investigated

Seventh TEPHINET Global Scientific Conference in Amman, Jordan, November 2012

The Jordanian Ministry of Health in collaboration with the Eastern Mediterranean Public Health Network [EMPHNET] hosted the Seventh Global Scientific Conference of the Training Programs in Epidemiology and Public Health Interventions Network [TEPHINET] in Jordan in November 2012. This was the first time this Conference was held in the Eastern Mediterranean region. The Conference theme was [communicable and noncommunicable diseases: public health challenges and successes]. Over 400 participants including field epidemiology training program residents, graduates and public health officials from 66 countries attended the Conference as well as 187 people from 57 countries who attended the conference sessions on line. The programme included 121 oral and 130 poster presentations in addition to 5 pre-conference workshops and 9 roundtable discussions. All sessions were recorded and virtually broadcasted and made available on line. The Conference succeeded in creating opportunities for dialogue between residents and graduates of field epidemiology training programmes and public health stakeholders across the region and the globe

Influenza and respiratory syncytial virus infections in British Hajj pilgrims.

Viral respiratory infections including influenza and respiratory syncytial virus (RSV) have been reported during the Hajj among international pilgrims. To help establish the burden of these infections at the Hajj, we set up a study to confirm these diagnoses in symptomatic British pilgrims who attended the 2005 Hajj. UK pilgrims with symptoms of upper respiratory tract infection (URTI) were invited to participate; after taking medical history, nasal swabs were collected for point-of-care testing (PoCT) of influenza and for subsequent PCR analysis for influenza and RSV. Of the 205 patients recruited, 37 (18%) were positive for either influenza or RSV. Influenza A (H3) accounted for 54% (20/37) of the virus-positive samples, followed by RSV 24% (9/37), influenza B 19% (7/37), and influenza A (H1) 3% (1/37). Of the influenza-positive cases, 29% (8/28) had recently had a flu immunisation. Influenza was more common in those who gave a history of contact with a pilgrim with a respiratory illness than those who did not (17 versus 9%). The overall rate of RSV was 4% (9/202). This study confirms that influenza and RSV cause acute respiratory infections in British Hajj pilgrims. Continuing surveillance and a programme of interventions to contain the spread of infection are needed at the Hajj, particularly when the world is preparing for an influenza pandemic.

Infective endocarditis at a tertiary care centre in Saudi Arabia: review of 47 cases over 10 years

To describe the pattern of infective endocarditis in a tertiary hospital in Riyadh, Saudi Arabia, a retrospective review was made of all cases admitted between 1993 and 2003. Of 47 patients, a native valve was involved in 37 [78.7%] and a prosthetic valve in 10 [21.3%]. Predisposing cardiac conditions were present in 27 patients: rheumatic and congenital heart disease were the most common. Blood cultures were positive in 76.4% of patients: the most commonly isolated organisms were Staphylococcus spp. in 20 patients [12 Sta. aureus and 8 coagulase-negative staphylococci] and Enterococcus spp. [6 patients]. The complication rate was 78.7% and hospital mortality rate was 8.5%

In vitro activity of quinolones against S. pneumoniae, H. influenzae and M. catarrhalis in Saudi Arabia

Susceptibility of 88 clinical Streptococcus pneumoniae isolates, 116 Haemophilus influenzae isolates and 80 Moraxella catarrhalis isolates to 6 fluoroquinolones--ciprofloxacin, ofloxacin, levofloxacin, trovafloxacin, grepafloxacin and gemifloxacin--were determined. Isolates were from patients with invasive disease at 4 hospitals in Saudi Arabia between 1996 and 1998. S. pneumoniae isolates were fully susceptible to trovafloxacin, grepafloxacin and gemifloxacin; susceptibility to ofloxacin and levofloxacin was 97.7% and 98.9% respectively. H. influenzae isolates were susceptible to all agents, except for trovafloxacin [99.1%]. M. catarrhalis strains were fully sensitive to all agents except ofloxacin [97.5%]. No isolates were resistant to gemifloxacin or grepafloxacin

SARS: the new challenge to international health and travel medicine

Severe acute respiratory syndrome [SARS], the first severe new infectious disease of this millennium, caused widespread public disruption. By July 2003, 8427 probable SARS cases had been reported from 29 countries with a case fatality rate of 9.6%. The new febrile respiratory illness spread around the world along the routes of international air travel, with outbreaks concentrated in transportation hubs or densely populated areas. The etiologic agent was identified as a novel coronavirus, SARS-CoV. The disease is transmissible person-to-person through direct contact, large droplet contact and indirect contact from fomites and unwashed h and s. Saudi Arabia successfully prevented the entry of the disease by imposing travel restrictions, special entry requirements, screening procedures at airports, including temperature checks, and quarantine. Ongoing efforts are aimed at developing case investigation, case management and surveillance protocols for SARS