Impact of pH1N1 influenza A infections on the Otolaryngology, Head and Neck Clinic during Hajj, 2009

OBJECTIVE: To examine the possible implications of the 2009 H1N1 influenza A (pandemic flu, pH1N1) on this religious gathering and provide a response plan for the Otolaryngology, Head and Neck (ENT) clinic during the Hajj pilgrimage.

METHODS: This study was conducted between November and December 2009. All patients presenting to the ENT clinic at Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia were recorded. Descriptive statistics were used to analyze the data.

RESULTS: A total of 3087 patients were included (mean age 35±7.8 years), of which, 2114 were males (68.5%), and 973 females (31.5%, male to female gender ratio=2.17:1). Among them, 1467 patients (47.5%) were Hajji and 1620 patients (52.5%) were non-Hajji. Saudi patients comprised 1602 (51.8%), while non-Saudi’s comprised 1485 (48.2%). Upper respiratory tract infections (URTI) including the diagnosis of pharyngitis, viral URTI, pH1N1, and tonsillitis represented (92%) of total diagnoses. Of these, only 77 suspected pH1N1 cases (2.5%) were observed in the ENT clinic. Management of 3045 patients (98.6%) included antimicrobials as part of their main therapy.

CONCLUSION: The pH1N1 cases presenting to our ENT Hajj clinic had a minimal impact on the clinic operation. The ENT Hajj Clinic helped alleviate pressure from the ER. Excessive use of antibiotic usage should be discouraged.