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Travel Med Infect Dis. 2014 Sep-Oct;12(5):481-4. doi: 10.1016/j.tmaid.2014.04.003. Epub 2014 Apr 21.

Occurrence of Tropheryma whipplei during diarrhea in Hajj pilgrims: a PCR analysis of paired rectal swabs.

Author information

1
Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 bd Jean Moulin, 13005 Marseille, France. Electronic address: philippe.gautret@club-internet.fr.
2
Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 bd Jean Moulin, 13005 Marseille, France.
3
Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 bd Jean Moulin, 13005 Marseille, France.
4
Public Health Directorate, Saudi Ministry of Health, WHO Collaborating Center for Mass Gathering Medicine, Riyadh, Kingdom of Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.

Abstract

BACKGROUND:

Tropheryma whipplei was recently associated with gastroenteritis in children. We hypothesize that T. whipplei may be a contributing microbe in traveller's diarrhea.

METHOD:

The presence of T. whipplei was investigated by PCR on rectal swab samples of Hajj pilgrims before and after travelling to the Kingdom of Saudi Arabia (KSA). Additionally a rectal swab was performed at the time of diarrhea for some pilgrims.

RESULTS:

A total of 129 pilgrims underwent rectal swab samples before departure and on return. All pilgrims were negative for T. whipplei before travel. One pilgrim (0.8%) was positive on return but did not reported diarrhea. A total of 30 pilgrims (23.3%) experienced diarrhea during the stay in the KSA. Nine pilgrims with diarrhea underwent the additional rectal swab during their diarrhea episode, two of them were positive for T. whipplei.

CONCLUSIONS:

This work suggests that T. whipplei may be associated with adult traveller's diarrhea, by finding T. whipplei DNA individuals negative before and after the episode of diarrhea. Further study addressing this issue in larger cohorts of Hajj pilgrims with systematic sampling at the time of diarrheal episode may help to understand the potential role of T. whipplei in traveller's diarrhea.

KEYWORDS:

Diarrhea; Hajj; Traveller; Tropheryma whipplei

PMID:
24797353
DOI:
10.1016/j.tmaid.2014.04.003
[Indexed for MEDLINE]
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